Skip to main content

Advertisement

Log in

Febrile conditions in rheumatology

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Fever is not the most frequent symptom in rheumatology; however, its occurrence always draws attention to a severe underlying pathologic process. The rheumatologic assessment of febrile patients usually takes place for three reasons: the patient’s fever is associated with known rheumatic disease or musculoskeletal symptoms, or rheumatologic cause is suggested as the underlying cause of fever of unknown origin. The primary task of the rheumatologist is to rule out infections and autoimmune processes. In addition to the musculoskeletal and accompanying symptoms, the information about the course of fever and the observation of the continuity or periodicity of fever provide help to establish the diagnosis. A summarising discourse about this issue is rarely published in this speciality; therefore, we found it important to provide an overview of rheumatological diseases accompanied by fever.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. O’Grady NP, Barie PS, Bartlett JG, Bleck T, Carroll K, Kalil AC, Linden P, Maki DG, Nierman D, Pasculle W, Masur H, American College of Critical Care Medicine; Infectious Diseases Society of America (2008) Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America. Crit Care Med 36:1330–1349

    Article  PubMed  Google Scholar 

  2. Becker JH, Wu SC (2010) Fever—an update. J Am Pediatr Med Assoc 4:281–290

    Google Scholar 

  3. Greisman LA, Mackowiak PA (2002) Fever: beneficial and detrimental effects of antipyretics. Curr Op Infect Dis 15:241–245

    Article  CAS  Google Scholar 

  4. Bernheim HA, Block LH, Atkins E (1979) Fever: pathogenesis, pathophysiology, and purpose. Ann Intern Med 1:261–270

    Google Scholar 

  5. Carpenter CR, Schuur JD, Everett WW, Pines JM (2011) Evidence-based diagnostics: adult septic arthritis. Acad Emerg Med 8:781–796

    Article  Google Scholar 

  6. Margaretten ME, Kohlwes J, Moore D, Bent S (2007) Does this adult patient have septic arthritis? JAMA 297:1478–1488

    Article  PubMed  CAS  Google Scholar 

  7. Ginesty E, Dromer C, Galy-Fourcade D, Bénazet JF, Marc V, Zabraniecki L, Railhac JJ, Fournié B (1998) Iliopsoas bursopathies. A review of twelve cases. Rev Rhum Engl Ed 65:181–186

    PubMed  CAS  Google Scholar 

  8. Shetty AK, Kumar A (2007) Osteomyelitis in adolescents. Adolesc Med State Art Rev 18:79–94

    PubMed  Google Scholar 

  9. Assmann G, Simon P (2011) The SAPHO syndrome—are microbes involved? Best Pract Res Clin Rheumatol 25:423–434

    Article  PubMed  CAS  Google Scholar 

  10. Ahlhelm FJ, Lieb JM, Ulmer S, Sprenger T, Stippich C, Kelm J (2011) Inflammatory diseases of the spinal column and the myelon. Radiologie 51:763–771, In German

    Article  CAS  Google Scholar 

  11. Kanoun ML, Khorbi A, Khmiri C, Tebourbi A, Hadded N, Boughzala W, Ben Maitig M, Chebil M, Hachem A, Essadem H (2007) Diagnosis and treatment of Brodie’s abscess in adults: about twenty cases. Tunis Med 85:857–861

    PubMed  Google Scholar 

  12. Khandaker G, Dierig A, Rashid H, King C, Heron L, Booy R (2011) Systematic review of clinical and epidemiological features of the pandemic influenza A (H1N1) 2009. Influenza Other Respir Viruses 5:148–156

    Article  Google Scholar 

  13. Shah D, Flanigan T, Lally E (2011) Routine screening for HIV in rheumatology practice. J Clin Rheumatol 17:154–156

    PubMed  Google Scholar 

  14. Várvölgyi C, Bubán T, Szakáll S, Hargitai Z, Galuska L, Jeney C, Kakuk G, Gaál J (2002) Fever of unknown origin with seronegative spondyloarthropathy: an atypical manifestation of Whipple’s disease. Ann Rheum Dis 61:377–378

    Article  PubMed  Google Scholar 

  15. Kasitanon N, Sukitawut W, Louthrenoo W (2009) Acute rheumatic fever in adults: case report together with an analysis of 25 patients with acute rheumatic fever. Rheumatol Int 29:1041–1045

    Article  PubMed  Google Scholar 

  16. Zhou WJ, Yang CD (2009) The cause and clinical significance of fever in systemic lupus erythematosus. Lupus 18:807–812

