Type 2 Lepra Reaction as a Cause of Pyrexia of Unknown Origin
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Leading causes of classic pyrexia of unknown origin
Infection Neoplasms Tuberculosis Lymphoma Occult bacterial abscess Renal carcinoma Endocarditis Atrial myxoma Brucellosis Infection Connective tissue Tuberculosis Still's disease Occult bacterial abscess Variants of rheumatoid arthritis Endocarditis Systemic lupus erythematosus Brucellosis Temporal arteritis Polymyalgia rheumatica Infection Other (geographical) Tuberculosis Familial Mediterranean fever Occult bacterial abscess Kikuchi-Fujimoto disease Endocarditis Melioidosis Brucellosis Pyrexia of unknown origin
defined as temperature >38.3[degrees]C for >3 weeks, with >2 outpatient visits or 3 days' inpatient investigations.
Objective: To determine the frequency of underlying causes of pyrexia of unknown origin
on bone marrow examination.
Such manifestations of HLH can be confused with sepsis, pyrexia of unknown origin
, hepatitis or malignancy (14).
This grandfather of infection imaging continues to play a role in the following: pyrexia of unknown origin
(PUO), immunocompromised patients with fever, suspected osteomyelitis in the spine, chronic osteomyelitis, and certain lung infections.
From literature search, most of the studies on leptospirosis were conducted among febrile patient or pyrexia of unknown origin
(PUO) patient with other associated sign and symptoms such as jaundice; and patient with obvious foci of infection such as dengue and malaria were excluded from the study.
Box 1 Common signs and symptoms of tuberculosis (Davies 2003) The following are signs and symptoms that would be suggestive of an active TB infection: * Cough for more than three weeks, with or without sputum production * Loss of appetite * Weight loss * Night sweats * Lethargy * Lymphadenopathy * Pyrexia of unknown origin
* Haemoptysis * Other focal signs and symptoms dependant on the site of disease It is important to note that not all patients will present with the above symptoms.
Between January 2005 and December 2008, a total of 5340 patients attending Out Patient Departments (OPDs) and wards of Paediatric and Medicine departments of Ispat General Hospital, Rourkela, provisionally diagnosed as having enteric fever or pyrexia of unknown origin
(PUO) were included in this study.
(1) Uraemic tumoral calcinosis may induce a systemic inflammatory response presenting as a pyrexia of unknown origin
. (7) The extensor surfaces of joints are usually involved, with the hip, shoulder and elbow (in order of decreasing frequency) commonly affected.
Coverage includes an introduction to medical diagnosis; critical illness; cardiovascular, respiratory, gastrointestinal, and neurological presentations; miscellaneous presentations such as frequency of micturition, hematuria, joint pain or swelling, back pain, pyrexia of unknown origin
, anemia, and skin rash; and biochemical abnormalities.