Fever associated with metal device. Case report

Abstract

Metal constructions can cause fever even after a few years post implantation. This paper describes a case of 27 year old female with a fever associated with titanium construction implanted for kyphoscoliosis. 3 years post-operatively she developed afever (up to 39°С) and associated back pain. Examination revealed a hepatomegaly and lymphadenopathy (cervical and inguinal groups). Other investigations showed: neutrophilic leukocytosis (16×109\L), thrombocytosis (620×109\L), elevation of the C-reactive protein (76 ng/ml), ESR (62 mm/h) and ferritin (1615 ng/ml). There were no features of infection, connective tissue disease or hemoblastosis. A short course of therapy with methylprednisolone led to transient improvement. The metal device was surgically removed which caused an immediate elimination of fever and subsequent resolution of leukocytosis, thrombocytosis, lymphadenopathy and hepatomegaly.

Keywords

• fever of unknown origin
• metal device
• hypersensitivity
• inflammation
• immune fever