Treatment with anti-cancer chemotherapy in a patient with fever of unknown origin and progressive pulmonary nodules.
- Author:
Yu Jung KIM
1
;
Sunyoung KIM
;
Myoung Don OH
;
Chul Gyu YOO
;
Dae Seog HEO
;
Chul Woo KIM
;
Yung Jue BANG
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. heo1013@plaza.snu.ac.kr
- Publication Type:Case Report
- Keywords:
Fever of unknown origin;
Chemotherapy;
Lymphoproliferative disorder
- MeSH:
Anti-Bacterial Agents;
Collagen;
Cyclophosphamide;
Diagnosis;
Doxorubicin;
Drug Therapy*;
Fever of Unknown Origin*;
Fever*;
Humans;
Lung;
Lymphoproliferative Disorders;
Pneumonia;
Prednisolone;
Vascular Diseases;
Vincristine
- From:Korean Journal of Medicine
2006;71(4):442-448
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Classic causes of fever of unknown origin (FUO) are infections, neoplasms, collagen vascular diseases and drugs. However, large studies of FUO have consistently reported that a considerable proportion of patients with FUO remain undiagnosed. We report a patient with a prolonged course of FUO and progressive pulmonary nodules in whom extensive clinical and laboratory evaluation did not reveal specific diagnosis. The patient had recurrent episodes of fever for more than three years, and the pulmonary nodules gradually progressed in size and number despite administration of antibiotics including antifungal and antituberculosis agents. Several pathologic examinations demonstrated an organizing pneumonia or non-neoplastic lung parenchyma with lymphoplasmacytic infiltration only. After a protracted course of disease, we thought that this patient might have lymphoproliferative disorder, possibly EBV-associated, and started anti-cancer chemotherapy. He was successfully treated with eight cycles of chemotherapy including cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP).
