ABSTRACT
We describe a case of Wegener's disease with massive painful bilateral submandibular gland enlargement as the presenting symptom. The diagnosis was based on histologically documented nasal mucosa involvement, focal necrotizing glomerulonephritis, episcleritis and anti-neutrophil cytoplasmic antibody.
Subject(s)
Granulomatosis with Polyangiitis/complications , Submandibular Gland Diseases/etiology , Female , Humans , Middle Aged , Submandibular Gland/pathology , Submandibular Gland Diseases/pathologyABSTRACT
OBJECTIVE: To determine the relative proportions of the diagnostic categories in patients with fever of unknown origin who were examined in the 1980s. STUDY DESIGN: Prospective case series. SETTING: General Internal Medicine Service based at University Hospital, Leuven, Belgium. PATIENTS: One hundred ninety-nine consecutive patients meeting the classic criteria of fever of unknown origin who were treated in the 1980s. MAIN OUTCOME MEASUREMENT: The final diagnosis established at discharge or during follow-up. RESULTS: Infections were found in 45 patients (22.6%), tumors were found in 14 (7%), multisystem diseases were found in 42 (21.5%), drug-related fever was found in six (3%), factitious fever was found in seven (3.5%), habitual hyperthermia was found in five (2.5%), miscellaneous diseases were found in 29 (14.5%), and no diagnosis was reached in 51 (25.6%). CONCLUSIONS: Tumors were a less important cause of fever of unknown origin in the 1980s. The same holds true for some infectious diseases, such as abscesses and hepatobiliary disorders. Multisystem diseases were more frequently found, and the number of undiagnosed cases increased. Although these shifts in the disease spectrum in fever of unknown origin most probably resulted from a constellation of factors, we suspect that these changes are mainly due to easy and early diagnosis by new diagnostic modalities, such as ultrasonography and computed tomography, of previously common causes of fever of unknown origin.
Subject(s)
Fever of Unknown Origin/etiology , Abscess/complications , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Infections/complications , Length of Stay , Male , Middle Aged , Prospective Studies , Tomography, X-Ray Computed , UltrasonicsABSTRACT
A case of palmar fasciitis and arthritis (PFA) is described in a man with both a prolactinoma and metastatic cancer of the prostate. This rare condition is mainly described in women with ovarian cancer and our case is the first reported association of PFA with cancer of the prostate.
Subject(s)
Carcinoma/complications , Fasciitis/complications , Osteoarthritis/complications , Prostatic Neoplasms/complications , Hand , Humans , Male , Middle Aged , Neoplasms, Multiple Primary , Pituitary Neoplasms/complications , Prolactinoma/complicationsABSTRACT
One month after a Burch operation, performed because of urinary stress incontinence, a 65-yr-old woman developed progressive suprapubic pain and a characteristic waddling gait. Initial treatment with bed rest, non-steroidal antiphlogistics and corticosteroids was unsuccessful. Six months later, a biopsy of the symphysis performed because of persisting disabling pain yielded a positive culture of Pseudomonas aeruginosa. A longlasting treatment with intravenously administered antibiotics followed by ofloxacin orally, resulted in complete clinical cure and progressive radiological improvement. The distinction between noninfectious osteitis pubis and infectious symphysitis or osteomyelitis of the pubis is discussed.
