Computed tomography in the diagnosis of fever of unknown origin: case report.

Y. Shumskaya, N. Kostikova, D. A. Akhmedzyanova, M. M. Suleymanova, E. Fominykh, M. Mnatsakanyan, R. Reshetnikov
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引用次数: 0

Abstract

Fever of unknown origin (FUO) can be a symptom of at least two hundred diseased. Positron emission tomography-computed tomography (PET/CT) is an informative, but not readily available imaging tool. We present a clinical case of giant cell arteritis where computed tomography (CT) played a key role in the diagnosis. A 61-year-old woman presented to the hospital with a nocturnal fever up to 39,5С, chest and scapular pain, weight loss (10 kg in 3 months). Lymphoproliferative and infectious diseases were excluded. Baseline colonoscopy had revealed erosions in the colonic mucosa, and the patient was admitted to the gastroenterology department with the preliminary diagnosis of ulcerative colitis. Follow-up colonoscopy had excluded this diagnosis. Additional imaging via chest and abdominal CT scan revealed wall thickening of aorta and its branches with subtle contrast enhancement. 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. Despite the fact that CT is not the gold standard for the differential diagnosis of FUO, in this case it assisted in establishing the definitive diagnosis.
计算机断层扫描对不明原因发热的诊断:病例报告。
不明原因发热(FUO)可能是至少200名患者的症状。正电子发射断层扫描计算机断层扫描(PET/CT)是一种信息丰富但不易获得的成像工具。我们报告了一例巨细胞动脉炎的临床病例,其中计算机断层扫描(CT)在诊断中起着关键作用。一名61岁的妇女因夜间发烧高达39.5С、胸部和肩胛骨疼痛、体重减轻(3个月内减轻10公斤)而被送往医院。排除淋巴增生性疾病和传染病。基线结肠镜检查显示结肠粘膜有侵蚀,患者被送入胃肠科,初步诊断为溃疡性结肠炎。随访结肠镜检查排除了这一诊断。胸部和腹部CT扫描的额外成像显示主动脉及其分支的壁增厚,并有细微的对比增强。排除结核性大动脉炎和梅毒性大动动脉炎。患者被诊断为巨细胞动脉炎,累及头臂干、锁骨下动脉和腹腔干。泼尼松龙给药后症状减轻。尽管CT不是FUO鉴别诊断的金标准,但在这种情况下,它有助于确定最终诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
44
审稿时长
5 weeks
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