Calachanis Marco, Ferrero Paolo, Orzan Fulvio, Marchisio Filippo, Trevi Giampaolo
Cardiology Unit, Molinette Hospital, Turin, Italy.
Ital Heart J. 2003 Nov;4(11):816-8.
Fever of unknown origin is one of the most intriguing issues in clinical practice. One of the most feared diagnoses, especially in patients with known valvular disease, is endocarditis. The differential diagnosis of fever is often complicated by the clinical-pathological overlap between the systemic inflammatory response in different types of pathologies such as infectious, autoimmune or neoplastic disorders. We report a case of a patient presenting with fever, cutaneous nodules and malaise, with a known mitral valve prolapse and moderate regurgitation, in which the diagnosis of Wegener's granulomatosis was finally made.
不明原因发热是临床实践中最具挑战性的问题之一。最令人担忧的诊断之一,尤其是在已知患有瓣膜病的患者中,是心内膜炎。发热的鉴别诊断常常因不同类型病理(如感染性、自身免疫性或肿瘤性疾病)中的全身炎症反应之间的临床病理重叠而变得复杂。我们报告一例患者,该患者有发热、皮肤结节和不适症状,已知患有二尖瓣脱垂和中度反流,最终诊断为韦格纳肉芽肿。