Paniculitis como manifestación de síndrome febril prolongado en pediatría: Caso clínico

Abstract

Introduction: Fever of unknown origin (FUO) is defined as fever over 7 to 10 days without a diagnosis despite a complete initial study. The most frequent causes are infections, autoimmune and tumors. Even though most cases are self-limited there is a minority that has an underlying etiology with an ominous forecast, encouraging a systematized study. Objective: To report a rare case of a boy who presented fever of unknown origin associated to panniculitis and was diagnosed of subcutaneous panniculitis-like-T cell lymphoma and to emphasis the importance of a sequential study of FUO, in order to reach a diagnosis in patients who need a timely intervention. Clinical case: A ten year old boy, previously healthy, presented subcutaneous nodular lesions of 2 month of evolution, located in abdominal region and extremities, given few symptoms, associated with prolonged fever. He was hospitalized for proper study, in first instance infectious and immune causes were discarded and through lesions biopsy the diagnose of subcutaneous panniculitis-like-T cell lymphoma was reached. Conclusion: When FUO is diagnosed, most prevalent causes must be discarded. Then, differential diagnosis, such as immune and neoplasic etiologies, have to be considered. If FUO is associated to elemental nodular lesions, biopsy must be indicated early, in order to find potential malignant cases, avoiding therapeutic delay.

Subcutaneous Disseminated Nodules in a 13-Year-Old Girl: Answer

“…4 Furthermore, in the last 4 years, 6 cases have been founded in the literature, settling an estimating of 32 cases reported in total, including the new case reported in this study. [5][6][7][8][9][10] Clinically SPTCL is characterized by multiple painless subcutaneous nodules or indurated plaques that varied in diameter and preferentially involved the lower extremities and/or the trunk. 5 In children, it is reported too in the face and neck, as in our patients.…”

“…4 Furthermore, in the last 4 years, 6 cases have been founded in the literature, settling an estimating of 32 cases reported in total, including the new case reported in this study. 5–10…”

Craniopharyngioma as a Cause of Fever of Unknown Origin

“…Fever of unknown origin (FUO) is defined as a body temperature above 38.3°C on at least two occasions and a duration of illness of ≥3 weeks or having multiple febrile episodes over this time, in which the diagnosis has not been established ( 1 ). It has been recorded that no etiology could be determined in 10% to 32% of fever cases ( 2 ).…”

An unusual cause of fever of unknown origin with enlarged lymph nodes—relapsing polychondritis

“…[ 1 ] It was recorded that no etiology could be determined in 10% to 32% of fever cases. [ 2 ] As fever could be an atypical presentation of frequent clinical pictures, identifying the etiological diagnosis for FUO is a great challenge for the clinicians. Although the majority cases with FUO are progressing favorably, about 5% patients have a final ominous prognosis with a neoplastic diagnosis, establishing the importance of cautious differential diagnosis for FUO.…”