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Fulltext Prevalence of non-dengue thrombocytopaenia among adult patients presenting with acute febrile illness in primary outpatient clinics

Tong SF, Aziz NA, Chin GL

Medicine & Health, 2006;1(1):25-30.
MyJurnal

A proportion of patients with acute viral fever with thrombocytopaenia does not necessary have dengue infection. Managing them indiscriminately as dengue infection may not be appropriate. The prevalence of this problem is not exactly known. The objective of this study is to determine the prevalence of acute non-dengue febrile thrombocytopaenia among adult patients presenting with acute non-specific febrile illness in an outpatient setting. This was a clinic-based cross sectional study. Consecutive patients presenting with non-specific febrile illness of less than two weeks were selected from the Primary Care Centre of Hospital Universiti Kebangsaan Malaysia (HUKM) and the Batu 9 Cheras Health Clinic. Full blood count was done on the day of visit and dengue serology was done on day five of illness for all patients enrolled. Seventy three patients participated in this study from May to November 2003. Among the patients, 35 (47.9%) were noted to have thrombocytopaenia. Fourteen (40%) patients with thrombocytopaenia were serologically negative. The prevalence of non-dengue febrile thrombocytopaenia was 19.2%. A significant number of patients with acute non-specific febrile illness with thrombocytopaenia were negative for dengue serology. These patients should be differentiated from those with acute febrile thrombocytopaenia, as they might differ in their natural history from those with dengue infection, and hence require different management strategies.

Study site: Primary Care Centre of Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Fever
Epidemiology and short-term outcome of kawasaki disease in Malaysian children

Hung, Liang Choo

Malaysian Journal of Paediatrics and Child Health, 2007;15(1):28-32.
MyJurnal

Background: Kawasaki Disease (KD) and acute rheumatic fever are the two leading causes of acquired heart disease in children in the developing countries. Objectives: To determine the epidemiology of KD and its short-term outcome in Malaysian children. Materials & Methods: A retrospective study of patients with a diagnosis of KD at the Kuala Lumpur Hospital from January 1999 to December 2003. Results: 84 patients with KD were seen over the 5 year period. Of these, 52 (61.90%) were male and 32 (38.10%) female. Malays comprised 51 (60.71%), Chinese 30 (35.71%) and Indian 3 (3.57%). Their ages ranged from 2 months to 11 years 1 month old. There were 25 (29.76%) patients less than one year old, 50 (59.52%) aged 1-4 years, 4 (4.76%) aged 5-7 years and 5 (5.95%) were more than 7 years old. Echocardiographic examination during the acute phase showed that 24 patients (28.57%) had coronary artery dilatation; 23 had mild dilatation and one had giant aneurysm involving both coronary arteries. Echocardiographic examination at 8 weeks showed that 5 (21.74%) of the 23 patients with mildly dilated coronary arteries had resolved; the bilateral giant coronary aneurysms remained the same. There was no death due to KD over the 5 year period. Conclusion: KD occurred most commonly in children aged 1-4 years old with a peak at 17 months. There was male preponderance with a male to female ratio of 1.6:1. Despite immunoglobulin therapy, 29% of patients had coronary artery involvementduring the acute phase; 22% of those with mild coronary artery dilatation resolved at 8 weeks after disease onset.

Matched MeSH terms: Rheumatic Fever
Fulltext Retropharyngeal Abscess: A Seven-Year Review Clinical Presentation, Diagnosis and Management

Medicine & Health, 2009;4(2):84-90.
MyJurnal

This was a retrospective study of operative records between 2000 – 2007 from two ear, nose and throat (ENT) referral centers in Malaysia to review demographic patterns, clinical presentations and management of retropharyngeal abscess (RPA). Our case series comprised of eight patients with five females and three males with a median age at presentation of 47 years. Comorbid factor in this series was diabetes mellitus, with four patients having diabetes. There were three cases of fish bone ingestion. The commonest presentation was dysphagia or odynophagia. None of them had fever. All patients were treated with broad spectrum intravenous antibiotics (IV) and drainage was performed for the abscess. Four patients underwent transoral drainage with three having the cervical approach and one having spontaneous ruptureAll patients recovered well from the infection and only one patient passed away due to septicaemia. In conclusion, patients with retropharyngeal abscess may present with vague symptoms of sore throat, odynophagia without fever due to partial antibiotics treatment. A correct diagnosis should be made so that adequate treatment can be given to prevent mortality.

