Fever of unknown origin, Polysynovitis and adult Still's disease.

Abstract

A 48-year-old male patient with a history of type 2 diabetes mellitus, who reported a previous admission for presenting a clinical case characterized by fever, adenopathies, and a positive test for Borrelia, for which he received treatment with antibiotics, without obtaining a favorable response he was released. Due to the persistence of the symptoms, complementary tests were performed that resulted in severe anemia, leukocytosis, elevated ferritin, HIV negative, hepatosplenomegaly and a biopsy of inguinal adenopathy which reported reactive lymphadenitis, after 10 months of persistent symptoms and worsening of the symptoms, enters a new hospital center presenting fever, polyarthritis, weight loss, generalized cutaneous-mucosal pallor, generalized cutaneous rash and hepatosplenomegaly, for which it is evaluated as a case of fever of unknown origin, excluding infections, neoplasms, other autoimmune diseases, and due to high clinical suspicion, the diagnostic conclusion of Adult Still's disease was reached, the relevance of this case is determined because it is a rare systemic inflammatory disorder of unknown etiology that is responsible for a significant proportion of cases of fever of unknown origin and can also have sequel as in this case, it was also observed at 48 years old and its diagnostic age is 25 years old. In the same way, it was a man who was affected, when it frequently occurs in the women finding the present case within the 27% that occurs after 35 years and the less than 30% that occurs in men.