Korean J Med.  2006 Oct;71(4):442-448.

Treatment with anti-cancer chemotherapy in a patient with fever of unknown origin and progressive pulmonary nodules

• Kim YJ
• Kim S
• Oh MD
• Yoo CG
• Heo DS
• Kim CW
• Bang YJ

Abstract

Classic causes of fever of unknown origin (FUO) are infections, neoplasms, collagen vascular diseases and drugs. However, large studies of FUO have consistently reported that a considerable proportion of patients with FUO remain undiagnosed. We report a patient with a prolonged course of FUO and progressive pulmonary nodules in whom extensive clinical and laboratory evaluation did not reveal specific diagnosis. The patient had recurrent episodes of fever for more than three years, and the pulmonary nodules gradually progressed in size and number despite administration of antibiotics including antifungal and antituberculosis agents. Several pathologic examinations demonstrated an organizing pneumonia or non-neoplastic lung parenchyma with lymphoplasmacytic infiltration only. After a protracted course of disease, we thought that this patient might have lymphoproliferative disorder, possibly EBV-associated, and started anti-cancer chemotherapy. He was successfully treated with eight cycles of chemotherapy including cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP).

Keyword

Fever of unknown origin; Chemotherapy; Lymphoproliferative disorder

MeSH Terms

Anti-Bacterial Agents
Collagen
Cyclophosphamide
Diagnosis
Doxorubicin
Drug Therapy*
Fever of Unknown Origin*
Fever*
Humans
Lung
Lymphoproliferative Disorders
Pneumonia
Prednisolone
Vascular Diseases
Vincristine
Anti-Bacterial Agents
Collagen
Cyclophosphamide
Doxorubicin
Prednisolone
Vincristine