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Severe Adult-Onset Still's Disease Mimicking Systemic Infection
Rajani Gubbala1, Ganshyam Jagathkar1, Nagalakshmikanth Reddy Mayaluri1
1Department of Critical Care, MaxCure Hospitals, Hyderabad, Telangana, India.
Abstract:
Adult-onset Still's disease (AOSD) is an uncommon entity that can mimic infection. Patients present with fever for more than 1-week, joint pain, and rash. We report a case of 22-year-old male who presented with fever, sore throat, and abdominal pain. During hospitalization, he had multiple episodes of tachycardia and tachypnea requiring mechanical ventilation. The patient had elevated white blood cell count, procalcitonin, and troponin. He was extensively investigated and diagnosed as AOSD. He responded to steroids and was discharged on day 20.
Insights
Adult-onset Still's disease (AOSD) can mimic infections. This case highlights AOSD diagnosis in a young male with fever, joint pain, and rash, successfully treated with steroids.
Area of Science:
- Rheumatology
- Internal Medicine
- Clinical Case Study
Background:
- Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder.
- AOSD often presents with characteristic symptoms of fever, rash, and arthritis, but can mimic infectious processes.
- Early and accurate diagnosis is crucial for effective management and preventing complications.
Observation:
- A 22-year-old male presented with prolonged fever, sore throat, and abdominal pain.
- The patient developed tachycardia and tachypnea, necessitating mechanical ventilation.
- Laboratory findings included elevated white blood cell count, procalcitonin, and troponin levels.
Findings:
- The patient was diagnosed with Adult-onset Still's disease (AOSD) after extensive investigation.
- The clinical presentation and laboratory results were consistent with AOSD, despite initial suspicion of infection.
- The patient showed a positive response to corticosteroid therapy.
Implications:
- This case underscores the importance of considering AOSD in the differential diagnosis of pyrexia of unknown origin, especially when infection is suspected.
- Prompt recognition and treatment of AOSD with corticosteroids can lead to favorable outcomes.
- Further research into the diagnostic challenges and optimal management strategies for AOSD is warranted.