Vaishya Raju, Agarwal Amit Kumar, Vijay Vipul
Orthopaedics, Indraprastha Apollo Hospitals.
Cureus. 2016 Feb 14;8(2):e496. doi: 10.7759/cureus.496.
Pyrexia of unknown origin (PUO) in a patient with acquired immunodeficiency syndrome (AIDS) is a challenging clinical problem despite recent advances in the diagnostic modalities. The diagnosis of the cause of fever is especially difficult in the postoperative period as the focus remains on the operative site. We present an unusual cause of PUO in a patient with advanced HIV disease during an immediate postoperative period following total hip arthroplasty (THA) for osteoarthritis (OA) of the left hip. The fever started on the eighth postoperative day, and after an extensive workup to rule out infection it was found that the patient was allergic to sulfa drugs. The fever subsided after discontinuation of trimethoprim/sulfamethoxazole. Fever in an immunocompromised patient should not be attributed only to infection. A high index of suspicion along with careful history making is required to diagnose drug fever. An early diagnosis of drug fever can reduce hospital stay and the costs of investigations and treatment.
尽管诊断方式最近有所进展，但获得性免疫缺陷综合征（AIDS）患者的不明原因发热（PUO）仍是一个具有挑战性的临床问题。在术后阶段，发热原因的诊断尤其困难，因为关注点仍在手术部位。我们报告了一例晚期HIV疾病患者在因左髋骨关节炎（OA）行全髋关节置换术（THA）后的术后即刻出现不明原因发热的不寻常病因。发热始于术后第八天，在进行广泛检查以排除感染后，发现患者对磺胺类药物过敏。停用甲氧苄啶/磺胺甲恶唑后发热消退。免疫功能低下患者的发热不应仅归因于感染。诊断药物热需要高度怀疑并仔细询问病史。早期诊断药物热可缩短住院时间并降低检查和治疗费用。