Matched MeSH terms: Fever
Fulltext Neonatal malaria presenting as neonatal sepsis: a case report

Lim KY, Ang EL, Tan KK, Mustakim S

Malaysian Journal of Paediatrics and Child Health, 2016;22(1):48-57.
MyJurnal

Neonatal malaria may be overlooked likely due to its non-specific features and low prevalence in Malaysia. In this case report, we detail a case of neonatal malaria in an 18-day old baby girl of Myanmar origin who presented with 6 days of intermittent fever but was otherwise well. Initially, she was treated as neonatal sepsis. She then developed thrombocytopaenia and severe anaemia with persistent spikes of temperature. This prompted a series of investigations and multiple changes of antibiotics. The diagnosis of neonatal malaria surfaced when her peripheral blood film incidentally revealed the presence of Plasmodium vivax parasites. Peripheral blood smears are simple and inexpensive. Therefore practising especially in endemic areas for malaria, we need to consider this diagnosis when dealing with neonatal sepsis that does not respond to standard treatment.

Matched MeSH terms: Fever
Fulltext Spontaneous spinal subarachnoid haemorrhage: a rare complication of dengue fever

Nur Hidayati Mohd Sharif, Nor Arisah Misnan, Norashikin Saidon, Phaik Yee Ooi, Hilwati Hashim

Journal of Clinical and Health Sciences, 2017;2(2):54-57.
MyJurnal

A 37-year-old woman presented with a short history of fever and bilateral lower limb
weakness. She also had impaired sensory function up to T4 spine level and lax anal tone.
Laboratory investigations confirmed dengue infection with mild thrombocytopenia. MRI of the
spine showed a spinal subarachnoid haemorrhage from the level of T4 till T9. Despite
medical and surgical interventions, her lower limb weakness persists. A high index of
suspicion is needed to recognise dengue-related neurological complications. This diagnosis
should be considered in any patients from dengue endemic areas presenting with acute
febrile illness with atypical neurological manifestations.

Matched MeSH terms: Fever
Fulltext Expression of recombinant E1 Glycoprotein of Chikungunya virus in Baculovirus expression system

Sum, Magdline Sia Henry, Andrew, Anna, Maling, Milda Aren

Journal of Biochemistry, Microbiology and Biotechnology, 2015;3(1):26-29.
MyJurnal

Chikungunya is an acute febrile illness caused by chikungunya virus (CHIKV). In this study, the envelope E1 gene of CHIKV was cloned and expressed in a baculovirus system. The recombinant E1 protein with N-term 6-His residues protein was successfully expressed and purified as confirmed by SDS-PAGE and western blot analysis. The seroreactivity of the recombinant protein was evaluated in immunoassay for anti-CHIKV IgM and IgG antibodies. The recombinant antigen showed 69% sensitivity and 100% specificity for anti-CHIKV IgG by dot blot assay. Detection of anti-CHIKV IgM by dot assay showed 79% sensitivity and 100% specificity. No cross reactivity of the antigen was observed with anti-dengue virus serum samples. The results strongly support that the recombinant E1 protein has potential to be used as diagnostic antigen. The used of the antigen in a dot blot assay gives an advantage for laboratory detection without the need of any specialised equipment.

Matched MeSH terms: Chikungunya Fever
A 6-year safety surveillance of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in South Korea

Lee SM, Lee JH, Song ES, Kim SJ, Kim JH, Jakes RW, et al.

