Cunha Burke A, Apostolopoulou Anna, Gian John
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA; State University of New York, School of Medicine, Stony Brook, NY, USA.
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA; State University of New York, School of Medicine, Stony Brook, NY, USA.
Heart Lung. 2017 May-Jun;46(3):205-207. doi: 10.1016/j.hrtlng.2017.01.009. Epub 2017 Mar 1.
Fever of unknown origin (FUO) is defined as prolonged fever of >101 °F for at least 3 weeks that remains undiagnosed after a focused inpatient or outpatient workup. One of the most elusive FUO diagnoses is miliary tuberculosis (TB) which typically has few/no localizing signs/symptoms. Since the introduction of intravesicular Bacille Calmette-Guerin (BCG) treatment for bladder carcinoma, miliary BCG has only rarely been reported as a cause of FUO. As with miliary TB, there are few/no clues to suspect miliary BCG. We present an interesting case of FUO due to miliary BCG without any localizing signs, i.e., no lung, liver or prostate involvement. The only clues to the diagnosis of this FUO due to disseminated BCG were morning temperature spikes and otherwise unexplained highly elevated ferritin levels.
不明原因发热（FUO）定义为体温持续高于101°F至少3周，经过针对性的住院或门诊检查后仍未确诊。最难诊断的FUO之一是粟粒性肺结核（TB），其通常很少有/没有定位体征/症状。自膀胱内注射卡介苗（BCG）用于膀胱癌治疗以来，粟粒性BCG作为FUO病因的报道极为罕见。与粟粒性肺结核一样，几乎没有/没有线索怀疑粟粒性BCG。我们报告一例有趣的由粟粒性BCG引起的FUO病例，无任何定位体征，即无肺部、肝脏或前列腺受累。诊断该播散性BCG所致FUO的唯一线索是早晨体温峰值以及其他无法解释的铁蛋白水平高度升高。
