Unexplained Fever Associated with Diseases of the Gastrointestinal Tract
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
Although fever is not generally considered to be a characteristic manifestation of carcinoma of the colon, certain authors68,69 claim that fever may be one of the earliest symptoms of colorectal cancer. Fever of unknown origin has been described in this condition by other authors.58,70 Initially, when tumor size is small, the symptomatology is variable and nonspecific. Later the complaints become more typical according to the side of the colon affected. Right-sided features include diarrhea alternating with constipation, vomiting, abdominal pain, anemia, rectal bleeding (late), a palpable mass, and fever. On the left side, the manifestations are mainly abdominal distension, constipation, rarely diarrhea, obstructive features, rectal bleeding (in 70% of cases), and a palpable mass.
Miscellaneous procedures
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
99mTc-HMPAO-labelled WBC scintigraphy may be used to detect and localise suspected sites of infection/inflammation with or without localising symptoms. Common indications include: Fever of unknown origin.Osteomyelitis of the appendicular skeleton.Infected joint and vascular prosthesis.Diabetic foot.Post-operative abscesses.Lung infections.Inflammatory or ischaemic bowel disease.
Gastrointestinal system
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
6.13. In Crohn's disease of childhoodthe stomach and duodenum may be involved.diarrhoea with blood and mucus is a characteristic early symptom.growth retardation is a characteristic feature.surgical resection of the affected gut is curative.fever of unknown origin may be the presenting symptom.
Fatal epidural abscess with meningitis: a rare complication of colorectal surgery
Published in Acta Chirurgica Belgica, 2021
Elodie Gaignard, Damien Bergeat, David Kieser, Fabien Robin, Bernard Meunier
Several cases of epidural abscess and meningitis caused by abdominal sepsis have been described in the literature in the setting of Crohn’s disease [4,5], appendicitis [6], duodenal ulcer [7] and colorectal surgery [8]. These infections are developed after the introduction of bacteria into the sterile epidural space. Most commonly, this occurs from haematogenous seeding from an anatomically distanced source, such as endocarditis, infected catheters, soft tissue, urinary or respiratory infections. More rarely, bacteria enter in the epidural space by direct extension of infected tissue, which was the case reported here. The ensuing symptoms vary from fever of unknown origin, to axial back pain or neurological dysfunction. Epidural abscess complicating AL is rarely mentioned in a context of fever after colorectal surgery, yet the prognosis is affected by the severity of the infection, which itself is affected by the time to diagnosis. Thus, a delay in diagnosing and treating this complication, because of a lack of awareness of this complication, may result in permanent neurological dysfunction, sepsis and death. This was the case in our patient who experienced 4 months of low-grade fever and failure to thrive before decompensating into septic shock. Only at this stage, the classic triad of back pain, fever and neurologic dysfunction was recognised.
Murine typhus
Published in Baylor University Medical Center Proceedings, 2022
Seamus Lonergan, Gowtham Ganesan, Stephen J. Titus, Kashif Waqiee Ahmed
Fever of unknown origin is defined as a fever >38.3°C with a duration of at least 3 weeks and an uncertain diagnosis after 1 week of study in the hospital.1 This creates a diagnostic and clinical dilemma in the evaluation of patients suffering from febrile symptoms that are longer than a typical self-limited disease course, but yet less than the 3-week threshold. We present a case of murine typhus that fell into this category and highlights the importance of a thorough history and physical, which aid in creating a targeted diagnostic approach.
Non-infectious Fever After Acute Spinal Cord Injury in the Intensive Care Unit
Published in The Journal of Spinal Cord Medicine, 2019
Fatma Ülger, Mehtap Pehlivanlar Küçük, Çağatay Erman Öztürk, İskender Aksoy, Ahmet Oğuzhan Küçük, Naci Murat
Fever is an adaptive response to physiological stress regulated tightly by endogenous pyrogenic and antipyretic mechanisms, and usually responds to antipyretic treatment. Although the mechanism of fever development after SCI is not fully understood, injury to the hypothalamus, the main center of the brain involved in thermoregulation, can cause thermodysregulation and especially hyperthermia.11 It was reported in animal studies that temperature-sensitive neurons in the spinal cord can also regulate temperature changes; therefore, nerve damage due to traumatic SCI results in neurogenic fever with thermodysregulation independent of the sympathetic system.14 Cases of hyperthermia secondary to thermodysregulation do not respond to antipyretic treatment and must be treated by cooling and distributing the produced heat.11,15,16 The elevated body temperature resulting from hyperthermia syndrome often exceeds 41.0 °C. Various conditions have been implicated as potential causes of hyperthermia syndrome: subarachnoid hemorrhage, acute neurological cases such as traumatic brain injury or intracerebral hemorrhage, drug-induced hyperthermia syndromes, malignant hyperthermia, neuroleptic malignant syndrome, thyroxoxis, pheochromocytoma, and others. In addition, the incidence deep vein thrombosis and non-infectious fever of unknown cause is also high in patients with central nervous system impairment.17 Is every non-infectious fever of unknown origin in SCI patients a "neurogenic fever"? This question is difficult to answer in the absence of definitive criteria for neurogenic fever diagnosis. However, the incidence of neurogenic fever has been reported at 2.6% to 27.8% in many studies.11–13,15,18,19 Savage et al. identified "neurogenic fever" in approximately one out of every in every 20–25 patients.20 The frequency of non-infectious fever among our patients was comparable to the rate reported by Savage et al.
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