Unusual Cause of Prolonged Fever of Unknown Origin

Mathews, Dionna; McMahon, Pamela M.; Bolton, Michael

doi:10.1177/0009922817693303

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…Fixed lymphadenopathy, especially if supraclavicular, with hepatosplenomegaly may indicate malignancy, as well as EBV infection; on the other hand, when it is isolated, cervical, unilateral, and painful, it is more often an expression of contiguous infectious processes and Lemierre's syndrome should be considered. More rarely, lymphadenomegaly is a finding of KD or, exceptionally, Kikuchi syndrome-Fujimoto [53].…”

Section: Physical Examinationmentioning

confidence: 99%

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Trapani,

Fiordelisi,

Stinco

et al. 2023

Children

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Fever of unknown origin (FUO) can be caused by four etiological categories of diseases. The most common cause of FUO in children is represented by infections, followed by inflammatory conditions and neoplastic causes; a decreasing quote remains still without diagnosis. Despite the fact that several diagnostic and therapeutic approaches have been proposed since the first definition of FUO, none of them has been fully validated in pediatric populations. A focused review of the patient’s history and a thorough physical examination may offer helpful hints in suggesting a likely diagnosis. The diagnostic algorithm should proceed sequentially, and invasive testing should be performed only in select cases, possibly targeted by a diagnostic suspect. Pioneering serum biomarkers have been developed and validated; however, they are still far from becoming part of routine clinical practice. Novel noninvasive imaging techniques have shown promising diagnostic accuracy; however, their positioning in the diagnostic algorithm of pediatric FUO is still not clear. This narrative review aims to provide a synopsis of the existent literature on FUO in children, with its major causes and possible diagnostic workup, to help the clinician tackle the complex spectrum of pediatric FUO in everyday clinical practice.

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Section: Physical Examinationmentioning

confidence: 99%

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Trapani,

Fiordelisi,

Stinco

et al. 2023

Children

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show abstract

“…Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease (KFD), is a self-limiting inflammatory disease with nonneoplastic lymphadenectasis. It occurs more frequently in older children, with major clinical manifestations of cervical lymphadenopathy and long-term fever (1)(2)(3)(4). The laboratory findings could be leukopenia and/or neutropenia, sometimes accompanied by increased levels of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) in serum (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…It occurs more frequently in older children, with major clinical manifestations of cervical lymphadenopathy and long-term fever (1)(2)(3)(4). The laboratory findings could be leukopenia and/or neutropenia, sometimes accompanied by increased levels of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) in serum (1)(2)(3)(4)(5). As a disease with low incidence, KFD is easily misdiagnosed as other diseases, such as lymphoma, lymph node tuberculosis, infectious mononucleosis, and Kawasaki disease (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Histiocytic Necrotizing Lymphadenitis Mimicking Acute Appendicitis in a Child: A Case Report

Hua

Chen

et al. 2021

Front. Pediatr.

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Background: Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease (KFD), is a self-limiting inflammatory disease with low incidence and high misdiagnosis rate in children. Furthermore, cases where the clinical presentation resembles acute appendicitis are very rare.Case Presentation: A 14-year-old boy was misdiagnosed as acute appendicitis and received operative treatment at his early visit. He suffered from abdominal pain, vomiting, diarrhea, fever, and lymphadenitis at the ileocecal junction, which were found by B-ultrasonography examination and surgery. Lymphadenectomy, as well as appendectomy, was performed, and KFD was identified by pathological examination. The patient was transferred to our hospital for further therapy because of recurrent fever and abdominal pain after the appendectomy. His temperature became normal after methylprednisolone was administered, and no recurrence was observed till now during follow-up.Conclusions: Necrotizing lymphadenitis involving mesenteric lymph nodes may cause acute-appendicitis-like symptom; KFD should be a diagnostic consideration for mesenteric lymphadenitis.

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Unusual Cause of Prolonged Fever of Unknown Origin

Cited by 2 publications

References 13 publications

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Histiocytic Necrotizing Lymphadenitis Mimicking Acute Appendicitis in a Child: A Case Report

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