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ABSTRACT: Infectious diseases remain one of the most important causes of fever of unexplained origin (FUO). We review the spectrum of infectious diseases in the different clinical situations of patients with FUO, namely in classical FUO, in patients with HIV infection, in health care-associated or nosocomial FUO, and in immunocompromised patients with FUO. The most important question is which clinical features make a specific disease a candidate to cause FUO.
Der Internist 11/2012; · 0.30 Impact Factor
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ABSTRACT: Das Spektrum von Infektionen als Ursache eines Fiebers unklarer Genese ist breit und hängt von individuellen Risikofaktoren
der Patienten ab. Die zugrunde liegenden Infektionen zeigen dabei oft atypische Verlaufsformen. Eine Unterteilung in ambulante,
nosokomiale und Infektionen bei immunkompromittierten Patienten strukturiert das Krankheitsbild und auch das differenzialdiagnostische
Vorgehen sinnvoll. Wir geben einen Überblick über die wichtigsten infektiösen Ursachen eines Fiebers unklarer Genese.
Infectious diseases are important causes of fever of unknown origin (FUO). The spectrum of infectious agents is broad and
diagnosis depends on careful evaluation of individual risk factors. Infectious diseases presenting as FUO are frequently atypical
presentations of well known infections, e.g. tuberculosis or infectious endocarditis. In this review we present an overview
of infectious causes of FUO classified into community acquired infections, nosocomial infections, and infections in immunocompromised
hosts.
Der Internist 04/2012; 50(6):659-667. · 0.30 Impact Factor
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ABSTRACT: Ein 52-jähriger Mann unter immunsuppressiver Therapie aufgrund einer ANCA-negativen Vaskulitis stellte sich mit Fieber und
erhöhten Entzündungsparametern sowie einer Paraparese der Beine vor. Differenzialdiagnostisch kam sowohl eine akute Infektion,
ein akuter Schub der Vaskulitis als auch eine Arzneimittelreaktion in Betracht. Trotz intensiver diagnostischer Maßnahmen,
inklusive einer FDG-PET-Untersuchung, konnte keine definitive Ursache gefunden werden. Unter empirischer Antibiose in Kombination
mit einer Steroidstoßtherapie normalisierten sich das Fieber und die erhöhten Entzündungsparameter im Verlauf.
A 52 year old patient with immunosuppressive therapy for ANCA-negative vasculitis presented with fever and paraparesis of
the legs, laboratory findings displayed high inflammatory markers. The differential diagnosis comprised acute infection, an
exacerbation of vasculitis or a drug reaction. Despite meticulous diagnostics, including FDG-PET, no definitive cause for
the symptoms could be uncovered. Empirical antibiotic treatment in combination with high doses of glucocorticosteroids lead
to prompt resolution of fever and inflammatory laboratory markers.
Der Internist 04/2012; 50(6):656-658. · 0.30 Impact Factor
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ABSTRACT: Infectious diseases are important causes of fever of unknown origin (FUO). The spectrum of infectious agents is broad and diagnosis depends on careful evaluation of individual risk factors. Infectious diseases presenting as FUO are frequently atypical presentations of well known infections, e.g. tuberculosis or infectious endocarditis. In this review we present an overview of infectious causes of FUO classified into community acquired infections, nosocomial infections, and infections in immunocompromised hosts.
Der Internist 07/2009; 50(6):659-67. · 0.30 Impact Factor
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ABSTRACT: A 52 year old patient with immunosuppressive therapy for ANCA-negative vasculitis presented with fever and paraparesis of the legs, laboratory findings displayed high inflammatory markers. The differential diagnosis comprised acute infection, an exacerbation of vasculitis or a drug reaction. Despite meticulous diagnostics, including FDG-PET, no definitive cause for the symptoms could be uncovered. Empirical antibiotic treatment in combination with high doses of glucocorticosteroids lead to prompt resolution of fever and inflammatory laboratory markers.
Der Internist 07/2009; 50(6):656-8. · 0.30 Impact Factor
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ABSTRACT: Detecting the source of obscure gastrointestinal bleeding can be difficult. Capsule endoscopy is a promising diagnostic tool for investigating patients with this condition, although identifying the source of intermittent or low-grade bleeding remains a diagnostic challenge. We present case reports of two patients with obscure gastrointestinal bleeding, in whom the source of recurrent bleeding episodes was diagnosed by capsule endoscopy while they were on anticoagulation therapy. The first patient, an 81-year-old white woman, was on long-term oral anticoagulation because she had chronic atrial fibrillation. Capsule endoscopy demonstrated a bleeding tumor in the region of the terminal ileum. The second patient, a 59-year-old white man, underwent an initial capsule endoscopy, which was negative. After initiation of anticoagulation with heparin, a second capsule endoscopy procedure in this patient revealed several small bleeding lesions in the proximal small bowel. In both cases a gastrointestinal stromal tumor was identified as the bleeding source and was resected. These two cases demonstrate that provocation of bleeding during capsule endoscopy may increase its sensitivity.
Endoscopy 06/2006; 38(5):526-8. · 5.21 Impact Factor
