Malignancy or inflammation? A case report of a young man with fever of unknown origin.
A case of a young man with fever of unknown origin is presented. This diagnosis can be frustrating for both patients and physicians because the diagnostic workup often involves numerous noninvasive and invasive procedures that sometimes fail to explain the fever. In the presented case some of the imaging diagnostic findings suggested malignant hematological disorder. However, histopathological and microbiological investigation proved vertebral osteomyelitis caused by Staphylococcus haemolyticus. Diagnosis was established by positron emission tomography, magnetic resonance imaging, and culture and histopathological analysis of a spinal biopsy. 3 months of antibiotic therapy was curative. Biopsy and microbiological investigation may be necessary in patients with fever, back pain and evidence of a spinal lesion on imaging, even if neoplastic disease is suspected.
First Department of Medicine, University of Debrecen Medical and Health Science Center, Nagyerdei krt 98, 4032 Debrecen, Hungary.
Mariann
M
Harangi
Tibor
T
Kovács
Éva
É
Rákóczi
László
L
Rejto
László
L
Mikó
László
L
Tóth
Gabriella
G
Szucs
László
L
Galuska
György
G
Paragh
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002908:Chronic Disease; D002939:Ciprofloxacin / Q000627:therapeutic use; D005335:Fever of Unknown Origin / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin