ABSTRACT
Pyrexia of unknown origin (PUO) is one of the most challenging medical problems. Endocrine causes of PUO are rare. Fever is common in a few endocrine disorders (e.g., thyroid storm, adrenal crisis and pheochromocytoma). However, PUO as the sole presenting feature is very rare with only a few reported cases in the literature. We present the case of a middle-aged male who came to us with PUO, weight loss and loss of appetite. The unusual symptomatology like loss of appetite, altered bowel habits made diagnosis difficult. This case highlights the importance of considering thyroid disorder in the differential diagnosis of PUO. Abnormal thyroid function may be an early clue for diagnosis.
ABSTRACT
We report a case of pyrexia of unknown origin (PUO) in a 19-year-old male, who was admitted with a history of pyrexia for 2 weeks. The diagnosis remained uncertain despite multiple investigations and the patient subsequently had various clinical manifestations similar to those seen in coronavirus disease 2019 (COVID-19). Since it was initially presumed to be pyrexia due to viral origin or enteric fever, patient was started on empirical treatment. The diagnosis of COVID-19 was confirmed by corroborating various biochemical markers that had a greater association with COVID-19. Patient was discharged after 21 days with empirical antibiotics, anticoagulants and other supportive medications. He required no further hospital admissions and has been on regular follow-up.
ABSTRACT
A Covid-19 é uma doença causada pelo betacoronavírus SARS-CoV-2. O vírus é transmitido pelo contato interpessoal próximo, por meio de gotículas respiratórias. Dentre as medidas de prevenção contra contágio e disseminação da doença, é recomendado a higienização das mãos com água e sabão e/ou álcool em gel e o afastamento social, uso de máscaras de pano e a aferição da temperatura utilizando termômetro digital infravermelho para o controle de acesso nos ambientes públicos, a fim de impedir possíveis portadores sintomáticos do vírus. Temos por objetivo, refletir sobre a eficácia da aferição da temperatura em ambientes públicos utilizando termômetro digital com sensor de infravermelho. Baseado nos conhecimentos da fisiologia da temperatura corporal e processos febris, apresentados na literatura especializada, e na experiência da identificação de portadores utilizando o procedimento de aferição de temperatura descrito, é evidente a necessidade de uma elaboração de políticas públicas de combate à pandemia mais abrangente, que enfatize a necessidade do conjunto das medidas sanitárias. Aliado a isso, é necessário um programa de testagem contínuo e em massa, permitindo o mapeamento e a busca por auxílio e orientação médica especializada, bem como um programa de educação e conscientização da população para a necessidade de quarentena e isolamento social em casos suspeitos que apresentem sintomas de pirexia.
Covid-19 is a disease caused by the betacoronavirus SARS-CoV-2, which is transmitted through close interpersonal contact through respiratory droplets. Among the preventive measures against contagion and dissemination, the guidelines recommend hand hygiene with water and soap or hand sanitizer, social withdrawal, use of cloth masks and temperature measurement using digital infrared thermometer for access control in public environments to prevent possible symptomatic carriers. This study sought to reflect on the effectiveness of measuring temperature in public environments using a digital infrared thermometer. Based on specialized literature on body temperature physiology and febrile response, as well as on the practice of carrier identification by temperature measurement, the research point to the need of elaborating more comprehensive public policies to combat the pandemic, emphasizing a combination of health measures. Moreover, a continuous and mass testing program is needed, allowing the mapping and search for specialized medical help, as well as an education and awareness program on the need for quarantine and social isolation is symptomatic carriers.
Covid-19 es la enfermedad causada por el betacoronavirus SARS-CoV-2. El virus se transmite por contacto interpersonal cercano, a través de gotitas respiratorias. Entre las medidas preventivas contra el contagio y propagación de la enfermedad, se recomiendan la higiene de manos con agua y jabón y / o gel de alcohol y el retraimiento social, el uso de mascarillas de tela y la medición de la temperatura mediante un termómetro digital infrarrojo para su control. para prevenir posibles portadores sintomáticos del virus. Nuestro objetivo es reflexionar sobre la efectividad de medir la temperatura en entornos públicos utilizando un termómetro digital con sensor de infrarrojos. Con base en el conocimiento de la fisiología de la temperatura corporal y los procesos febriles, presentado en la literatura especializada, y en la experiencia de identificación de portadores mediante el procedimiento de medición de temperatura descrito, se evidencia la necesidad de la elaboración de una política pública más integral para combatir la pandemia., que enfatiza la necesidad de todas las medidas sanitarias. A ello se suma un programa de pruebas continuas y masivas, que permitan el mapeo y búsqueda de asistencia y orientación médica especializada, así como un programa de educación y sensibilización de la población sobre la necesidad de cuarentena y aislamiento social en casos sospechosos, que presentan síntomas del pirexia.
