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Type B Aortic Dissection Masquerading As Acute Pyelonephritis: Think Beyond Measures.
Anas Ibraheem1,2, Abdullah Abdullah3, Kumari Priyam3
1Internal Medicine, Imamein Kadhimein Medical City, Baghdad, IRQ.
Cureus
|March 19, 2024
Summary
A rare case of aortic dissection (AD) presented atypically with loin pain and fever, mimicking pyelonephritis. Prompt diagnosis and multidisciplinary care are vital for managing this life-threatening condition.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Nephrology
Background:
- Aortic dissection (AD) is a critical condition requiring timely diagnosis for effective treatment.
- Delayed diagnosis of AD can lead to severe complications and increased mortality.
- Atypical presentations of AD pose significant diagnostic challenges for clinicians.
Observation:
- A 64-year-old female with hypertension presented with loin pain and fever, initially diagnosed as pyelonephritis.
- Despite treatment, her condition worsened, showing signs of kidney injury and negative urine cultures.
- Subsequent investigations revealed type B aortic dissection causing renal infarction.
Findings:
- A contrast-enhanced CT scan identified renal infarction due to a thrombus in the abdominal aorta, indicative of type B AD.
- The patient's atypical symptoms, including loin pain and fever, masked the underlying aortic dissection.
- A multidisciplinary team managed the patient with blood pressure control and anticoagulation.
Implications:
- This case highlights the importance of considering AD in patients with unusual symptoms, even when initial diagnoses seem apparent.
- Comprehensive diagnostic approaches, including advanced imaging, are crucial for identifying rare AD presentations.
- A patient-centered, multidisciplinary approach is essential for optimizing outcomes in complex cases of aortic dissection.
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