A case record published by the New England Journal of Medicine examines a 19-year-old woman presenting with fever, swollen neck glands, and an abnormally low white blood cell count.
The New England Journal of Medicine has posted a case record from Massachusetts General Hospital detailing the assessment and management of a teenage patient with three distinct symptoms: persistent fever, cervical lymphadenopathy (swollen lymph nodes in the neck), and leukopenia (a lower-than-normal level of white blood cells, which help the body fight infection).
Case records of this kind walk through the clinical reasoning doctors use when faced with overlapping symptoms that could point to several different conditions. A low white blood cell count alongside fever and swollen glands can have all sorts of causes — from viral infections to autoimmune conditions — which is why the case sits at the intersection of haematology (blood disorders) and rheumatology (conditions affecting joints, muscles and the immune system), the two specialities tagged in the journal’s post.
The journal did not summarise the outcome or diagnosis in the tweet itself.
Anyone in the UK experiencing persistent fever, noticeably swollen glands, or unexplained fatigue should contact their GP in the first instance. If symptoms come on suddenly or feel severe, NHS 111 is available by phone or online around the clock. In an emergency, call 999.
Source: @NEJM
Fever, Swollen Glands and a Low White Cell Count: What a New England Journal Case Study Shows Quiz
5 questions