Subject(s)
Signs and Symptoms , Gatekeeping , Disease Prevention , Pandemics , Fever , Hand Hygiene , Betacoronavirus , SARS-CoV-2 , COVID-19ABSTRACT
It is very rare to have a lymphomatous involvement of ovary. Malignant lymphoma of ovary is a well-known late manifestation of disseminated nodal disease. Primary ovarian lymphoma with ovarian mass as an initial manifestation is a rare entity and may have varied presentations which can cause confusion to the physician and cause delay in diagnosis. Study presents a case of non-Hodgkin’s lymphoma where the initial presentation was fever with weight loss, and was evaluated as pyrexia of unknown origin. When no other cause of fever was identified PET-CT was done showing metabolically active uterine mass with no lymphadenopathy. Exploratory laparotomy was planned followed by hysterectomy with bilateral salpingo ophorectomy with omentectomy. Ovarian malignancy was detected intraoperatively, which was diagnosed as diffuse large B cell lymphoma, NHL double expresser phenotype on histopathology and IHC. Patient was started on chemotherapy and is doing fine.
ABSTRACT
Mevalonate kinase deficiency (MKD) is a rare autosomalrecessive autoinflammatory disease caused by mutations inMVK. We report two siblings with MKD, presenting withrecurrent febrile illnesses, detected to have compoundheterozygous variants in MVK. MKD mimics common pediatricconditions and should be considered as a differential diagnosis.
ABSTRACT
Petersdorf and Beeson defined pyrexia of unknown origin (PUO) as a complaint with temperature surpassing 38.30 C, developing over a period of at least three weeks, with no possible opinion reached after one week of inpatient investigation. In the present study, an attempt has been made to find out the causes of PUO based on bone marrow morphology. The range of diseases causing PUO not only seems to be determined by geographical factors, but time also plays a vital role. Bone marrow examination plays an important role in early diagnosis of core cause for PUO and is the best tool for picking haematological and non-haematological disorders in any age group.METHODSAll patients presenting with classical PUO coming to Government Medical College, Jammu, fulfilling the criteria of Petersdorf RG et al whether inpatient or outpatient over a period of two years were included in this cross-sectional study.RESULTSOut of 76 patients, 48 were males and 28 were females. Age of patients varied from 12 years to 70 years. Majority of patients were in the age group of 30-44 years comprising of 45% of total cases. Anaemia was seen in nearly 50% of cases of PUO. Most common diagnosis was neoplastic changes, seen in 20% of patients, 16% cases show megaloblastic changes, iron deficiency was seen 10 % cases, reactive myeloid hyperplasia was seen in 18% cases, haemophagocytosis in 6% cases, 5% cases showed hypocellular marrow. Among infections, malaria was the commonest constituting 5.2% cases. Out of total of 15 cases of neoplastic changes in bone marrow, majority of them were acute myeloid leukaemia seen in 40% cases.CONCLUSIONSBone marrow examination is an important investigation of PUO in arriving at an etiological diagnosis. The most frequent causes of pyrexia of unknown origin observed in children were acute lymphoblastic leukaemia, megaloblastic anaemia and haemophagocytosis, whereas in adults, the main causes were malignancies, megaloblastic anaemia and reactive myeloid hyperplasia. This study sheds light on the current spectrum of diseases causing pyrexia of unknown origin in this region.
ABSTRACT
Human brucellosis is a zoonosis with worldwide distribution, with great importance in developing countries like India. The diagnosis of brucellosis is frequently difficult to establish as it mimics many other infectious and non-infectious diseases. The use of feasible diagnostic tests seems to be great importance for diagnosing human brucellosis. The present study was carried out to study the seroprevalence of human brucellosis by estimating IgG and IgM by ELISA in central India.METHODSA total of 124 serum samples were collected over a period of one year, and processed in a tertiary care teaching hospital in central India. Serum samples of patients admitted to the hospital with the diagnosis of pyrexia of unknown origin (PUO) were investigated for detectable IgG and IgM antibodies by ELISA. The observance values thus obtained were converted to Nova Tec Unit (NTU) by using the formula according to the manufacturer’s instructions.RESULTSOf the total of 124 serum samples, ELISA detected presence of IgG antibodies in 12 (9.67%) indicating chronic infection and IgM antibodies in 28 (22.58%) suggesting acute and recent infection.CONCLUSIONSELISA has the ability to measure two specific immunoglobulins for effective diagnosis and is also a rapid method for detecting seroprevalence of human brucellosis in the community.
