Debski Marcin, Stepniewski Piotr, Wróbel Michał
Warszawski Uniwersytet Medyczny, Katedra i Klinika Chorób Wewnetrznych i Endokrynologii.
Pol Merkur Lekarski. 2013 Jan;34(199):45-8.
Fever of unknown origin is often a diagnostic challenge. Here we present a case of 55-year-old woman with a history of a few months fever, progressing weakness and salmon-coloured, macular skin rash. The differential diagnosis included neoplasmatic conditions, infections and connective tissue disorders. Finally adult onset Still's disease was suspected. Glucocorticosteroid treatment was induced. During the therapy a central nervous system infection occurred, which was fatal for the patient. The presented clinical case shows that among many causes of fever of unknown origin, adult onset Still's disease should be taken into account.
不明原因发热常常是一个诊断难题。在此,我们报告一例55岁女性病例,该患者有持续数月的发热、进行性虚弱以及鲑鱼色斑丘疹病史。鉴别诊断包括肿瘤性疾病、感染和结缔组织病。最终怀疑为成人斯蒂尔病。开始使用糖皮质激素治疗。在治疗期间发生了中枢神经系统感染,这对患者是致命的。该临床病例表明,在不明原因发热的诸多病因中,成人斯蒂尔病应予以考虑。