Hum Vaccin Immunother, 2018 Aug 07.
PMID: 30084702 DOI: 10.1080/21645515.2018.1502525

In 2010, Korea introduced 10-valent pneumococcal conjugate vaccine for children aged 6 weeks to 5 years against invasive disease caused by Streptococcus pneumoniae serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F and cross-reactive 19A. The aim of this 6-year real-world study of 646 healthy Korean children from 16 centers vaccinated in routine practice is to monitor vaccine safety, as per Ministry of Food and Drug Safety regulations. Around 50% had a past or existing medical condition, 19.3% an existing condition and 7.6% received concomitant medication). Total of 489 recorded adverse events (AEs) were reported in 274 infants; 86% were mild and the rest moderate, only three were reported as serious. Most AEs (97.8%) were not related to vaccination; one case of injection-site swelling and of fever was related, two cases of fever were probably related, five cases of fever and one case each of diarrhea and coughing were possibly related. None of the serious AEs were related to vaccination. Of 11 adverse drug reactions (ADRs) in 10 subjects, none were serious. Overall, 263 subjects (40.7%) received medication (mainly antibiotics or antipyretics) for the treatment of an AE, of which 6 subjects were treated for an ADR. There was no difference in the incidence of AEs according to age, sex or concomitant vaccination. Subjects with an existing medical condition had significantly more AEs than those without any conditions (p = 0.03), but no differences regarding ADRs. Four-dose vaccination with PHiD-CV appears to have a clinically-acceptable safety profile for Korean children. ClinicalTrials.gov identifier: NCT01248988.

Matched MeSH terms: Fever
Adult diphtheria in Malaysia: A case report

Loganathan T, Mohamed PY

Med J Malaysia, 2018 10;73(5):340-341.
PMID: 30350821 MyJurnal

In November 2016, a 28-year-old Malay man presented to the emergency department in respiratory distress, with a history of fever and sore throat. A clinical diagnosis of acute diphtheria was made and the patient was isolated and ventilated in the intensive care unit, and received diphtheria antitoxin and intravenous antibiotics. Initial laboratory findings failed to confirm diphtheria, leading to discontinuation of antibiotics and quarantine. Public health measures were reinstated after a reference laboratory cultured Corynebacterium diphtheriae. Although there was no contact with ill persons, investigation revealed incomplete immunisation history, and injection of high dose steroids prior to onset of symptoms.

Matched MeSH terms: Fever
Fulltext Study of Ebola virus outbreak dynamics, impact of vaccination and other preventive measures on transmission control

Che Ismail Che Noh, Fox, Anthony William

Borneo Journal of Medical Sciences, 2018;12(2):9-18.
MyJurnal

Ebola virus disease (EVD) is an emerging and remerging zoonosis associated with high fatality rate, mainly caused by the Zaire Ebola virus (ZEBOV) and Sudan Ebola virus (SEBOV) strains. Approximately 20 epidemics of EVD have been documented mainly in Central African countries since 1976. Currently, there are no therapeutics agents and vaccines yet approved for EVD. However, several promising therapeutics and vaccines candidates are actively undergoing various phase of clinical development. This study aims to study the EVD dynamics and evaluate the potential impacts of vaccines and other preventive measures on EVD transmission control and significance of medical intervention on outcome of the disease. An initial branch chain model of EVD dynamics was built based on data obtained from previous study. Different epidemiological scenarios for EVD with impacts of intervention were simulated using Berkeley-Madonna Version 8.3.18 software. Every reduction in the exposure rate of EBV infection by 10% produces two- to five-fold improvement in protection against EVD. Transmission control is optimum when the rate of exposure to EBV infection is reduced below 1%. Optimal control of EVD transmission can be achieved through strategic implementation of successful vaccination programme, and other preventive measures as well as rapid delivery of supportive medical care.

