Still's disease, an important differential diagnosis: Report of a Case

Abstract

Still's disease is a multisystemic inflammatory disorder of unknown cause characterized by episodes of fever, skin rash, arthralgia and mainly myalgias. This is a case of a 24-year-old patient who presented a subacute febrile episode associated with arthralgia, headache, cutaneous maculopapillary lesions, cervical, submandibular, axillary and inguinal lymph nodes. Initial studies reported elevation of acute phase reactants, serum ferritin, liver dysfunction and negative immune profile. The skin biopsy reported signs compatible with erythema multiforme. Initially, multiple differential diagnoses of infectious and autoimmune characteristics were considered. Steroid and symptomatic management was indicated. The patient recovered and was discharged without complications. Still syndrome is discussed as a rare disease that still generates a diagnostic challenge for the clinician.