Fever, rash, swollen joints, and sore throat in a young man
Q1: What is the most probable diagnosis?
The most probable diagnosis in this patient is adult onset Still's disease. This patient had fever for more than a week, rash, arthralgia, and leucocytosis fulfilling the four major criteria for the diagnosis of adult Still's disease. He also had minor criteria (lymphadenopathy, sore throat, liver dysfunction, and negative rheumatoid factor, and antinuclear antibodies), thus confirming the diagnosis. The investigations excluded infections, malignancies, and rheumatic diseases. The markedly raised serum ferritin concentration strengthens the diagnosis of adult onset Still's disease.
Adult Still's disease is one of …