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A case of Pyrexia of Unknown origin

Name: Halabasappa Sangayya

Age: 62 yrs/ Male

Religion: Hindu

Occupation: Clerk

Address: Kalwadi, Bijapur District, Karnataka State, India

Chief complaints:

  1. Recurrent episodes of high fever since 3 years.
  • Accompanied by: Rigors, Sweating, Fatigue, Dizziness, Light-headedness, Malaise.

History of presenting illness:

Patient was apparently alright 3 years back after which he developed recurrent episodes of high fever which was acute in onset. The fever was of relapsing type (temperature returns to normal days before rising again) & each episode of fever lasted for about 2-3 days. Fever was accompanied by rigors, sweating, malaise, fatigue, dizziness, & light-headedness. For these complaints he had visited a local doctor and was prescribed paracetamol and antibiotics. But the episodes of high fever with accompanying symptoms kept occuring roughly 3-4 times a year & each episode would last for about 2 to 3 days.

Negative history to rule out Tuberculosis:

  • No history of anorexia.
  • No history of weight loss
  • No history of respiratory infections like sinusitis, tonsillitis, otitis media, pharyngitis).
  • No history of cough.

Past history:

No previous history of similar illness.

No history of surgical operations in the past.

No previous history of blood transfusion.

No history of allergies.

Family history:

No history of similar complaints in the family.

No family history of lymphoproliferative diseases.

No family history of cancer.

Drug history:

Paracetamol and antibiotics given by a local doctor.

No other drug history.

Differential diagnosis based on history:

  •  Brucellosis: Can cause fever, chills, fatigue, weakness, backache, & myalgia. Also causes Hepatospleenomagaly, lymphadenopathy, arthritis, bursitis, sarcoilitis. 
  • HIV: Can cause unexplained persistent fever.
  • Malaria
  • Lymphoma
  • Pyogenic infection

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