Abstract

Abstract Adult-onset Still’s disease (AOSD) is an uncommon autoinflammatory condition with symptoms of fever, rash, arthralgia/arthritis, and multi-organ involvement. Here, we report the case of a young teenage girl, with known rheumatic heart disease on monthly penicillin. She presented with a high-grade fever and a maculopapular rash, with swelling of the preorbital region and extremities for the preceding 4 weeks. She was referred from another hospital with a fever of unknown origin. After an extensive work-up, we diagnosed the patient with AOSD, supported by the Yamaguchi criteria, based on the presenting clinical features, elevated serum ferritin levels, and negative serologic studies, and after ruling out other possible diagnoses, including medication-induced diseases, infectious causes, rheumatic conditions, and malignant causes. The patient was treated with glucocorticoids, and the clinical and laboratory results showed dramatic improvement.

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