1/11. A case of fever following antiepileptic treatment.A 23-year-old female patient treated with 900 mg oxcarbazepine for complex partial seizures is presented. Good seizure control and slight fever were noted a few weeks after drug administration. Reduction of oxcarbazepine and replacement with valproate resulted in a transient normothermia. Because of fever reappearance, vigabatrin was added and valproate was gradually reduced. seizures reappeared, but the body temperature fell below 37 degrees C. Substitution of valproate for lamotrigine resulted in seizure control but abnormal body temperature (37- 37.6 degrees C) was noted again. Repeated hospital admission for clinical and laboratory investigation before any change of treatment revealed no other abnormal findings. The patient's abnormal temperature possibly reflects a derangement of high-level temperature control.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/11. A case of fever of unknown origin with severe stomatitis in renal transplant recipient resulting in graft loss.We present a case of fever of unknown origin and life-threatening stomatitis developed about 60 months after renal transplantation. He was 15 yr old at the transplantation. Bacterial, fungal, and viral infections were not evident. Fever and stomatitis were resistant to acyclovir and to any anti-bacterial or anti-fungal treatment. Graft biopsy revealed a small focus of acute vascular rejection, but the findings were not severe enough to be an etiology of the fever in this case. The administration of cyclosporine (CYA) was stopped 19 d before graftectomy, but the clinical picture was unchanged. Fever and stomatitis was resolved immediately after graftectomy and the discontinuation of immunosuppressants such as mizoribine (MZ) and prednisolone. Pathological changes of the graft included chronic transplant glomerulopathy, acute glomerulitis, and lymphocyte infiltration in peritubular capillaries. Thus we suppose that immunosuppressants were the cause of both fever and stomatitis in this case. We speculate that a fever in this case might be due to the immunosuppressant itself, i.e., CYA or MZ, or viral infection probably herpes-simplex virus infection. It is probably the immunosuppressive state per se that may cause the resistance of his muco-cutaneous lesion to anti-viral agent.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/11. A 72-year-old female with adult Still's disease.We treated a 72-year-old woman with adult Still's disease. The diagnosis was made on the basis of a prolonged, high grade, quotidian fever, polyarthritis, maculopapular skin rashes and exclusion of other possible diseases. A high serum ferritin value was a key factor both in making the diagnosis and in the follow-up. The patient responded to the administration of oral prednisolone at 30 mg/day, which was tapered to 10 mg/day, with no recurrence of symptoms. This disorder can be an important cause of prolonged fever in the elderly as well as in the younger population.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/11. Postoperative toxic shock syndrome following adrenalectomy: a case report.This report describes a fatal case of toxic shock syndrome following surgical procedure of adrenalectomy. Toxic shock syndrome is a severe multisystemic illness associated with staphylococcus aureus infection. The disease is usually associated with menstruation and tampon usage. However, it has recently been reported in the postoperative period following simple surgical procedures. The surgical wound does not usually appear infected. The syndrome is associated with specific strains of Staphylococci producing the toxic shock syndrome toxin 1 (TSST-1), that mainly contributes to the illness. The major clinical signs are: fever, diarrhea, cutaneous rash and hypotension. Toxic shock syndrome requires early recognition and prompt aggressive symptomatic treatment based essentially on fluids administration, appropriate intravenous antibiotics and corticosteroids.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/11. vancomycin allergy presenting as fever of unknown origin.A 37-year-old woman receiving long-term hemodialysis was admitted to the hospital with a fever of unknown origin (6 weeks of unexplained, persistent, low-grade fever). Although she had received vancomycin hydrochloride 5 days before the onset of fever, the drug was not suspected as the cause because of the duration of fever, the administration of vancomycin on prior occasions without incident, and the lack of allergic stigmata. After hospitalization, vancomycin and gentamicin sulfate were administered empirically. Immediately thereafter, her temperature rose to 40 degrees C, and over the ensuing 24 hours, eosinophilia and a maculopapular rash developed that resolved entirely when antibiotic therapy was stopped and low-dose steroid therapy was instituted. The prolonged hypersensitivity reaction after a single dose of vancomycin is consistent with the greatly extended half-life of this drug in the population with end-stage renal disease and should alert physicians to the possibility of such persistent idiosyncratic reactions in this group.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/11. Beneficial effect of chloramphenicol on pyrexia in patients with acute leukemia.6 patients with acute leukemia are described. All of them suffered from high temperature and malaise, and showed negative urine and blood cultures. High doses of gentamicin, cephalothin and cerebenicillin failed to lower the fever. The temperature became normal after administration of chloramphenicol (CAP) 2.0 g/day. In 3 out of 6 patients the peripheral blood blast cell count decreased following CAP administration. Incubation of acute lymphoblastic leukemia cells with CAP in vitro showed a marked decrease in the dna synthesizing activity of the leukemic cells. The role of CAP as an additional tool in the treatment of acute leukemia is discussed.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
7/11. listeriosis and borreliosis as causes of antepartum fever.fever of unknown origin in the pregnant woman presents special diagnostic, therapeutic, and obstetric problems. Two such clinically ill, febrile third-trimester patients, one presenting with maternal septicemia and transplacental fetal listeriosis and the other with borreliosis, are discussed. Although the neonatal outcome in such infections historically is poor, the infants of these mothers survived. It is suggested that special diagnostic procedures, timely administration of parenteral antibiotics, and vigilant antepartum testing be considered in all similar pregnant patients.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/11. CPPD crystal deposition disease as a cause of unrecognised pyrexia.We describe three cases of CPPD crystal deposition disease in elderly patients whose main symptom was fever. Misdiagnosis of such cases is possible because of the similarity of the clinical picture to that of septic fever. The probable mechanisms causing the fever are discussed. There was spectacular improvement in these patients after a high dose of oral colchicine and loperamide and no relapse was observed during the long term administration of colchicine in a conservative dose together with supplementary magnesium.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/11. Visceral leishmaniasis misdiagnosed as malignant lymphoma.Visceral leishmaniasis is a chronic infectious disease caused by a protozoan parasite of the genus Leishmania, characterized by intermittent fever, monocytosis, hepatosplenomegaly and hypergammaglobulinemia. This morbid condition is rather difficult to diagnose correctly, especially at its early stage, because it is rarely encountered in japan. Recently we treated a case of visceral leishmaniasis in which the patient was misdiagnosed as malignant lymphoma, and went through splenectomy and steroid administration, which made the diagnosis more difficult.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/11. scrub typhus associated with multiorgan failure: a case report.The spectrum of clinical severity for scrub typhus ranges from inapparent, mild, to severe or fatal. The pathologic changes are focal or disseminated multiorgan vasculitis of the small blood vessels, a fact that helps explain the great diversity of clinical manifestations that can be encountered. We reported a case of scrub typhus with unusual and serious multiorgan involvement, including tubulointerstitial nephritis (tin) with acute renal failure (ARF), interstitial pneumonitis with adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), liver function impairment, upper gastrointestinal bleeding, prolonged hyperamylasaemia and hyperlipasaemia. chloramphenicol administration rapidly altered the clinical course, but with sequelae of renal impairment and prolonged hyperamylasaemia and hyperlipasaemia for 10 months.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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