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Am J Med 2010 Jul;123(7):e3

Ned Tijdschr Geneeskd 2003 Sep;147(37):1778-83

Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde, Meibergdreef 9, 1105 AZ Amsterdam.

A 41-year-old man presented with unexplained bleeding from the right tonsil. He subsequently developed periodic fever, cervical lymphadenopathy and hepatosplenomegaly. Despite extensive bacteriological, serological and radiographic investigations for infectious disease, rheumatic disease and malignancy no diagnosis was made. Read More

Am J Med 2002 Mar;112(4):312-3

J R Soc Med 2001 Feb;94(2):84-5

Department of Medicine, York District Hospital, York YO31 8HE, UK.

Ann Hematol 1996 Jul;73(1):39-40

Division of Hematological Oncology, IST, Università di Genoa, Italy.

We report the unusual case of a 43-year-old man with a diagnosis of clinical stage I A mixed cellularity Hodgkin's disease (HD), who relapsed 4 years after diagnosis with exclusive bone marrow involvement and a cyclic variation in body temperature typical of Pel-Ebstein fever. In the absence of clinical and laboratory signs of infection, a restaging of the lymphoma was performed. Total-body CT scan revealed no parenchymal or lymph node involvement, while a bone-marrow biopsy was positive for the presence of Reed-Sternberg cells. Read More

N Engl J Med 1995 Jul;333(1):66-7

N Engl J Med 1995 Feb;332(7):436

Cooper Hospital-University Medical Center, Camden, NJ 08103.

South Med J 1993 Dec;86(12):1424-6

Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614-0622.

We describe a case of fever of unknown origin (FUO) of 9 months' duration in which the finding of regularly spaced multiple Beau's lines (the "ladder nail" sign) pointed to the possibility of a relapsing fever of the Pel-Ebstein variety and an underlying lymphoma. Subsequent investigation confirmed the association of the Beau's lines and fever, as well as the diagnosis of Hodgkin's disease as the cause of the FUO. In this setting, Beau's lines may provide an important diagnostic clue and should be carefully looked for on physical examination. Read More

An Med Interna 1989 Jul;6(7):388-9

Neth J Med 1983 ;26(3):74-6

Scand J Haematol 1979 Nov;23(5):378-80

A 46-year-old man with an aortic valve replacement was investigated for recurrent episodes of fever associated with splenomegaly and haemolytic anaemia. Initially bacterial endocarditis was suspected. At laparotomy he proved to have mixed cellularity Hodgkin's disease confined to the spleen. Read More

Ann Clin Lab Sci 1977 Jan-Feb;7(1):1-5

During lymphomatous diseases, bouts of intermittent or relapsing Pel-Ebstein fever occasionally repeat in remarkably regular tempo resembling the episodes of benign periodic fever. Febrile episodes alone, especially during acute lymphomatous disease, occasionally precede overt evidence of underlying disease for months. In that event, diagnosis and treatment of lymphomas are delayed. Read More

Acta Med Scand 1975 Apr;197(4):311-6

One hundred and four patients with Hodgkin's disease have been studied retrospectively in order to evaluate the relationship between fever associated with the disease (Pel-Ebstein type) and the development of anaemia. In the material 19 episodes of fever were found to be of this type. The mean loss of Hb during a fever period was 14% (range 2-33). Read More

Acta Med Scand 1963 Nov;174:583-8

Arch Intern Med (Chic) 1950 May;85(5):795-805

Prensa Med Argent 1946 Mar;33:441-5