Presenting with Prolonged Fever: Resolution with Anti-inflammatory Treatment

Cheston Berlin, Danielle K. Boal, Richard J. Zaino, Stephen R. Karl

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A patient is described who presented with a 1-month history of daily fever to 38.8°C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver. A liver biopsy specimen showed large nodules that were yellow and gritty in texture. Microscopic examination of biopsy specimens of these nodules showed extensive areas of necrotizing granulomatous inflammation with palisading histiocytes and occasional giant cells surrounded by necrotic foci. There was an associated fibroinflammatory infiltrate. The patient was treated with a nonsteroidal anti-inflammatory agent with prompt cessation of fever. A repeat CT examination of the liver after 14 months of treatment showed only mild hepatomegaly and a normal liver parenchyma. The focal lesions had disappeared. This is a case of hepatic granulomata in a child showing features of necrotizing inflammation.

Original languageEnglish (US)
Pages (from-to)339-342
Number of pages4
JournalClinical Pediatrics
Volume29
Issue number6
DOIs
StatePublished - Jan 1 1990

Fingerprint

Anti-Inflammatory Agents
Fever
Liver
Hepatomegaly
Therapeutics
Inflammation
Biopsy
Histiocytes
Splenomegaly
Arthralgia
Non-Steroidal Anti-Inflammatory Agents
Giant Cells
Exanthema
Granuloma

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Berlin, Cheston ; Boal, Danielle K. ; Zaino, Richard J. ; Karl, Stephen R. / Presenting with Prolonged Fever : Resolution with Anti-inflammatory Treatment. In: Clinical Pediatrics. 1990 ; Vol. 29, No. 6. pp. 339-342.
@article{0ddf5fa87f234aae969b0b49b4f620e2,
title = "Presenting with Prolonged Fever: Resolution with Anti-inflammatory Treatment",
abstract = "A patient is described who presented with a 1-month history of daily fever to 38.8°C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver. A liver biopsy specimen showed large nodules that were yellow and gritty in texture. Microscopic examination of biopsy specimens of these nodules showed extensive areas of necrotizing granulomatous inflammation with palisading histiocytes and occasional giant cells surrounded by necrotic foci. There was an associated fibroinflammatory infiltrate. The patient was treated with a nonsteroidal anti-inflammatory agent with prompt cessation of fever. A repeat CT examination of the liver after 14 months of treatment showed only mild hepatomegaly and a normal liver parenchyma. The focal lesions had disappeared. This is a case of hepatic granulomata in a child showing features of necrotizing inflammation.",
author = "Cheston Berlin and Boal, {Danielle K.} and Zaino, {Richard J.} and Karl, {Stephen R.}",
year = "1990",
month = "1",
day = "1",
doi = "10.1177/000992289002900610",
language = "English (US)",
volume = "29",
pages = "339--342",
journal = "Clinical Pediatrics",
issn = "0009-9228",
publisher = "SAGE Publications Inc.",
number = "6",

}

Presenting with Prolonged Fever : Resolution with Anti-inflammatory Treatment. / Berlin, Cheston; Boal, Danielle K.; Zaino, Richard J.; Karl, Stephen R.

In: Clinical Pediatrics, Vol. 29, No. 6, 01.01.1990, p. 339-342.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Presenting with Prolonged Fever

T2 - Resolution with Anti-inflammatory Treatment

AU - Berlin, Cheston

AU - Boal, Danielle K.

AU - Zaino, Richard J.

AU - Karl, Stephen R.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - A patient is described who presented with a 1-month history of daily fever to 38.8°C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver. A liver biopsy specimen showed large nodules that were yellow and gritty in texture. Microscopic examination of biopsy specimens of these nodules showed extensive areas of necrotizing granulomatous inflammation with palisading histiocytes and occasional giant cells surrounded by necrotic foci. There was an associated fibroinflammatory infiltrate. The patient was treated with a nonsteroidal anti-inflammatory agent with prompt cessation of fever. A repeat CT examination of the liver after 14 months of treatment showed only mild hepatomegaly and a normal liver parenchyma. The focal lesions had disappeared. This is a case of hepatic granulomata in a child showing features of necrotizing inflammation.

AB - A patient is described who presented with a 1-month history of daily fever to 38.8°C. There was no sign of joint pain or swelling and no skin rash. The patient had impressive hepatomegaly without splenomegaly. The only abnormal laboratory test was a sedimentation rate of 120 mm/hr. Ultrasound examination showed hypoechoic foci throughout the liver. These foci were confirmed by CT scan, which showed multiple well-marginated lesions of decreased attenuation and variable size throughout the right and left lobes of the liver. A liver biopsy specimen showed large nodules that were yellow and gritty in texture. Microscopic examination of biopsy specimens of these nodules showed extensive areas of necrotizing granulomatous inflammation with palisading histiocytes and occasional giant cells surrounded by necrotic foci. There was an associated fibroinflammatory infiltrate. The patient was treated with a nonsteroidal anti-inflammatory agent with prompt cessation of fever. A repeat CT examination of the liver after 14 months of treatment showed only mild hepatomegaly and a normal liver parenchyma. The focal lesions had disappeared. This is a case of hepatic granulomata in a child showing features of necrotizing inflammation.

UR - http://www.scopus.com/inward/record.url?scp=0025299661&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025299661&partnerID=8YFLogxK

U2 - 10.1177/000992289002900610

DO - 10.1177/000992289002900610

M3 - Article

C2 - 2361343

AN - SCOPUS:0025299661

VL - 29

SP - 339

EP - 342

JO - Clinical Pediatrics

JF - Clinical Pediatrics

SN - 0009-9228

IS - 6

ER -