Recruitment lecture 12.16.2019

Today at conference we presented a elderly patient with history of aortic dissection presenting with weight loss and fever without other localizing symptoms. Exam revealed hepatosplenomegaly. Extensive workup for infectious, inflammatory and neoplastic etiologies showed pancytopenia, transaminitis, hepatosplenomegaly with some increased FDG uptake on PET CT and reactive changes on BM with noncaseating granulomas. Further workup with AFB blood culture showed infection with Mycobacterium Chimaera – secondary to previous cardiac (on pump) surgery. m chimaera – 12.16

Take home points:

  • A systematic approach to FUO can help elucidate the underlying etiology
  • When the etiology of FUO is determined, it is often due to infection, systemic inflammatory disease or neoplastic
  • M. Chimaera infection should be on the DDx for patients s/p cardiac surgery after 2006 presenting with B symptoms


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