Recurrent Febrile Panniculitis with Respiratory Failure: A Case Report
- 1Department of Dermatology, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China
- 2Department of Pathology, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China
- 3Department of Respiratory and Critical Care Medicine, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China
Abstract
Febrile panniculitis encompasses a heterogeneous group of inflammatory, infectious, and neoplastic disorders, and the historical label Weber-Christian disease should be used only with caution after more specific causes have been excluded. We report a 61-year-old woman with two months of recurrent remittent fever, cough, progressive dyspnea, weight loss, and episodic erythematous lesions that appeared one to two days before each febrile episode and faded with residual hyperpigmentation. Broad infectious and autoimmune investigations were unrevealing, and antibacterial therapy produced no improvement. Hypoxemic respiratory failure worsened during hospitalization, requiring high-flow nasal oxygen. A deep skin biopsy showed mixed septal and lobular inflammation with focal liquefactive fat necrosis and neutrophilic infiltration, supporting acute panniculitis. Her family subsequently reported marked improvement after systemic glucocorticoid therapy, although intermittent recurrence persisted during six months of follow-up. The close temporal coupling of fever and cutaneous inflammation, together with severe respiratory compromise, makes this presentation clinically instructive. However, pulmonary panniculitis could not be established without respiratory-tissue histology. This case supports a pattern-based diagnosis of idiopathic febrile panniculitis rather than uncritical use of an eponym—Weber-Christian disease, and highlights the need for deep biopsy, systematic exclusion of secondary causes, and longitudinal diagnostic reassessment.
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BibTeX
@article{zhang2026recurrent,
title = {{Recurrent Febrile Panniculitis with Respiratory Failure: A Case Report}},
author = {Jing Zhang and Zhangying Jiang and Meiling Chen and Xin Wang},
journal = {Clinical, Cosmetic and Investigational Dermatology},
year = {2026},
month = oct,
doi = {10.2147/ccid.s646484},
url = {https://doi.org/10.2147/ccid.s646484},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Recurrent Febrile Panniculitis with Respiratory Failure: A Case Report
AU - Jing Zhang
AU - Zhangying Jiang
AU - Meiling Chen
AU - Xin Wang
PY - 2026
DA - 2026/10/26
JO - Clinical, Cosmetic and Investigational Dermatology
DO - 10.2147/ccid.s646484
UR - https://doi.org/10.2147/ccid.s646484
AB - Febrile panniculitis encompasses a heterogeneous group of inflammatory, infectious, and neoplastic disorders, and the historical label Weber-Christian disease should be used only with caution after more specific causes have been excluded. We report a 61-year-old woman with two months of recurrent remittent fever, cough, progressive dyspnea, weight loss, and episodic erythematous lesions that appeared one to two days before each febrile episode and faded with residual hyperpigmentation. Broad infectious and autoimmune investigations were unrevealing, and antibacterial therapy produced no improvement. Hypoxemic respiratory failure worsened during hospitalization, requiring high-flow nasal oxygen. A deep skin biopsy showed mixed septal and lobular inflammation with focal liquefactive fat necrosis and neutrophilic infiltration, supporting acute panniculitis. Her family subsequently reported marked improvement after systemic glucocorticoid therapy, although intermittent recurrence persisted during six months of follow-up. The close temporal coupling of fever and cutaneous inflammation, together with severe respiratory compromise, makes this presentation clinically instructive. However, pulmonary panniculitis could not be established without respiratory-tissue histology. This case supports a pattern-based diagnosis of idiopathic febrile panniculitis rather than uncritical use of an eponym—Weber-Christian disease, and highlights the need for deep biopsy, systematic exclusion of secondary causes, and longitudinal diagnostic reassessment.
SN - 1178-7015
ER -