Computed tomography in the diagnosis of fever of unknown origin: A case report
- Authors: Shumskaya Y.F.1, Kostikova N.V.2, Akhmedzyanova D.A.1, Suleymanova M.M.2, Fominykh E.V.2, Mnatsakanyan M.G.2, Reshetnikov R.V.1
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Affiliations:
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies
- The First Sechenov Moscow State Medical University (Sechenov University)
- Issue: Vol 4, No 3 (2023)
- Pages: 393-402
- Section: Case reports
- URL: https://journals.rcsi.science/DD/article/view/254077
- DOI: https://doi.org/10.17816/DD472068
- ID: 254077
Cite item
Abstract
Fever of unknown origin can be a symptom of at least 200 diseases. Positron emission tomography-computed tomography, although highly informative, may not be readily available as an imaging tool. We present a clinical case of giant cell arteritis where computed tomography played a key role in arriving at a diagnosis.
A 61-year-old woman presented to the hospital with a nocturnal fever up to 39.5°С, accompanied by chest and scapular pain, and substantial weight loss (10 kg over 3 months). Lymphoproliferative and infectious diseases were excluded. Baseline colonoscopy had revealed erosions in the colonic mucosa, leading to a preliminary diagnosis of ulcerative colitis, and subsequently, the patient was admitted to the gastroenterology department. Follow-up colonoscopy had excluded this diagnosis. Additional imaging via chest and abdominal computed tomography scan revealed wall thickening of aorta and its branches with subtle contrast enhancement.
Conditions, such as tuberculous aortoarteritis and syphilitic aortitis, were excluded. The patient was diagnosed with giant cell arteritis involving brachiocephalic trunk, subclavian arteries, and celiac trunk. Prednisolone was administered with subsequent reduction in symptoms.
Although computed tomography may not be regarded as the gold standard for the differential diagnosis of fever of unknown origin, this case underscores its valuable contribution in establishing a definitive diagnosis.
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##article.viewOnOriginalSite##About the authors
Yuliya F. Shumskaya
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies
Author for correspondence.
Email: ShumskayaYF@zdrav.mos.ru
ORCID iD: 0000-0002-8521-4045
SPIN-code: 3164-5518
Russian Federation, Moscow
Nina V. Kostikova
The First Sechenov Moscow State Medical University (Sechenov University)
Email: n.kostikowa@yandex.ru
ORCID iD: 0000-0003-3509-7271
SPIN-code: 7962-4554
Russian Federation, Moscow
Dina A. Akhmedzyanova
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies
Email: dina_akhm@mail.ru
ORCID iD: 0000-0001-7705-9754
SPIN-code: 6983-5991
Russian Federation, Moscow
Maria M. Suleymanova
The First Sechenov Moscow State Medical University (Sechenov University)
Email: ashe.danny.jush@gmail.com
ORCID iD: 0000-0002-5776-2693
SPIN-code: 7193-6122
Russian Federation, Moscow
Ekaterina V. Fominykh
The First Sechenov Moscow State Medical University (Sechenov University)
Email: evfominykh@mail.ru
ORCID iD: 0000-0003-3733-4381
Cand. Sci (Med.), Head of the Radiology Department
Russian Federation, MoscowMarina G. Mnatsakanyan
The First Sechenov Moscow State Medical University (Sechenov University)
Email: mnatsakanyan08@mail.ru
ORCID iD: 0000-0001-9337-7453
SPIN-code: 2015-1822
MD, Dr. Sci. (Med), Professor
Russian Federation, MoscowRoman V. Reshetnikov
Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies
Email: reshetnikov@fbb.msu.ru
ORCID iD: 0000-0002-9661-0254
SPIN-code: 8592-0558
Cand. Sci. (Phys.-Math.)
Russian Federation, MoscowReferences
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