    Article  PubMed  CAS  Google Scholar 

  17. Rovin BH, Tang Y, Sun J, Nagaraja HN (2005) Clinical significance of fever in the systemic lupus erythematosus patient receiving steroid therapy. Kidney Int 68:747–759

    Article  PubMed  CAS  Google Scholar 

  18. Quintana G, Medina YF, Rojas C, Fernandez A, Restrepo JF, Rondon F, Iglesias A (2008) The use of procalcitonin determinations in evaluation of systemic lupus erythematosus. J Clin Rheumatol 14:138–142

    Article  PubMed  Google Scholar 

  19. Amberger CC, Dittmann H, Overkamp D, Brechtel K, Bares R, Kötter I (2005) Large vessel vasculitis as cause of fever of unknown origin (FUO) or systemic inflammation. Diagnosis using 18-F-fluor-2-deoxy-D-glucose positron emission tomography ((18)F-FDG-PET). Z Rheumatol 64:32–39, In German

    Article  PubMed  CAS  Google Scholar 

  20. Lachmann HJ (2011) Clinical immunology review series: an approach to the patient with a periodic fever syndrome. Clin Exp Immunol 165:301–309

    Article  PubMed  CAS  Google Scholar 

  21. Jacobs C, Ciaccio ZE (2010) Periodic fever syndromes. Curr Allergy Asthma Rep 10:398–404

    Article  PubMed  Google Scholar 

  22. Riera E, Olivé A, Narváez J, Holgado S, Santo P, Mateo L, Bianchi MM, Nolla JM (2011) Adult onset Still’s disease: review of 41 cases. Clin Exp Rheumatol 29:331–336

    PubMed  CAS  Google Scholar 

  23. Bálint G, Bálint PV (2004) Felty’s syndrome. Best Pract Res Clin Rheumatol 18:631–645

    Article  PubMed  Google Scholar 

  24. Edrees A (2011) Relapsing polychondritis: a description of a case and review article. Rheumatol Int 6:707–713

    Article  Google Scholar 

  25. Pineton de Chambrun M, Wechsler B, Geri G, Cacoub P, Saadoun D (2011) New insights into the pathogenesis of Behçet’s disease. Autoimmun Rev 11(10):687–698

    Article  PubMed  Google Scholar 

  26. Vardhanabhuti V, Venkatanarasimha N, Bhatnagar G, Maviki M, Iyengar S, Adams WM, Suresh P (2012) Extra-pulmonary manifestations of sarcoidosis. Clin Radiol 3:263–276

    Article  Google Scholar 

  27. Touitou I, Kone-Paut I (2008) Autoinflammatory diseases. Best Pract Res Clin Rheumatol 22:811–829

    Article  PubMed  CAS  Google Scholar 

  28. Farasat S, Aksentijevich I, Toro JR (2008) Autoinflammatory diseases: clinical and genetic advances. Arch Dermatol 144:392–402

    Article  PubMed  CAS  Google Scholar 

  29. Ozen S, Frenkel J, Ruperto N, Gattorno M, Eurofever Project (2011) The Eurofever Project: towards better care for autoinflammatory diseases. Eur J Pediatr 170:445–452

    Article  PubMed  Google Scholar 

  30. Braun-Falco M, Ruzicka T (2011) Skin manifestations in autoinflammatory syndromes. J Dtsch Dermatol Ges 9:232–246

    PubMed  Google Scholar 

  31. Yu JR, Leslie KS (2011) Cryopyrin-associated periodic syndrome: an update on diagnosis and treatment response. Curr Allergy Asthma Rep 11:12–20

    Article  PubMed  CAS  Google Scholar 

  32. Lachmann HJ, Hawkins PN (2009) Developments in the scientific and clinical understanding of autoinflammatory disorders. Arthritis Res Ther 11:212

    Article  PubMed  Google Scholar 

  33. Shaw PJ, McDermott MF, Kanneganti TD (2011) Inflammasomes and autoimmunity. Trends Mol Med 17:57–64

    Article  PubMed  CAS  Google Scholar 

  34. Church LD, Cook GP, McDermott MF (2008) Primer: inflammasomes and interleukin 1beta in inflammatory disorders. Nat Clin Pract Rheumatol 4:34–42

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We express our most sincere gratitude to Dr. Éva Székely for her outstanding help during the writing of this publication.

Disclosures

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G. Speer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tóth, E., Speer, G. Febrile conditions in rheumatology. Clin Rheumatol 31, 1649–1656 (2012). https://doi.org/10.1007/s10067-012-2064-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-012-2064-7

Keywords

Navigation