Matched MeSH terms: Hemorrhagic Fever, Ebola
Fulltext Knowledge and Concerns of Parents Regarding Childhood Fever at a Public Health Clinic in Kuching, East Malaysia

Bong WT, Tan CE

Open Access Maced J Med Sci, 2018 Oct 25;6(10):1928-1933.
PMID: 30455776 DOI: 10.3889/oamjms.2018.339

BACKGROUND: Parental anxiety regarding fever may be unwarranted as most cases are owing to self-limiting causes.
AIM: To assess the level of knowledge and concerns regarding childhood fever among parents with young children in a public health clinic in Kuching, East Malaysia.
METHODS: This cross-sectional study was conducted among parents recruited from a maternal and child health clinic, with children aged 6 months to 6 years. The participants completed a self-administered questionnaire regarding their knowledge and concerns about childhood fever. Descriptive statistical analyses were performed, and associations between dependent and independent variables were determined.
RESULTS: Only 26.1% of participants were found to have good knowledge. Knowledge regarding childhood fever was significantly associated with parent's ethnicity, education level, and household income. About 72% of parents were always worried about their child's illness. Three major reasons for their concerns were persistently rising temperature; discomfort caused by the fever, and feared complications of fever.
CONCLUSION: Excessive parental anxiety due to poor knowledge and misconceptions about fever may lead to poor quality of life and inappropriate management of fever. Healthcare providers may help by educating parents about fever and serious signs that indicate the need to seek healthcare advice.

Matched MeSH terms: Fever
Fulltext Self-Medication Among King Khalid University Students, Saudi Arabia

Alshahrani SM, Alavudeen SS, Alakhali KM, Al-Worafi YM, Bahamdan AK, Vigneshwaran E

Risk Manag Healthc Policy, 2019;12:243-249.
PMID: 31814786 DOI: 10.2147/RMHP.S230257

Purpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia.
Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia.
Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study.
Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended.

Matched MeSH terms: Fever
Countries at risk of importation of chikungunya virus cases from Southern Thailand: A modeling study

Tuite AR, Watts AG, Khan K, Bogoch II

Infect Dis Model, 2019;4:251-256.
PMID: 31667444 DOI: 10.1016/j.idm.2019.09.001

Southern Thailand has been experiencing a large chikungunya virus (CHIKV) outbreak since October 2018. Given the magnitude and duration of the outbreak and its location in a popular tourist destination, we sought to determine international case exportation risk and identify countries at greatest risk of receiving travel-associated imported CHIKV cases. We used a probabilistic model to estimate the expected number of exported cases from Southern Thailand between October 2018 and April 2019. The model incorporated data on CHIKV natural history, infection rates in Southern Thailand, average length of stay for tourists, and international outbound air passenger numbers from the outbreak area. For countries highly connected to Southern Thailand by air travel, we ran 1000 simulations to estimate the expected number of imported cases. We also identified destination countries with conditions suitable for autochthonous CHIKV transmission. Over the outbreak period, we estimated that an average of 125 (95% credible interval (CrI): 102-149) cases would be exported from Southern Thailand to international destinations via air travel. China was projected to receive the most cases (43, 95% CrI: 30-56), followed by Singapore (7, 95% CrI: 2-12) and Malaysia (5, 95% CrI: 1-10). Twenty-three countries were projected to receive at least one imported case, and 64% of these countries had one or more regions that could potentially support autochthonous CHIKV transmission. The overall risk of international exportation of CHIKV cases associated with the outbreak is Southern Thailand is high. Our model projections are consistent with recent reports of CHIKV in travelers returning from the region. Countries should be alert to the possibility of CHIKV infection in returning travelers, particularly in regions where autochthonous transmission is possible.

Matched MeSH terms: Chikungunya Fever
Fulltext Tc99m-besilesomab with the added benefit of Single Photon Emission Computed Tomography/Computed Tomography (spect/ct): current role in infection detection and localisation

Farahnaz Mohamed Aslum Khan, Siti Zarina Amir Hassan, Noor Khairiah A. Karim, Khadijah Abdul Hamid, Leong, Chee Loon

Malaysian Journal of Medicine and Health Sciences, 2018;14(201):1-8.
MyJurnal

Imaging modality has become increasingly important in hospital setting especially in cases of unknown site of infection/pyrexia of unknown origin (PUO) and osteomyelitis (OM). In recent years, nuclear imaging has been used and is known to deliver prompt and precise diagnoses of numerous infectious diseases. The purpose of the study is to detect and localise the site of infection using Tc99m-besilesomab and to assess the added contributions of single photon emission computed tomography/computed tomography (SPECT/CT) over planar scan in patients with PUO and OM. Methods: Tc99m-besilesomab with SPECT/CT were prospectively performed in 23 patients (eight males, 15 females) with suspected infection. True findings were diagnosed by both cold and hot spot in the scan with reference to positive blood or tissue cultures, or other additional imaging. Results: Tc99m-besilesomab managed to detect presence of infection with high sensitivity of 87.5% and specificity of 71.4%. Interobserver variability agreement that was obtained between the presence of infection and the ability of Tc99m-besilesomab imaging to detect it was significant (p

