Adult Onset Still's Disease Masquerading as Sepsis in an Asplenic Patient

Adult onset Still's disease (AOSD) is a rare inflammatory disorder of unknown etiology. It is a diagnosis of exclusion. We report a case of post-splenectomised man, presented with high grade fever, joint pain and body ache. Since Overwhelming Post Splenectomy Infection (OPSI) was the initial probable diagnosis, empirical antibiotic therapy was initiated. Evaluation to find a septic focus, autoimmune diseases ad malignancies was carried out which showed negative results. Since alternative diagnoses were excluded and the Yamaguchi's criteria for AOSD was fulfilled, the patient was treated with IV steroids which resulted in rapid resolution of his symptoms. AOSD with asplenia is a unique condition because immunosuppressive therapy for AOSD may increase the risk of OPSI in such a patient. This is the first case report of AOSD in an asplenic patient from India.