What can be hidden behind a persistent fever syndrome?

Fever is a defense mechanism of the body that occurs in various pathological situations, most often being secondary to an infectious disease. A prolonged febrile syndrome can hide many clinical problems, thus delaying a correct diagnosis and treatment. We present the case of a 52-year-old patient who addressed with a high fever associated with a generalized skin rash, arthralgia, myalgia and fatigue. Initially, the patient was referred to the infectious disease clinic where numerous paraclinical investigations were performed which ultimately ruled out an infectious cause of fever. Prompt response to corticosteroid therapy after performing numerous combinations of antibiotics, led to a possible autoimmune disease, the patient being redirected to the rheumatology clinic. Following the biological, immunological and radiological investigations, the diagnosis of adult Still’s disease was supported and the corresponding immunosuppressive treatment was initiated with good clinical-biological evolution.