BMJ  2006;333:541 (9 September), doi:10.1136/bmj.38950.394745.68

Practice

Interactive case report

Fever of unknown origin: case progression

¹ Lister Hospital, Stevenage, Hertfordshire SG1 4AB

The first 150 words of the full text of this article appear below.

Last week (2 September, p 484) we presented the case of a 19 year old student who had a swinging fever of unknown origin. The differential diagnoses after initial investigations include malignancy (particularly lymphoma), sarcoidosis, connective tissue disease, vasculitis, and infective causes including tuberculosis, fungal infection, endocarditis, and HIV. She had no relevant risk factors for HIV, but sexual histories can be initially unreliable, particularly if taken in the presence of relatives. Although the initial presentation was consistent with viral illnesses such as infectious mononucleosis, they were excluded on serological tests.

Fig 1 Patient's chest radiograph

 
Three weeks after admission she continued to have spiking temperatures of up to 40°C. She also described a simultaneous erythematous rash, which was not raised and was most pronounced on the dorsal aspect of her legs. She thought that the rash was similar to her previous rash but not as prominent. It was not evident . . . [Full text of this article]

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