Korean J Fam Med.  2015 May;36(3):146-149. 10.4082/kjfm.2015.36.3.146.

Advanced Erosive Gout as a Cause of Fever of Unknown Origin

Affiliations
  • 1Department of General Internal Medicine, Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center, Mito, Japan. yasuharu.tokuda@gmail.com

Abstract

A 61-year-old man was referred to our hospital due to a 3-month history of fever of unknown origin, and with right knee and ankle joint pains. At another hospital, extensive investigations had produced negative results, including multiple sterile cultures of blood and joint fluids, and negative autoantibodies. His serum uric acid level was not elevated. However, after admission to our hospital, we performed right knee arthrocentesis, which revealed uric acid crystals. These findings, combined with the results of imaging tests, which showed joint degeneration, led to a diagnosis of advanced erosive gout. After receiving a therapeutic non-steroidal anti-inflammatory drug and a maintenance dose of colchicine for prophylaxis against recurrence, the patient's symptoms subsided and did not return. Advanced erosive gout should be considered a possible cause of fever of unknown origin and diagnostic arthrocentesis should be performed in patients with unexplained arthritis.

Keyword

Advanced Erosive Gout; Fever of Unknown Origin; Inflammatory Arthritis; Uric Acid Crystals

MeSH Terms

Ankle Joint
Arthritis
Autoantibodies
Colchicine
Diagnosis
Fever of Unknown Origin*
Gout*
Humans
Joints
Knee
Middle Aged
Recurrence
Uric Acid
Autoantibodies
Colchicine
Uric Acid
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