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- Title
Episodic Fever and Neutropenia in a 22-Year-Old Male.
- Authors
Rongqin Ren; Willis, Monte S.; Fedoriw, Yuri
- Abstract
Clinical History Patient: 22-year-old African-American male Chief Complaint: Episodic fevers History of Present Illness: The patient has experienced episodic fevers regularly for the past 6 months. Initially, the fevers occurred 4-6 weeks apart but have been increasing in frequency in the past 2 months. Each episode reportedly lasts about 3 days, with the fever peaking around 103°F. The fever is accompanied by muscle pain and occasionally sore throat, chills, and night sweats. There is no associated nausea, vomiting, or lymphadenopathy. During the previous 3 weeks, the patient reported a decreased appetite and an unintended weight loss of 10-20 pounds. The fevers typically resolved with acetaminophen, and the patient recently completed several courses of amoxicillin. Past Medical History: The patient was hospitalized approximately 3 weeks prior to this presentation for similar symptoms. At that time, he was noted to have a significantly reduced absolute neutrophil count, which recovered with supportive care. Since his discharge, he has had weekly complete blood counts, all of which have been normal. Social History: The patient is a smoker and drinks rarely. He denies substance abuse issues or recreational drug use. Family History: Non-contributory. Physical Exam Vital Signs: Temperature, 99°F; heart rate, 82 beats per minute; respiratory rate, 16 per minute; blood pressure, 160/80 mmHg. Skin: No rash. Lymph Nodes: No significant submandibular, cervical, or supraclavicular lymphadenopathy. Pulmonary: Clear to auscultation. Principal Laboratory Findings: See Table 1 and Image 1.
- Subjects
BLOOD cell count; BLOOD gases analysis; DIFFERENTIAL diagnosis; ETIOLOGY of diseases; FEVER; NEUTROPHILS; NEUTROPENIA; DIAGNOSIS; THERAPEUTICS
- Publication
Laboratory Medicine, 2010, Vol 41, Issue 12, p708
- ISSN
0007-5027
- Publication type
Case Study
- DOI
10.1309/LM6BBOG1VYT0SFNF