Fever of unknown origin following parathyroidectomy prior to onset of typical polymyalgia rheumatica symptoms: a case report

Figures & data

Figure 1 Course of body temperature and clinical events.

Notes: Pyrexia was not seen on the day of admission. On postoperative day 2, body temperature suddenly rose. Thereafter, pyrexia was controlled with daily administrations of acetaminophen. Three days after discharge, severe pain in both shoulders and morning stiffness suddenly occurred. Body temperature was controlled by daily acetaminophen administration and remained normal after switching to prednisolone.
Abbreviation: P, prednisolone; URTI, upper respiratory tract infection.

Table 1 Blood test findings prior to hospitalization and various time points after admission

Investigation	1 month before	Admission	PD 6	PD 9	PD 14	PD 21	PD 28
WBC (×10^2/L)	5.28	6.30	5.50	6.14	7.66	8.58	12.99
CRP (mg/L)	0.7	68.5	79.8	52.1	112.4	1.7	0.1
ESR (mm/h)	NT	NT	NT	113	NT	36	3

Notes: A blood examination, including CRP, ESR, and WBC, was performed 1 month prior to hospitalization and again at various time points after admission. Increased levels of CRP with no increase in WBC were noted on the day of admission, and then worsened. However, after starting prednisolone on PD 14, the levels of CRP and ESR showed dramatic decreases.

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; NT, not tested; PD, postoperative day; WBC, white blood cell.