ABSTRACT
A metabonomic approach involving an ultrahigh-performance liquid chromatography combined with Fourier transform ion cyclotron resonance mass spectrometry (UHPLC-FT-ICR-MS) was used to investi-gate the changes in the endogenous metabolites in the plasma of rats with yeast-induced pyrexia treated with Gegenqinlian decoction (GQLD), aspirin and itraconazole. The differences in the small molecule profiles of treatment using traditional Chinese medicine, etiological treatment and symptomatic treat-ment were elucidated. Thirty-six plasma metabolites were identified or putatively identified, and the effects of the three medicines on the thirty-six metabolites were studied. Their metabolic pathways indicated that GQLD, aspirin and itraconazole ameliorated the rats with yeast-induced pyrexia pre-dominantly by regulating the metabolisms of phospholipid, sphingolipid, fatty acid oxidation, fatty acid amides, amino acid and glycerolipid in vivo. The pharmacodynamics and metabonomic results showed that the three medicines exhibited the therapeutic effects on pyrexia by regulating the perturbations of multiple metabolisms. The study provided a scientific basis for an in-depth understanding of the ther-apeutic effects of GQLD, aspirin and itraconazole on rats with yeast-induced pyrexia.
ABSTRACT
Adult onset still’s disease is a rare systemic inflammatory disorder of unknown aetiology, characterized by clinical triad (high spiking fever, evanescent rash and arthritis) and biological triad with lack of serological markers as a true gold standard makes diagnosis difficulty. Here is a case of 32year old male presented with high grade fever for 2 months, joint pains and swelling for 1month rash for 3 days. O/E: pallor and B/L tender, swollen ankle and knee joints, and P/A: splenomegaly. Investigations showed-Hb%. 8 gms, neutrophilic leucocytosis with thrombocytosis, ESR:72 mm/1h, CRP elevated. ASO-titre, RA factor and Anti CCP antibodies are negative. Adult onset still’s disease is a heterogenous and rare systemic inflammatory disorder of unknown aetiology with lack of serological diagnostic modalities.
ABSTRACT
Background: Postpartum infectious complications following normal vaginal delivery remains a cause of major concern for the health care professionals due to higher morbidity and mortality and prolonged hospital stays and increased healthcare costs which makes us consider prophylactic use of antibiotics after normal vaginal delivery. On the other hand unjudicious use of antibiotics has led to widespread antibiotic resistance. Therefore this study was carried out to validate the use of prophylactic antibiotics in these patients and their role in prevention of puerperial pyrexia, wound infections and prolonged hospital stay.Methods: This Randomised clinical trial was conducted at KCHC-Kerala Co-operative Hospital Complex, Pariyaram, Kannur District, Kerala from 1st March 2012 to 30th April 2013. Eligible women were randomly assigned to group which does not receive prophylactic antibiotics (Group A) and group receiving prophylactic antibiotics (Group B). Patients in both the groups were examined every day till the patient was discharged from the hospital and observed for signs and symptoms of infected episiotomy wound, puerperial pyrexia and duration of hospital stay was noted.Results: Mean age in years was 25.6 for Group A and 26.2 for Group B. Mean gestational age in both the groups was 37.6 weeks. Mean duration of labour was 6.62 and 6.22 hours for Group A and B respectively. 6 subjects in Group A and 5 subjects in Group B had puerperial pyrexia. 3 Subjects in Group A and 2 subjects in Group B had wound infection. The mean duration of hospital stay for Group A was 4.18 with SD of 1.0 while mean hospital stay for Group B was 4.01 with SD of 1.1.Conclusions: By comparing subjects in both the groups with respect to puerperial pyrexia, wound infection and duration of hospital stay there was no statistical difference in any of the above criteria in both groups. Hence, in view of the risk of allergic reactions, toxicity and the selection of resistant strains the prophylactic administration of antibiotics does not seem to be justified in patients with episiotomy following vaginal delivery as per this study.
ABSTRACT
Brucellosis is a significant bacterial zoonotic disease with a high seroprevalence in low-to-middle-income countries where there is a significant contact of humans with animals. This prospective study was conducted to observe the seroprevalence of brucellosis in 75 symptomatic patients with pyrexia of unknown origin (PUO) and 75 high-risk individuals (10 veterinarians, 15 milkmen and 50 healthy contacts of symptomatic patients) with possible exposure to brucellosis. Serum samples collected from these patients and individuals were subjected to rose Bengal test (RBT) and ELISA for the detection of IgM and IgG antibodies. RBT was positive in 50 samples (40 PUO and 10 high risk), of which 25 (33.3%) PUO cases had detectable IgM antibodies, whereas IgG antibodies were detected in 20 patients. None of samples from high-risk individuals was reactive for IgM/IgG antibodies by ELISA. The overall seroprevalence in this study was 16.7% (33.3% in PUO patients). Being a predominantly livestock rearing area, brucellosis is a significant health-care problem in this part of India with this entity being linked to 33% of PUO cases.
