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Pitanje #191976Odgovoreno 9. 12. 2021.
Đorđe Jevtović
Đorđe JevtovićSpecijalista infektologije
Zakažite

Vaši simptomi, uz bolnost mišića grudnog koša mogli bi da ukazuju na epidemijsku pleurodinii, ali trajanje bolesti ne. Pleurodinija spontano prolazi posle nekoliko dana, retko duže traje. Titar Coxackie virus tip B specifičnih antitela jeste visok, ali bez pozitivnih  IgM antitela u akutnoj fazi bolesti, nema serološke dijagnoze. Potrebno je ispitati da li je neki drugi miozitis u pitanju. Trebalo bi uraditi dopunske laboratorijskeanalize, kao npr krvnu sliku, markere zaoaljenja, mišićne enzime(AST, CPK,LDH)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Pitanje #191946Odgovoreno 8. 12. 2021.
Đorđe Jevtović
Đorđe JevtovićSpecijalista infektologije
Zakažite

EBV specifična IgG antitela  imaju svi zdravi ljudi, koji taj virus steknu, najčešće do 5. godine života, ili u zrastu tinejdžera (kissing disease), ređe ksnije. Ako devojka ima pozitivna IgM antitela, onda je to znak skorašnje infekcije i može se povetati sa subfebrilnošću, u suprotnom nije EBV uzročnik. Spontano prolazi

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Pitanje #191922Odgovoreno 7. 12. 2021.
Đorđe Jevtović
Đorđe JevtovićSpecijalista infektologije
Zakažite

nisam znao, ali pronašao u literaturi, u pubmed bazi podataka. Psihogena febrilnost se opisuje ponajviše u Japanu i deluje dosta bezazleno;  leči se anksioloiticima, a antipiretici ne pomažu, evo pročitajte i vi siže tog revijalnog teksta. Drugi autori smatraju da je uvek neophodno isključiti neke inflamatorne bolesti, koje se mogu kriti iza "psyhognic fever"

Temperature 2:3, 368--378; July/August/September 2015; Published with license by Taylor & Francis Group, LLC

 

Takakazu Oka*
Department of Psychosomatic Medicine; Graduate School of Medical Sciences; Kyushu University; Fukuoka, Japan

 

Psychogenic fever:
how psychological stress affects body
temperature in the clinical population

 

Psychogenic fever is a stress-related, psychosomatic disease especially seen in young women. Some patients
develop extremely high core body temperature (Tc) (up to 41C) when they are exposed to emotional events, whereas
others show persistent low-grade high Tc (37–38C) during situations of chronic stress. The mechanism for psychogenic
fever is not yet fully understood. However, clinical case reports demonstrate that psychogenic fever is not attenuated
by antipyretic drugs, but by psychotropic drugs that display anxiolytic and sedative properties, or by resolving patients’
difficulties via natural means or psychotherapy. Animal studies have demonstrated that psychological stress increases
Tc via mechanisms distinct from infectious fever (which requires proinflammatory mediators) and that the sympathetic
nervous system, particularly b3-adrenoceptor-mediated non-shivering thermogenesis in brown adipose tissue, plays an
important role in the development of psychological stress-induced hyperthermia. Acute psychological stress induces a

transient, monophasic increase in Tc. In contrast, repeated stress induces anticipatory hyperthermia, reduces diurnal
changes in Tc, or slightly increases Tc throughout the day. Chronically stressed animals also display an enhanced
hyperthermic response to a novel stress, while past fearful experiences induce conditioned hyperthermia to the fear

context. The high Tc that psychogenic fever patients develop may be a complex of these diverse kinds of hyperthermic

responses.

ima i ovo

Psychogenic fever reflects a phenomenon where core body temperature is high (up to 41°C) or low-grade high (37–38°C) during either acute or chronic stress. Underlying mechanisms are distinct from infection-induced fever and involve the central and sympathetic nervous systems. Psychogenic fever appears a complex psychological, physiological and endocrinological phenomenon.

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