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A man with inflamed ears.

R P Shah1, V R Shah, D Reichmuth

  • 1University of South Florida, Tampa General Hospital, USA.

Hospital Practice (1995)
|April 23, 1999
PubMed
Summary
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A young man experienced worsening symptoms including fever and vision loss after a Still's disease diagnosis. Prompt treatment with prednisone was initiated, highlighting the importance of timely intervention for suspected systemic inflammatory conditions.

Area of Science:

  • Rheumatology
  • Ophthalmology
  • Infectious Disease

Background:

  • Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder characterized by fever, rash, and arthritis.
  • Diagnostic challenges in AOSD often arise due to its heterogeneous presentation and the exclusion of other conditions.
  • Early recognition and management are crucial to prevent potential organ damage.

Observation:

  • A 23-year-old male presented with acute onset fever, dyspnea, cough, conjunctivitis, reduced vision, and otalgia.
  • Symptoms emerged eight days post-discharge following a presumptive diagnosis of Still's disease.
  • Initial investigations, including synovial fluid analysis and extensive workup, were inconclusive.

Findings:

  • An evanescent macular pink rash appeared on day 15, raising suspicion for Still's disease.

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  • Despite a comprehensive diagnostic workup, the etiology remained elusive initially.
  • Treatment with oral prednisone was initiated, leading to patient discharge.

    • Implications:

    • This case underscores the diagnostic complexities of Still's disease, particularly in its early stages.
    • The presentation highlights the need for vigilance in recognizing evolving symptoms suggestive of AOSD.
    • Timely corticosteroid therapy can be effective in managing acute flares of Still's disease.