Still's disease of the adult, on the subject of a case

Abstract

Still's disease multisystemic inflammatory condition with joint involvement. It can manifest as a prolonged febrile syndrome. The diagnosis is made by exclusion, which implies challenges for the internist and patient. Male patient, 30 years old, from an urban area of ​​the Central department, Doctor. Ex-smoker. Feverish feeling He reports that 35 days before the consultation he presented with an afternoon feverish sensation with chills and occasional cough. Two weeks before the feverish sensation persisted, One week before, holocranial headache, dysphagia and odynophagia. Four days earlier, generalized erythematous and pruritic punctate lesions on all extremities when feverish peaks appeared. Two days before, disabling myalgias. Weight loss, 3kg in a week, L3100 leukocytes, 74% neutrophils, C-reactive protein 24mg / l. slight increase in liver enzymes. Abdominal ultrasound with hepatic steatosis. Spirometry with normal bronchodilator test. GeneXpert for mycobacteria, without relevant laboratory findings, prednisone 75mg / d is started with gradual decrease and suspension in 3 months. Favorable evolution. Until now there is no certainty of the cause, it is suspected as a trigger for infectious causes, which must be ruled out. It is frequent in young people from 16 to 35 years old without predominance over sex. There are no serological markers for diagnosis or prognosis. Good overall prognosis.