Adult onset Still's disease (AOSD) is a rare inflammatory disorder characterized by daily spiking fevers, arthritis and an evanescent rash, typically affecting young adults. We report a case of AOSD complicated by acute respiratory distress syndrome (ARDS). This uncommon presentation of AOSD has been infrequently described in literature.A 33 year old Hispanic male presented with recurrent daily fevers, sore throat and lymphadenopathy. Diagnostic evaluation including lymph node biopsy was negative for infectious causes. His clinical course was complicated by acute respiratory distress syndrome. AOSD was diagnosed based on clinical and laboratory findings. Patient was started on steroids and responded well with resolution of his respiratory failure and fever.AOSD is a rare febrile disorder primarily affecting young patients with varied presentations. Diagnosis is clinical and could be easily missed unless the evaluating physician is aware of both the typical as well as atypical presentations such as ARDS, as was found in our patient. Delayed diagnosis or misdiagnosis may lead to recurrent and prolonged hospitalizations in addition to costly and potentially harmful diagnostic workup and therapeutic interventions.
Adult onset Still's disease (AOSD) is a rare inflammatory disorder characterized by daily spiking fevers, arthritis and an evanescent rash, typically affecting young adults. Nonsuppurative pharyngitis, lymphadenopathy and hepatosplenomegaly are common manifestations. We report a case of AOSD presenting as recurrent daily fevers, sore throat and lymphadenopathy. His clinical course was complicated by acute respiratory distress syndrome, which is an uncommon presentation in AOSD and has been infrequently described in literature. He responded well to steroids.
Venous thromboembolism due to acquired hypercoagulable state in cancer patients is a well-known phenomenon. It is a frequent cause of death in this patient population. Prompt diagnosis and adequate management is needed for these patients to have favorable outcomes. In our patient with severe anemia, diagnosis with pulmonary embolism and subsequent diagnosis of colon cancer highlights the importance of systematic workup and management until a definite diagnosis is obtained.
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