Hospital Universitario 12 de Octubre, Madrid, Spain.
Rev Esp Cardiol. 2010 May;63(5):602-6. doi: 10.1016/s1885-5857(10)70123-7.
Few studies have investigated fever secondary to underlying acute aortic dissection. A retrospective analysis of 59 patients was carried out. Diagnostic criteria for fever secondary to underlying aortic dissection were defined. Five patients had a clinical presentation consistent with inflammatory fever due to acute aortic dissection. The main features were: fever occurred within the first 48 hours, the variability in body temperature was significantly less than with infectious fever (P=.015), episodes of fever did not affect the patient's general clinical condition, microbiological tests gave negative results, there was no response to empirical antimicrobial treatment, and fever disappeared within 24 hours in those treated with indomethacin. In conclusion, fever due to acute aortic dissection has distinct characteristics that enable it to be distinguished from infectious fever. Good management of this condition should not involve unnecessary diagnostic tests, the inappropriate use of antimicrobials, or a delay in applying the therapeutic measures necessary to treat the underlying aortic dissection.
鲜有研究调查过潜在急性主动脉夹层引起的发热。对 59 例患者进行了回顾性分析。定义了潜在主动脉夹层引起的发热的诊断标准。5 例患者的临床表现符合因急性主动脉夹层引起的炎症性发热。主要特征为：发热发生在最初的 48 小时内，体温变化显著小于感染性发热（P=.015），发热发作不影响患者的一般临床状况，微生物学检查结果为阴性，经验性抗菌治疗无效，并且在使用吲哚美辛治疗的患者中，发热在 24 小时内消失。总之，急性主动脉夹层引起的发热具有独特的特征，可以与感染性发热相区别。这种情况的良好管理不应涉及不必要的诊断性检查、不适当的使用抗菌药物或延迟应用治疗潜在主动脉夹层所需的治疗措施。