ABSTRACT
The study was conducted to determine the antipyretic and anti-inflammatory activity of the methanolic extract of Andographispaniculata (APE) in albino rats. Acute oral LD50 of APE in female rats was more than 2000 mg/kg. The antipyretic activitywas studied by inducing pyrexia with Brewer’s yeast. A total number of thirty albino rats (200 g) were used for the study ofanti-pyretic activity they were divided into five groups of six rats in each group. Group I served as control Normal saline andGroup II were given brewer’s yeast alone (20 ml/kg), Group III was administered standard drug Aspirin @ 100 mg /kg bodywt. while groups IV and V were treated with 200 mg/kg and 400 mg/kg of Andrographis paniculata extract respectively.Pyrexia was induced by subcutaneously injecting 20% w/v brewer’s suspension in below the nape of the neck of the animals.The anti-inflammatory activity of APE was assessed by measuring the reduction in carrageenan-induced paw oedema in rats.A twenty four albino rats (200 g) were used for the study of anti-inflammatory activity. Four groups were divided with six ratsin each group. Group I served as control Normal saline solution and Group II was administered standard drug phenylbutazone@ 100 mg/kg While, groups III and IV were treated with 200mg/kg and 400mg/kg of APE respectively. APE (@ 400 mg/kghad significant antipyretic and anti-inflammatory activity against reduced brewer’s yeast induced pyrexia and carrageenaninduced rat paw edema in rats suggesting potent antipyretic effect of APE. From these results it may be concluded that crudemethanolic extract of Andrographis paniculata have significant antipyretic activity and anti-inflammatory activity that mightbe due to combined effect of active constituents present in plant extract this strongly support the ethno pharmacologicaluse of the plant for the management of fever and inflammation
ABSTRACT
Background: Puerperium is strictly defined as the period of confinement during and just after birth. It is the period following childbirth during which body tissues specially the genital organ reverts back approximately to the pre-pregnant state both anatomically and physiologically. At some stages some of these well-orchestrated changes can go away resulting in complications which can endanger life.Methods: Retrospective c study was conducted in Department of Obstetrics and Gynecology of M.G.M. Medical College and M. Y. Hospitals, Indore. The cases were selected randomly from the patient who were admitted in M.Y. Hospital who had either a vaginal or caesarean delivery (both in our institution as well as outside institution) during the study period, irrespective of age, parity and registration status. Data was recorded in predesigned coded case report forms and statistical analysis was performed.Results: Authors found that puerperal pyrexia was the most common complication, accounting for 38.96% of total cases. The second most common complication was perineal pain affecting 28.15% of cases. The other complication was wound gaping/discharge (11.71%), mastitis and breast abscess (6.81%), secondary postpartum hemorrhage (5.33%), episiotomy gaping and infection (4%), perineal hematoma (0.59%), wound dehiscence (0.3%) and other rare causes accounted for 4.15% of the complication.Conclusions: Puerperal period is as important as antenatal period. Anaemia, suboptimal personal hygiene as well as improper sterilization can resulted in severe health hazards such as septicemia, disseminated intravascular coagulation as well as death. So, risk factor should be treated vigorously.
ABSTRACT
Anhidrotic ectodermal dysplasia (AED) is a rare hereditary disorder with a triad of sparse hair, dental hypoplasia, and anhidrosis. Here we report a case of AED with food allergy and atopic eczema. The patient was a 11-month-old boy admitted to our hospital with pyrexia for 2 weeks. He presented with a history of dry skin, eczema, and food allergy to egg. On clinical examination, his body temperature was 38.8°C, with dry skin and eczema almost all over the body, sparse eyebrows, and scalp hair. Laboratory investigations and physical examination did not show any evidence of infection. Radioallergosorbent test was positive to egg yolk, egg white, ovomucoid, milk, house dust, and house dust mite. As the child did not sweat despite the high fever, we performed the sweat test which revealed a total lack of sweat glands. Genetic examination revealed a mutation of the EDA gene and he was diagnosed as AED. His pyrexia improved upon cooling with ice and fan. His mother had lost 8 teeth and her sweat test demonstrated low sweating, suggestive of her being a carrier of AED. Atopy and immune deficiencies have been shown to have a higher prevalence in patients with AED. Disruption of the skin barrier in patients with AED make them more prone to allergic diseases such as atopic eczema, bronchial asthma, allergic rhinitis and food allergy. Careful assessment of the familial history is essential to differentiate AED when examining patients with pyrexia of unknown origin and comorbid allergic diseases.
