Shotty cervical lymphadenopathy3/8/2023 ![]() ![]() When the aetiological diagnosis eludes the clinician, patients with PUO are often diagnosed as having AOSD. The patient fulfilled the Yamaguchi criteria ( Table 3) for AOSD, with a good clinical and laboratory response to prednisone 80 mg once daily. A computed tomography (CT) scan and Doppler test excluded retropharyngeal abscess and Lemierre's syndrome. A fourth-generation HIV enzyme-linked immunosorbent assay (ELISA) was negative. A slightly enlarged left adenoid was noted that exuded a small volume of pus on biopsy, while histology revealed lymphoid hyperplasia. On admission to tertiary care, an aetiological differential diagnosis for the pyrexia of unknown origin (PUO) ( Table 2) included retropharyngeal abscess, Lemierre's syndrome, HIV seroconversion, and adult-onset Still's disease (AOSD). The relevant laboratory investigations are shown in Table 1. ![]() Shotty cervical lymphadenopathy was noted. He did not respond to ceftriaxone and had a continual significant fever daily. Ten days into his illness he was admitted to a regional hospital with an ongoing painful throat, generalised myalgia, fever (38.5☌) and a transient, recurring, salmon-pink rash on his hands and trunk. He did not respond to ceftriaxone and had a continual significant fever daily.Ī 20-year-old man presented with a severely sore throat and myalgia, which were unresponsive to antibiotics. He was admitted to a regional hospital with an ongoing painful throat, generalised myalgia, fever and a transient, recurring, salmon-pink rash on his hands and trunk. IIIFCP (SA), Cert ID (SA) Phys Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South AfricaĪ 20-year-old man presented with a severely sore throat and myalgia, which were unresponsive to antibiotics. IIPhD, FRCP Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa If you think you may have a medical emergency, call your physician or 911 immediately.IFCP (SA) Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa ![]() By using this Site you agree to the following Terms and Conditions. We offer this Site AS IS and without any warranties. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. ![]() MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. ![]()
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