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A 48-Year-Old Man with Fevers and Weight Loss
C Maxwell Shannon1, Roberto Cavazos1, Cecilia Cai1
1Baylor College of Medicine Internal Medicine Residency Program.
NEJM Evidence
|February 6, 2024
Summary
A 48-year-old man experienced unexplained fevers, night sweats, and significant weight loss. Examination revealed fever, tachycardia, and right upper quadrant abdominal tenderness, prompting diagnostic evaluation.
Area of Science:
- Internal Medicine
- Diagnostic Challenges
Background:
- The case presents a diagnostic dilemma in internal medicine.
- Focuses on evaluating constitutional symptoms like fever and weight loss.
Observation:
- A 48-year-old male reported 3 months of fevers, night sweats, and a 20-pound unintentional weight loss.
- Associated symptoms included a dry cough, but no dyspnea, chest discomfort, or hemoptysis.
- Physical examination findings were fever, tachycardia, and right upper quadrant abdominal tenderness.
Findings:
- The constellation of symptoms suggests a significant underlying pathology.
- Abdominal tenderness points towards potential hepatobiliary or gastrointestinal involvement.
- Constitutional symptoms warrant a broad differential diagnosis.
Implications:
- Highlights the importance of thorough evaluation for unexplained weight loss and fevers.
- Emphasizes the need to consider diverse etiologies in clinical diagnosis.
- Underscores the role of physical examination in guiding diagnostic workup.
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