Kikuchi-Fujimoto Disease (KFD) was first described in Japan in 1972. The disease frequently mimics tuberculous lymphadenitis, malign lymphoma, and many other benign and malignant conditions. To our knowledge, there is no previous study comparing the clinical and laboratory characteristics of patients from different geographical parts of the world. We searched literature records beginning from 1991 and analyzed epidemiological, clinical, and laboratory data of 244 patients (including cases diagnosed in our institution) reported in 181 publications. Of the 244 cases, 33% were male and 77% were female. Mean age was 25 (1-64) and 70% was younger than 30. Most of the cases were reported from Taiwan (36%), USA (6.6%), and Spain (6.3%). Fever (35%), fatigue (7%) and joint pain (7%) were the most frequent symptoms, while lymphadenomegaly (100%), erythematous rashes (10%), arthritis (5%), hepatosplenomegaly (3%), leucopenia (43%), high erythrocyte sedimentation rate (40%), and anemia (23%) being the most common findings. KFD was associated with SLE (32 cases), non-infectious inflammatory diseases (24 cases), and viral infections (17 cases). SLE was more frequent in cases from Asia than Europe (28 and 9%, respectively). The disease was self-limiting in 156 (64%) and corticosteroid treatment was necessary in 16 (16%) of the cases. The mortality rate was 2.1%. Early diagnosis is crucial as the clinical and laboratory presentation generally imitates situations needing lengthy and costly diagnostic and therapeutic interventions. Additionally, association with SLE needs further investigation.

Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies.

The diagnosis of diabetic foot infection (DFI) is usually a challenge to the clinician. Procalcitonin (PCT), a 116-amino acid propeptide of calcitonin, is a new marker of bacterial infections and sepsis. We evaluated the serum value of PCT as a marker of bacterial infection in diabetic patients with foot ulcers. Fortynine diabetic patients with foot ulcers were consecutively enrolled into the study. DFI was diagnosed clinically by the presence of purulent secretions or at least two of the symptoms of infl ammation including redness, warmth, swelling, and pain. According to these criteria, DFI was determined in 27 patients (DFI group) and not detected in 22 patients (NDFI group). The blood samples were taken for biochemical analysis on admission. PCT, white blood cell count (WBC) and erythrocyte sedimentation rate (ESR), but not C-reactive protein (CRP), was found signifi cantly higher in DFI group compared with NDFI group. The best cut-off value, sensitivity and specifi city were 0.08 ng/ml, 77% and 100% for PCT, 32.1 mg/dl, 29% and 100% for CRP, 8.6 10 9 /L, 70% and 72% for WBC and 40.5 mm/h, 77% and 77% for ESR, respectively. The area under the receiver operating characteristic curve for infection identifi cation was greatest for PCT (0.859; p < 0.001), followed by WBC (0.785; p = 0.001), ESR (0.752; p = 0.003), and fi nally CRP (0.625; p = 0.137). These results suggest that PCT may be a useful diagnostic marker for DFI. Additional research is needed to better defi ne the role of PCT in DFI.procalcitonin; infection procalcitonin; infection marker; C-reactive protein; erythrocyte sedimentation rate; white blood cell count

ported in 4 (5%) and 8 (10%) patients, respectively. Reason for drug discontinuation was not specified in 11 (14%) patients.Discussion. Aripiprazole was generally well tolerated, with a treatment continuation rate of 71% in this inpatient psychiatric setting. Adverse effects were reported as the reason for drug discontinuation in only 5% of patients. This reported rate may be an underestimate since the reason for drug discontinuation was not recorded in the discharge summaries of 11 patients. Despite this shortcoming, it is important to determine whether continuation rates observed in controlled clinical trials can be achieved in real-world settings. The rate of drug discontinuation due to adverse effects observed in this naturalistic setting was consistent with that described in prospective studies (7-11%). 3,4This evaluation provides some additional insight on dosing of aripiprazole in a real-world setting. In general, lower doses are being prescribed for children in our setting. Appropriate dosing in children has not been clearly delineated, and weight-based dosing has been proposed. In a case report by Davenport et al., 5 treatment initiation with a standard adult dose of 15 mg caused excessive sedation in a 9-year-old patient. It is evident that more research should be conducted to determine optimal dosing in children.

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