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D C Knockaert

Publications and source records attributed to D C Knockaert.

18 recordsLinked to original sources
PubMed1992

Fever of unknown origin, a literature survey.

This review summarizes the different causes of fever of unknown origin reported in the internationally indexed literature from 1961 till 1990. In 1961 Petersdorf published his landmark report that, for the first time, proposed criteria that cases have to meet to be considered as fever of unknown origin. We only retained cases and series that met these criteria. We meticulously compared the reported case series and tried to explain the differences between these series.

Collagen Diseases↗
PubMed1992

Diagnostic strategy for fever of unknown origin in the ultrasonography and computed tomography era.

Fever of unknown origin strictly defined by Petersdorf in 1961 may be caused by a whole array of conditions. A rational approach should be based upon the relative frequencies of the different causes and their importance for the health and life of the patient. Risks, discomfort and, to a limited degree, costs must be taken into consideration. The investigation protocol we propose takes into account all these factors and is mainly based upon an extensive literature survey and our personal experience with a series of 199 patients studied in the 1980 s.

Clinical Protocols↗
PubMed1992

Fever of unknown origin in the 1980s. An update of the diagnostic spectrum.

OBJECTIVE: To determine the relative proportions of the diagnostic categories in patients with fever of unknown origin who were examined in the 1980s. STUDY DESIGN: Prospective case series. SETTING: General Internal Medicine Service based at University Hospital, Leuven, Belgium. PATIENTS: One hundred ninety-nine consecutive patients meeting the classic criteria of fever of unknown origin who were treated in the 1980s. MAIN OUTCOME MEASUREMENT: The final diagnosis established at discharge or during follow-up. RESULTS: Infections were found in 45 patients (22.6%), tumors were found in 14 (7%), multisystem diseases were found in 42 (21.5%), drug-related fever was found in six (3%), factitious fever was found in seven (3.5%), habitual hyperthermia was found in five (2.5%), miscellaneous diseases were found in 29 (14.5%), and no diagnosis was reached in 51 (25.6%). CONCLUSIONS: Tumors were a less important cause of fever of unknown origin in the 1980s. The same holds true for some infectious diseases, such as abscesses and hepatobiliary disorders. Multisystem diseases were more frequently found, and the number of undiagnosed cases increased. Although these shifts in the disease spectrum in fever of unknown origin most probably resulted from a constellation of factors, we suspect that these changes are mainly due to easy and early diagnosis by new diagnostic modalities, such as ultrasonography and computed tomography, of previously common causes of fever of unknown origin.

Abscess↗
PubMed1991

Massive eosinophilic ascites: differential diagnosis between idiopathic hypereosinophilic syndrome and eosinophilic gastroenteritis.

This paper describes a patient with massive eosinophilic ascites as presenting manifestation probably due to idiopathic hypereosinophilic syndrome. Eosinophilic ascites and stomach wall involvement were the first detected abnormalities. The subsequent course was characterised by interstitial pulmonary disease and pleural and pericardial effusion. Grand mal epilepsy and numbness of the left arm indicated central nervous system involvement. Treatment with corticosteroids resulted in complete remission. The differential diagnosis of eosinophilic gastroenteritis and idiopathic hypereosinophilic syndrome is discussed.

Aged↗
PubMed1991

Palmar fasciitis and arthritis associated with cancer of the prostate.

A case of palmar fasciitis and arthritis (PFA) is described in a man with both a prolactinoma and metastatic cancer of the prostate. This rare condition is mainly described in women with ovarian cancer and our case is the first reported association of PFA with cancer of the prostate.

Carcinoma↗
PubMed1991

Aztreonam-flucloxacillin double beta-lactam treatment as empirical therapy of serious infections in very elderly patients.

Aztreonam, the first monocyclic beta-lactam antibiotic with pure anti-Gram-negative activity, combined with flucloxacillin, a penicillinase resistant penicillin, was given as empirical treatment of 53 serious infections in very elderly people. Eighteen of the cases had positive blood cultures and 11 had a clinical picture of sepsis without positive blood cultures: Of 49 evaluable infections, 45 (92%) were cured. In 40% of the infections, antibiotic treatment could be narrowed after 72 hours to one antibiotic. Diarrhoea, mostly transitory, was the only side-effect. Aztreonam-flucloxacillin combination is a safe and effective empirical treatment regimen for serious infections in very elderly patients.

Aged↗
PubMed1990

Near fatal subacute thallium poisoning necessitating prolonged mechanical ventilation.

