Abstract

Background: The importace of early dedection and diagnoses of malignant pathologies is well known [1,2]. It gets even more important, a neccessity indeed, when fever is the dominant or the only symptom or when microbic agents are isolated.

Material: The study included 131 cases, admitted at the Infectious Disease Hospital during 1980-2010, age-group 35 - 70 yrs old. Fever represented the dominant or the only symptom related to 17 different types of tumor pathologies.

Methods: We built the etiological and nosologic structure of infectious pathologies [3] that resulted to be wrong diagnoses asociated to the presence of a tumor pathology [4,5]. We also made evidence of clinical and laboratory data that contributed in these misdiagnoses.

Results: Infectious Wrong Diagnoses: Brucellosis: 13 cases with recurrent fever, sweats, joint pain, 9 cases seropositive for Brucella – Diagnosed Tumor: renal carcinoma 2; PNET 1; metastasis 3; lymphoma 3;mesothelioma 1, Hepatocellular Carcinoma (HCC) 1,gastric 1,seminoma 1. Sepsis: 39 cases with continuos /high fever tachicardia; tachipnoe; leucocitosis;13 positive blood cultures( S.aureus 7, S.epidermitis 5, Sh.sonnei 1)-Tumors: Acute Lymphoid Leucosis(ALL) 1,HCC 3,renal 2;surenal 1,billiary tract 2;leucosis 5;lymphoma 4; metastasis with no primary focus 5, mixoma1. Leishmaniasis: 10 cases with intense/high fever, asthenia, weightloss, hepatosplenomegaly; 4 seropositive cases - Tumors: HCC 1,gastric 1, metastasis 1, Chronic Mieloid Leucosis(CML) 1,Hairy Cell Leucosis(HCL) 1,lymphoma 5.Toxoplasmosis: 13 cases with continous/moderate fever, lymphadenopathy, sweats; 7 seropositive cases -Tumors: Non Hodgkin Lymphoma 12, gastric 1. Typhoid fever: 18 cases with continuos fever, hepatoslenomegaly; 5 cases with positive Vidal -Tumors: HCC 5, colon 4, gastric 3; splenic lymphoma 1, ALL 3, CML 2. Dysanteric syndrome: 9 cases with mucus bloody diarrhea and 6 with positive microbial agents (shigela 2, salmonella,trichuris,1, ascarids1,enthamoeba1 ) - Tumors: colon 5, prostatic 1,uterus 2,ovarial 1. Influenza: 2 cases with continuos/high fever, toxicosis, upper respiratory syndrome -Tumors: thyroid cancer 1,bronchial 1.Tonsillofaringitis:3 cases with hyperpirexia, odinophagia, difficulty in speaking and positive cultures: S.aureus1, S.βhemolitik 2.- Tumors: thyroid cancer 1,ALL2.

Conclusion: 1.Tumor fever was associated with clinical syndromes which strongly suggested an Infectious disease in 83% of cases.2.We encountered positivity for infective agents in 35.87% of cases with tumor fever 3.Misdiagnosis was related in all cases with the microbiologic and serologic proof of Infectious Diseases.

Keywords: Tumor Fever; Infectious Nosologies; Misdiagnose

References

1. Jang SJ., et al. “Diagnostic approach and prognostic factors of cancers”. Advances in Anatomic Pathology 18.2 (2011):165-172. 
2. Kim HL., et al. “Paraneoplastic signs and symptoms of renal cell carcinoma: implications for prognosis”. Journal of Urology 170 (2003): 1742-1746. 
3. John Haddon The Etiology of Infectious Diseases”. British Medical Journal 2.1089 (1881): 798. 
4. Song TN., et al. “Misdiagnosis of a small cell lung cancer resulting from inaccurate pathology”. The Annals of Thoracic Surgery 99.5 (2015): e125-e127. 
5. Aurélie Schwingabc., et al “.Leishmania infection: Misdiagnosis as cancer and tumor-promoting potential”. Acta Tropica 197 (2019): 104855.
6. Efstathiou SP., et al. “Fever of unknown origin: discrimination between infectious and non-infectious causes”. European Journal of Internal Medicine 21 (2010): 137-143.
7. B Salzberger., et al. “Dtsch Med Wochenschr [Infections as a Cause of Unexplained Fever 142.13 (2017): 951-960. 
8. Horowitz HW. “Fever of unknown origin or fever of too many origins?” The New England Journal of Medicine 368 (2013): 197-199. 
9. Zell JA and Chang JC. “Neoplastic fever: a neglected paraneoplastic syndrome”. Support Care Cancer 13 (2005): 870-877. 
10. Menkin V. “Chemical basis of fever”. Science 100 (1944): 337-378.
11. Conti B., et al. “Cytokines and fever”. Frontiers in Bioscience 9 (2004): 1433-1449. 
12. Brusch JL and Weinstein L. “Fever of unknown origin”. Medical Clinics of North America 72 (1988): 1247-1261.
13. Chang JC and Gross HM. “Utility of naproxen in the differential diagnosis of fever of undetermined origin in patients with cancer”. The American Journal of Medicine 76 (1984): 597-603.
14. Cunha BA. “Fever in malignant disorders”. Infectious Diseases in Clinical Practice 29 (2004): 335-336. 
15. Petersdorf RG and Beeson PB. “Fever of unexplained origin: report on 100 cases”. Medicine 40 (1961): 1-30.
16. Durack DT and Street AC. “Fever of unknown origin-reexamined and redefined”. Current Clinical Topics in Infectious Diseases 11 (1991): 35-51.
17. Cunha Burke A and Klein Natalie C. “Pseudoinfections”. Infectious Diseases in Clinical Practice: 4.2 (1995): 95-103.
18. Bino S., et al. “Southeastern European Health Network (SEEHN) Communicable Diseases Surveillance: a decade of bridging trust and collaboration”. Emerg Health Threats Journal 6 (2013).
19. WHO. The World Health Report changing history (2004).
20. Petersen LR and Catchpole M. “Surveillance for infectious diseases in the European Union. A small European centre may have an important coordinating role”. British Medical Journal 323 (2001): 818-819.
21. Harrison A., et al. “Can the NHS cope in future”. British Medical Journal 314 (1997): 139-142. 
22. Anderson TV and Mooney G. “The challenge of medical practice variations”. London: McMillan (1990).
23. Acestor N., et al. “Mapping the Aetiology of Non-Malarial Febrile Illness in Southeast Asia through a Systematic Review—Terra Incognita Impairing Treatment Policies”. PLoS one 7.9 (2012): e44269. 
24. Afifi S., et al. “Hospital-Based Surveillance for Acute Febrile Illness in Egypt: A Focus on Community-Acquired Bloodstream Infections”. American Journal of Tropical Medicine and Hygiene 73.2 (2005): 392-399. 
25. Archibald LK and Reller LB. “Clinical Microbiology in Developing Countries”. Emerging Infectious Diseases 7.2 (2001): 302-305. 

Citation

Citation: M Qato., et al. “Infectious Nosologies and Tumoral Fever, A Crucial Alliance". Acta Scientific Medical Sciences 4.3 (2020): 122-126.

Copyright

Copyright: © 2020 M Qato., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.