Fever of unknown origin in a Swiss-born child: don’t miss tuberculosis!

  • Melanie Cegielski Pediatric Infectious Diseases Unit, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland.
  • Bernard Vaudaux Pediatric Infectious Diseases Unit, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland.
  • Katia Jaton Institute of Microbiology, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland.
  • David Bervini Department of Neurosurgery, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland.
  • Marie-Helene Perez | marie-helene.perez@chuv.ch Pediatric Intensive Care Unit, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland.

Abstract

Tuberculosis incidence is low in Switzer land. We report here on a Swiss-born toddler. Tuberculosis manifested with a fever of unknown origin, mimicking an inflammatory or autoimmune disorder triggering a high dose of corticosteroid treatment. The disease went unrecognized for several weeks until development of a miliary tuberculosis with advanced central nervous system involvement. This case highlights the difficulties encountered in diagnosing tuberculosis and in identifying the origin of this case. It reminds us that this disease must never be forgotten when facing a child with persistent fever who must be screened for, before starting immunosuppressive therapy.

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Author Biographies

Melanie Cegielski, Pediatric Infectious Diseases Unit, University Hospital and University of Lausanne (CHUV), Lausanne

MD

Department of Pediatrics

Bernard Vaudaux, Pediatric Infectious Diseases Unit, University Hospital and University of Lausanne (CHUV), Lausanne

MD

Department of pediatrics

Katia Jaton, Institute of Microbiology, University Hospital and University of Lausanne (CHUV), Lausanne

MD

Institute of Microbiology

David Bervini, Department of Neurosurgery, University Hospital and University of Lausanne (CHUV), Lausanne

MD

Department of Neurosurgery

Marie-Helene Perez, Pediatric Intensive Care Unit, University Hospital and University of Lausanne (CHUV), Lausanne

MD

Department of Pediatrics

Published
2012-02-28
Section
Case Reports
Keywords:
fever, Swiss, tuberculosis.
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How to Cite
Cegielski, M., Vaudaux, B., Jaton, K., Bervini, D., & Perez, M.-H. (2012). Fever of unknown origin in a Swiss-born child: don’t miss tuberculosis!. Clinics and Practice, 2(2), e36. https://doi.org/10.4081/cp.2012.e36