The authors describe a case of severe sensory-motor polyneuropathy caused by subacute thallium-intoxication rapidly progressing to respiratory failure due to complete muscle paralysis. After more than 2 months of mechanical ventilation, weaning from the ventilator was possible. Further intensive physical rehabilitation required an additional 6 months hospital stay, and 18 months later, neurological recovery was complete except for the distal lower limbs muscles. The authors discuss the different forms of thallotoxicosis and the present treatment is reviewed. Maximal prolonged therapeutic support should be offered in severe thallotoxicosis because of possible near complete recovery.

Critical Care↗
PubMed1990

Temporal arteritis: the silent presentation and delay in diagnosis.

To determine the frequency of the so-called silent or occult presentation of temporal arteritis (presentation with mere constitutional symptoms) and the resulting delay in diagnosis in this particular group, the medical records of all patients (n = 82) with temporal arteritis or polymyalgia rheumatica, presenting between 1982 and 1988 at the Department of General Internal Medicine of the University Hospital, were retrospectively analysed. Only biopsy-proven cases (n = 34) were studied further. Of the 34 patients with temporal arteritis, 13 (38%) presented with the silent or occult form. In this group the mean delay in diagnosis was 21.5 d (range 2-105) in contrast to a delay of 8.5 d (range 1-40) in the other group (P less than 0.05). Increased awareness of this presentation should lead to earlier diagnosis and treatment of this potentially life-threatening disease, resulting in a shorter hospital stay and fewer technical investigations, with a considerable financial saving.

Aged↗
PubMed1990

Infectious osteitis pubis.

One month after a Burch operation, performed because of urinary stress incontinence, a 65-yr-old woman developed progressive suprapubic pain and a characteristic waddling gait. Initial treatment with bed rest, non-steroidal antiphlogistics and corticosteroids was unsuccessful. Six months later, a biopsy of the symphysis performed because of persisting disabling pain yielded a positive culture of Pseudomonas aeruginosa. A longlasting treatment with intravenously administered antibiotics followed by ofloxacin orally, resulted in complete clinical cure and progressive radiological improvement. The distinction between noninfectious osteitis pubis and infectious symphysitis or osteomyelitis of the pubis is discussed.

Aged↗
PubMed1989

[Septic sacroiliitis].

Three patients are described with septic sacroiliitis caused by Staphylococcus aureus, two occurring spontaneously and a third following septic thrombophlebitis. The diagnosis and treatment of this rather rare disease are discussed based upon our findings and the literature data.

Adolescent↗
PubMed1989

Ankylosing spondylitis. An unusual manifestation of familial Mediterranean fever. Report of a case complicated by amyloidosis and polyneuropathy.

We report a case of familial Mediterranean fever (FMF) with typical clinical and roentgenological findings of ankylosing spondylitis. The spinal involvement in FMF is discussed. A second unusual feature of this case is the occurrence of polyneuropathy which could possibly be ascribed to the slowly evolving amyloidosis during continuous colchicine treatment.

Amyloidosis↗
PubMed1989

Suppurative pylethrombosis: a changing clinical picture.

In 2 patients presenting with fever of undeterminated origin, cryptogenic suppurative pylethrombosis caused by Bacteroides fragilis was diagnosed. Combined antibiotic and anticoagulant therapy resulted in recanalization of the thrombosed vessels. The role of ultrasonography and computed tomography scan in the diagnosis and follow-up of this rare condition is discussed.

Bacteroides Infections↗
PubMed1989

Clinical value of gallium-67 scintigraphy in the investigation of fever or inflammation of unknown origin in the ultrasound and computed tomography era.

Gallium scintigraphy was performed in 54 consecutive patients hospitalized for exploration of fever or inflammation of unknown origin, in whom thorough initial exploration did not yield any clue. Only in 28 patients (51.8%) could a definite diagnosis be established. The positive gallium scintigraphy results were clinically rated as valuable, questionable or valueless according to their contribution to the diagnosis. Gallium scintigraphy was positive in 22 patients (40%) and deemed valuable in 13 patients (24%). A final diagnosis could be ascertained in 77% of the cases with a positive scintigram. In contrast a cause of fever or inflammation was found only in 34% of the cases with a negative scintigram. Gallium scintigraphy is valuable as an early localizing investigation rather than a last resort test in patients with fever or inflammation of unknown origin. A positive scintigram increases the chances of establishing a final diagnosis.

Evaluation Studies as Topic↗
PubMed1989

Ilioinguinal nerve entrapment: a little-known cause of iliac fossa pain.

The ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis. This report describes retrospectively the clinical picture of ilioinguinal nerve entrapment in 32 mainly non-surgical patients. In 14 cases a definite diagnosis was established and in 18 patients the diagnosis was considered probable. The mean delay in diagnosis was 12.8 months. Better knowledge of this syndrome may avoid invasive investigations and be cost saving.

Adolescent↗