Matched MeSH terms: Fever
Peri-oral bullous impetigo: a diagnostic dilemma for dentist

Zakaria A, Sockalingam S

Sains Malaysiana, 2013;42:89-91.

Bullous impetigo is a highly contagious skin infection commonly affecting children due to epidermolytic toxins of bacteria Staphylococcus sp. This presentation described a case of a 3 year-old Indian girl with bullous lesion around the peri-oral region. The lesion was initially thought to be of viral origin and was treated symptomatically. However, the lesion progressed without any resolution with more vesicles at distant sites. The patient was also having fever and refused any oral intake. At this point, a probable diagnosis of bacterial skin infection was considered and the patient was admitted. Intra-venous fluid was administered to rehydrate the patient and she was treated with topical antibiotic and antipyretic. The lesion resolved within 14 days without scarring. As dental practitioners, we should be aware of bacterial infection around the peri-oral region and consider it as part of a differential diagnosis so that an appropriate treatment can be given.

Matched MeSH terms: Fever
Quantitative HPLC analysis of gallic acid in benincasa hispida prepared with different extraction techniques

Fatariah Z, Zulkhairuazha TT, Wan Rosli W

Sains Malaysiana, 2014;43:1181-1187.

Ash gourd (Benincasa hispida, Bh) is traditionally claimed useful in treating asthma, cough, diabetes, haemoptysis and hemorrhages from internal organs, epilepsy, fever and balancing of the body heat. One of the major phenolic acids presented in Benincasa hispida is gallic acid, a phenolic compound which is linked with its ability in reducing Type II diabetes. The aim of the present study was to investigate the effect of different extraction techniques on the concentration of gallic acid in Bh. The Bh extracts were prepared with three different techniques namely; fresh extract (FE), low heating (LH) and drying and heating (DH). The gallic acid has been detected and quantified using high performance liquid chromatography (HPLC) coupled with uv-Vis detector. The amount of gallic acid detected in FE, LH and DH were 0.036, 0.050 and 0 272 mg1100 g, respectively. The limits of detection was 0.75 liglmL while the limit of quantification and recovery were 2.50 liglmL and 95 .53% , respectively. In summary, HPLC technique coupled with vv detector systems able to quantify gallic acid in Bh extracts. The gallic acid were present at higher concentration in Bh extracted using drying and heating, followed by low heating and fresh extract methods.

Matched MeSH terms: Fever
Fulltext Filariasis

Mak JW

Family Practitioner, 1982;5(3):23-26.

Brugia malayi and Wuchereria bancrofti infections cause lymphatic filariasis in Malaysia. About 2.5 million people live in endemic areas of filariasis, of whom 5% have microfilaraemia and probably twice as many are infected. There is a wide clinical spectrum of response to the infection. While some have asymptomatic microfilaraemia, others have episodic attacks of fever, lymphadenitis, retrograde lymphangitis and lymphoedema. Elephantiasis is a late complication. Tropical pulmonary eosinophilia and other forms of occult filariasis are due to hyper allergic reactions to microfilarial antigens. Parasitological and serological tests aid in confirming the clinical diagnosis. The drug of choice is diethylcarbamazine citrate.

