Difficulties in Diagnosing a Patient with Fever of Unknown Origin
E. I. Fomina,
E. E. Gubernatorova,
T. V. Adasheva,
T. V. Baturina,
P. S. Samoszhenova,
N. U. Timofeeva https://doi.org/10.20514/2226-6704-2024-14-5-370-380
EDN: NBZCES
Abstract
Fever of unknown origin is a difficult syndrome for differential diagnosis. Absence of a key feature, variety of causes and the lack of single examination algorithm makes difficult further diagnosis. The presented clinical case describes a 53-year-old patient with a prolonged fever of more than 1.5 months, pain syndrome in the facial area. During outpatient monitoring, the cause was not clarified. At the inpatient stage, a comprehensive examination was conducted for all classes of causes. The revealed changes in the thyroid gland and thyrotoxicosis made it possible to diagnose subacute thyroiditis. According to the literature, subacute thyroiditis is one of the rare causes of fever of unknown origin. Prescription of glucocorticosteroid made it possible to achieve complete regression of clinical symptoms in 4 days. After 5 months, subclinical hypothyroidism was achieved. The nosological approach and multidisciplinary interaction contributed to the correct tactics and a favorable outcome of the disease.
Supporting agencies: The authors declare no funding for this study
About the Authors
E. I. Fomina
Federal Budgetary Educational Institution of Higher Education «Russian university of Medicine» of the Ministry of Healthcare of the Russian Federation, Department of Therapy and Preventive Medicine
Russian Federation
Competing Interests:
Russian Federation
Elizaveta I. Fomina — Resident of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
E. E. Gubernatorova
Federal Budgetary Educational Institution of Higher Education «Russian university of Medicine» of the Ministry of Healthcare of the Russian Federation, Department of Therapy and Preventive Medicine
Russian Federation
Competing Interests:
Russian Federation
Ekaterina E. Gubernatorova — Candidate of Medical Sciences, Assistant of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
T. V. Adasheva
Federal Budgetary Educational Institution of Higher Education «Russian university of Medicine» of the Ministry of Healthcare of the Russian Federation, Department of Therapy and Preventive Medicine
Russian Federation
Competing Interests:
Russian Federation
Tatyana V. Adasheva — Doctor of Medical Sciences, Professor of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
T. V. Baturina
Private institution of higher education educational organization Medical University REAVIZ, Department of Internal Medicine
Russian Federation
Competing Interests:
Russian Federation
Tatyana V. Adasheva — Doctor of Medical Sciences, Professor of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
P. S. Samoszhenova
Federal Budgetary Educational Institution of Higher Education «Russian university of Medicine» of the Ministry of Healthcare of the Russian Federation, Department of Therapy and Preventive Medicine
Russian Federation
Competing Interests:
Russian Federation
Polina S. Samozhenova — resident of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
N. U. Timofeeva
Federal Budgetary Educational Institution of Higher Education «Russian university of Medicine» of the Ministry of Healthcare of the Russian Federation, Department of Therapy and Preventive Medicine
Russian Federation
Competing Interests:
Russian Federation
Natalya Yu. Timofeeva — Candidate of Medical Sciences, Associate Professor of the Department
Moscow
Competing Interests:
Co-author of the article Adasheva T.V. is a member of the editorial board of the journal «The Russian Archives of Internal Medicine». The article passed the journal’s peer review procedure. Adasheva T.V. was not involved in the decision to publish this article. The authors did not declare any other conflicts of interest.
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Review
For citations:
Fomina E.I., Gubernatorova E.E., Adasheva T.V., Baturina T.V., Samoszhenova P.S., Timofeeva N.U. Difficulties in Diagnosing a Patient with Fever of Unknown Origin. The Russian Archives of Internal Medicine. 2024;14(5):370-380. https://doi.org/10.20514/2226-6704-2024-14-5-370-380. EDN: NBZCES
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