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Bone sarcoidosis is usually considered a rare manifestation of multisystemic sarcoidosis. With the growing use of more sensitive imaging techniques, such as 18F-FDG PET, the detection rate of bone involvement seems to be increasing. We describe the case of a woman presenting with fatigue and general malaise having multiple bone lesions on 18F-FDG PET. A broad range of differential diagnoses was considered, including malignancy, infections, metabolic diseases and primary bone tumours, which may have delayed the diagnosis. Diagnostic work-up eventually led to an anatomopathological diagnosis of bone sarcoidosis. Immunosuppressive therapy is often necessary since sarcoid bone lesions - even asymptomatic - generally appear in more extensive forms of the disease with other organ involvement.

A 93-year-old patient came to our observation for general malaise, sensory obnubilation, aphasia and dysphagia. He had arterial hypertension in drug treatment. At the first medical contact, the bod...

This paper provides recommendations on the management of complications arising from intravesical treatment with bacillus Calmette-Guerin (BCG) for nonmuscle-invasive bladder tumors. There is minimal recommendations currently available as randomized trials on the side effects of intravesical BCG are lacking and severe complications are usually described in case reports only. All physicians giving intravesical BCG should be aware of the possible complications that could arise and how to treat these. The incidence of bladder irritation, general malaise, and fever is very high, while severe complications remain rare. Approximately 8% of patients have to stop treatment because of these complications. BCG infections and reactions can occur anywhere in the body, and may happen straight away or even several months or years after BCG treatment, making early diagnosis difficult. Additionally, correct diagnosis is hampered by the uncertain appearance of BCG in tissue and body fluid. An essential step in the management complications arising from BCG is written information for both the family doctor and the patient on the possible adverse events and their management. Recent data demonstrated that none of the earlier advocated methods to prevent BCG toxicity are valid: lowering the dose, tuberculostatic drugs, or oxybutynin. Severe complications are treated with three or four tuberculostatics over 3-12 months, depending on the severity of the situation. Corticosteroids are an essential therapy in BCG septicemia. Nonsteroidal anti-inflammatory drugs and corticosteroids can manage efficiently the immunological complications.

A 32-year-old Italian man developed fever and general malaise 3 weeks after arrival in Zaire. Malaria was diagnosed by a thick blood film, but consequent treatment with quinine was unsuccessful. After repatriation, the diagnosis of early stage sleeping sickness was established. Treatment with eflornithine (Ornidyl) resulted in complete recovery.

Chromosome studies were done in 8 males and 18 females who were accidentally exposed for 4 work days (i.e., 8 hr/day) to vapors of ortho dichlorobenzene. The clinical symptoms in 10 individuals included headache, general malaise, dizziness, and nausea. All persons had variable degrees of mucosal irritations. Of the 1345 cells studied, 120 disclosed chromosomal aberrations (mean = 8.92%), whereas a control group of 11 healthy individuals revealed 19 cells with aberrations in 942 cells examined (mean = 2.02%). The main chromosomal alterations were 84 single breaks (6.25%) and 86 double breaks (6.39%). In the control group there were 2 single breaks (0.92%) and 10 double breaks (1.06%), with significant statistic values of P less than .001 for the exposed group. Other chromosomal aberrations were poliploidy and ring formation but these were not statistically significant. Chromosome studies conducted 6 months later in 15 persons of the exposed group disclosed a significant reduction of chromosomal aberrations, but these were still present as compared with the control group. Although definite chromosomal changes occurred, these alterations seemed to be reversible after several months, at least with an original 4-day exposure to the clastogen chemical.

Unstable angina pectoris and feelings of fatigue and general malaise are often mentioned as premonitory symptoms of myocardial infarction. From a psychological point of view these feelings of fatigue and malaise reflect a syndrome of vital exhaustion and depression (VED). A questionnaire which measures this syndrome was given to 3,571 males who participated in a voluntary health check up. It was found that the prevalence of “imminent myocardial infarction,” defined as unstable angina pectoris plus electrocardiographic signs of ischaemia, was more than four times higher among exhausted and depressive persons, than among persons not so affected.

On November 6th 1919, a man aged 24 was admitted to the Ear, Nose and Throat Department of the Sabbatsberg Hospital who after having been troubled during the last week of October with cough and faintness, but no nasal catarrh, had been seized on the 30th of the same month with severe headache and general malaise. Two days later, on November 2nd, his temperature rose to about 39d` C, and both eye-lids on the left side showed a marked swelling. At the same time the vision in the left eye was somewhat impaired the patient seeing surrounding objects blurred. The next day, he vomited, and the eye-lids on the right side became oedematous. That day, November 3rd, the patient was admitted into the Maria Hospital, where he was treated till the 6th, when, as mentioned, he was brought over to the Sabbatsberg Ear clinic.