Matched MeSH terms: Fever
Fulltext The mystery of 'saturation gap': a case of dapsone-induced methaemoglobinemia in a pregnant mother with leprosy

Tang ASO, Yeo ST, Teh YC, Kho WM, Chew LP, Muniandy P

Oxf Med Case Reports, 2019 Jan;2019(1):omy111.
PMID: 30697428 DOI: 10.1093/omcr/omy111

Limited data regarding methemoglobinemia in pregnancy, particularly secondary to dapsone is available up to date. We report a case of dapsone-induced methemoglobinemia in a pregnant mother with multibacillary leprosy who presented with fever, productive cough and cyanosis of 2 days duration 2 weeks after multidrug therapy was commenced. On examination, she had central cyanosis with low oxygen saturation (SpO2 = 84-88%). Arterial blood gas analysis showed PO2 of 111 mmHg and SO2 of 98 mmHg. Patient was administered 100% oxygen inhalation, but there was no improvement in cyanosis. Vitamin C (1000 mg/day) was prescribed. Dapsone was replaced by ofloxacin 200 mg twice daily. There was a gradual increase in SpO2 level. She delivered a healthy baby. In conclusion, clinicians should be aware of the side effects of dapsone and know how to promptly manage any undesirable events. Ofloxacin is a safe and feasible alternative in replacement of dapsone in pregnancy.

Matched MeSH terms: Fever
Fulltext An evaluation of subcritical hydrothermal treatment of end-of-pipe palm oil mill effluent

Lee ZS, Chin SY, Cheng CK

Heliyon, 2019 Jun;5(6):e01792.
PMID: 31245637 DOI: 10.1016/j.heliyon.2019.e01792

This study evaluates the effects of subcritical hydrothermal treatment on palm oil mill effluent (POME) and its concomitant formations of solid hydrochar, liquid product and gaseous product. The reactions were carried out at temperatures ranged 493 K-533 K for 2 h. The highest reduction of chemical oxygen demand (COD) and biochemical oxygen demand (BOD) were 58.8% and 62.5%, respectively, at 533 K. In addition, the removal of total suspended solids (TSS) achieved up to 99%, with the pH of POME reaching 6 from the initial pH 4. The gas chromatography coupled with mass spectroscopy (GC-MS) analysis showed that the fresh POME contained n-Hexadecanoic acid as the dominant component, which gradually reduced in the liquid product in the reaction with increased temperature, in addition to the attenuation of carboxyl compounds and elevation of phenolic components. The gaseous products contained CO2, CO, H2, and C3 - C6 hydrocarbons. Traces of CH4 were only found at 533 K. CO2 is the dominant species, where the highest of 3.99 vol% per 500 mL working volume of POME recorded at 533 K. The solid hydrochars showed negligible morphological changes across the reaction temperature. The O/C atomic ratio of the hydrochar range from 0.157 to 0.379, while the H/C atomic ratio was in the range from 0.930 to 1.506. With the increase of treatment temperature, the higher heating value (HHV) of the hydrochar improved from 24.624 to 27.513 MJ kg-1. The characteristics of hydrochar make it a fuel source with immense potential. POME decomposed into water-soluble compounds, followed by deoxygenation (dehydration and decarboxylation) in producing hydrochar with lower oxygen content and higher aromatic compounds in the liquid product. Little gaseous hydrocarbons were produced due to subcritical hydrothermal gasification at low temperature.

Matched MeSH terms: Fever
Fulltext Necrotizing fasciitis of the upper back presenting with left shoulder pain

Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF

Clin Pract, 2020 Mar 31;10(1):1218.
PMID: 32373307 DOI: 10.4081/cp.2020.1218

Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.

Matched MeSH terms: Fever
Fulltext Adult-onset Still's disease: a case report

Ong PS, Sulaiman W

Oman Med J, 2011 Sep;26(5):e022.
PMID: 28845225 DOI: 10.5001/omj.2011.96

Adult-onset Still's disease (AOSD) is a rare clinical entity with unknown etiology, characterized by arthritis, fever, evanescent rash and other systemic presentations. This report described a 45-year-old male who presented with sore throat, fever, arthritis, evanescent rash, raised liver enzymes and hyperferritinemia. He was diagnosed to have AOSD based on Yamuguchi criteria after the exclusion of other potential diagnoses. The patient partially responded to combined celecoxib and prednisolone. He was also prescribed methotrexate and his symptoms improved.

Matched MeSH terms: Fever

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