BMJ  2006;333:691 (30 September), doi:10.1136/bmj.38950.395868.68

Practice

Interactive case report

Fever of unknown origin: case outcome

¹ Lister Hospital, Stevenage, Hertfordshire SG1 4AB

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

Four weeks ago we presented the case of a 19 year old student who presented with a spiking fever (2 September, p 484). Her condition deteriorated and she required intensive care. As she had no confirmed diagnosis her parents requested a second opinion (9 September, p 541). The parents were informed that her underlying disease had triggered a systemic inflammatory response affecting various organs with an uncertain prognosis. Although it is generally acknowledged that patients do not have an automatic right to a further opinion, doctors should always respect a patient's and relatives' wishes for a second opinion unless there are justifiable reasons for refusal—for example, if it may be harmful to the patient. Such requests should be handled sensitively and patients should be made to feel comfortable.

Our working diagnosis was of adult onset Still's disease. She was started on intravenous hydrocortisone, angiotensin converting enzyme inhibitors, and . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Fever of unknown origin: case progression

R Sivakumar, S Pavulari, and S Ellis
BMJ 2006 333: 541. [Extract] [Full Text] [PDF]

Fever of unknown origin: case presentation

R Sivakumar, S Pavulari, and S Ellis
BMJ 2006 333: 484. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Ellis, S (2006). Parents' view.. BMJ 333: 692-692 [Full text]  
• Mangin, D. (2006). Management of uncertainty.. BMJ 333: 693-693 [Full text]  
• Peile, E. (2006). Theory and practice of making difficult clinical decisions.. BMJ 333: 694-694 [Full text]  

Rapid Responses:

Read all Rapid Responses

Kawasaki Disease in adults

Niranjini Subramaniam, et al.
bmj.com, 6 Oct 2006 [Full text]