Prolonged Fever After the Treatment of Ulcerative Colitis in an Adolescent.
Autor: | Silverberg SL; Division of Infectious Diseases, Department of Paediatrics., Levy DM; Division of Rheumatology, Department of Paediatrics., Yama BA; Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada., Church PC; Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Hospital for Sick Children and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Sereti I; Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID)/NIH, Bethesda, Maryland., Kitai I; Division of Infectious Diseases, Department of Paediatrics. |
---|---|
Jazyk: | angličtina |
Zdroj: | Pediatrics [Pediatrics] 2024 Dec 01; Vol. 154 (6). |
DOI: | 10.1542/peds.2024-067175 |
Abstrakt: | A 17-year-old female was diagnosed with inflammatory bowel disease and started on infliximab. A few weeks after starting infliximab, she developed a recurrence of daily fevers associated with an intermittent dry cough, which worsened over the course of a month. A chest radiograph, abdominal ultrasound, and computed tomography scan of the chest and abdomen revealed a heterogeneous spleen with multiple hyperechoic areas, tiny splenic micronodules, and diffuse micronodularity throughout the lungs. She was transferred to a tertiary care hospital because of hypotension, new oxygen requirements, and ongoing fever. Her bloodwork on presentation to tertiary care revealed pancytopenia and elevated inflammatory markers; she had splenomegaly on MRI. As her clinical picture evolved, she continued to have persistent fevers and anorexia despite ongoing management. Infectious diseases, rheumatology, and gastroenterology were consulted to guide the evaluation and management of this patient's complex clinical course. (Copyright © 2024 by the American Academy of Pediatrics.) |
Databáze: | MEDLINE |
Externí odkaz: |