An unusual cause of fever of unknown origin with enlarged lymph nodes—relapsing polychondritis: A case report

Liu, Wei; Jiang, Hongli; Jing, Han; Mao, Bing

A 54-year-old man with a 3-month history of moderate-to-high fever (38.5°C-39.4°C) was referred to West China Hospital of Sichuan University (Chengdu, China) in April 2017. The fever arose without a trace and spiked 3 to 4 times per day with mild headache and dry cough, no chills, notable sweats, sore throat, hoarseness, stridor, arthralgia, dyspnea, nausea, vomiting, abdominal pain, diarrhea or urinary frequency, and urgency were complained. Investigations at another hospital failed to identify the cause. He had no response to any antipyretics and empiric antibiotics for suspected infections. The fever could be relieved by steroid but recurred. He lived in a rural area, worked as a peasant. History of contacts with animals (cows, sheep, insects, etc.), filthy water or food, and people with infectious diseases were denied. Upon admission, the patient was febrile (38.4°C) and diaphoretic. Percussion and auscultation of the lungs reveal no significant abnormality. The remainder of the physical examination was otherwise unremarkable.