Practice Interactive case report

Fever of unknown origin: case outcome

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38950.395868.68 (Published 28 September 2006) Cite this as: BMJ 2006;333:691
  1. R Sivakumar, specialist registrar, general medicine (sivasiva51@hotmail.com)1,
  2. S Pavulari, senior house officer, general medicine1,
  3. S Ellis, consultant physician and rheumatologist1
  1. 1 Lister Hospital, Stevenage, Hertfordshire SG1 4AB
  1. Correspondence to: R Sivakumar

    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 …

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