Subject(s)
Child , Humans , Infant , Male , Asthma , Body Temperature , Dermatitis, Atopic , Dust , Ectodermal Dysplasia , Eczema , Egg White , Egg Yolk , Eyebrows , Fever , Food Hypersensitivity , Hair , Hypohidrosis , Ice , Milk , Mothers , Ovomucin , Ovum , Physical Examination , Prevalence , Pyroglyphidae , Radioallergosorbent Test , Rhinitis, Allergic , Scalp , Skin , Sweat , Sweat Glands , Sweating , ToothABSTRACT
Wuchereria bancrofti is the most common parasite causing lymphatic filariasis. Microfilariae are demonstrated in the peripheral blood, body fluids, fine needle aspirates and in onchial ushings but it is an uncommon finding in the bone marrow. We report a case of a 45-year old male who presented with pyrexia of unknown origin and on peripheral blood and bone marrow examination found to have pancytopaenia with megaloblastoid changes in the bone marrow and W. bancrofti microfilariae.
ABSTRACT
Fever (also known as pyrexia or a febrile response) is defined as a body temperature above the normal range due to an increase in the temperature regulatory set-point. In Siddha medicine fever is considered as a disease which is caused by body heat. According to Sage Theraiyar, the primary cause for fever is 慉amam� or 慡eetham� which means an upset in the normal gastrointestinal function could be because of dysbiosis, indigestion, dyspepsia etc. Nowadays fever is emerged as an important indicator for infectious disease and a resource for research. In Siddha system of medicine, there are many herbal drugs that are used as antipyretic ingredients in many formulations. Siddha medicine has a wealth of remedies for the treatment of fever and associated conditions. Among them, herbs like Andrographis paniculata, Cedrus deodara have antimalarial activity. Polyherbal decoction Nilavembu kudineer is administered for Chikungunya, swine flu and dengue. Here an attempt has been made to explore the concepts of fever and some common varieties of herbal medicines used for the treatment of fever in Siddha. This article reviews the anti pyretic activity of the commonly used herbs in Siddha medicine.
ABSTRACT
Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies.Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks.Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%.Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications.
ABSTRACT
Background: Scrub typhus is lesser known cause of fever of unknown origin in India. Even if there have been reports documenting the prevalence of scrub typhus in different parts of India, it is still an unknown entity, and clinicians usually do not consider it as differential diagnosis. The present study was performed to document the prevalence of scrub typhus among febrile patients in western part of Uttar Pradesh and to assess the clinical profile of infected patients on the one hand and knowledge, attitude, and practices among clinicians on the other. Materials and Methods: A total of 357 adult patients with fever of more than 5-day duration were recruited. All patients underwent complete physical examination, and detailed clinical history was elicited as per predesigned pro forma. After primary screening to rule out malaria, enteric fever, and leptospirosis infection, secondary screening for scrub typhus was done by rapid screen test and IgM ELISA. Results: Scrub typhus infection was positive in 91 (25.5%) cases. The most common symptoms among the patients were fever (100%), pain in abdomen (79.1%), pedal edema 56 (61.5%), rash 44 (48.3%), headache 44 (48.3%), vomiting 42 (46.1%), constipation 33 (36.2%), cough 28 (30.7%), and lymphadenopathy 20 (21.9%). The median values of interleukin-8, interferon-gamma, and tumor necrosis factor-alpha in healthy controls were 15.54 pg/ml, 7.77 pg/ml, and 54.1 pg/ml, respectively, while the median values of these cytokines in scrub typhus-positive patients were 21.04 pg/ml, 8.74 pg/ml, and 73.8 pg/ml, respectively. Conclusion: Our results highlight that scrub typhus infection is an important cause of pyrexia of unknown origin, and active surveillance is necessary to assess the exact magnitude and distribution of the disease.
ABSTRACT
Background & objectives: Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Methods: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). Results: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. Interpretation & conclusions: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider Bartonella infection in the differential diagnosis of febrile illnesses and chronic diseases.
ABSTRACT
This descriptive study evaluated 49 children with fever lasting formore than 7 days at a tertiary hospital in urban Mumbai. Etiologicdiagnosis could be established in 88% of the cases. Infectionswere the causein 34 (79%)patients, 6 (14%) were diagnosed ascollagen vascular diseases, and 3 (7%) had other cause