The 510th case: fever of unknown origin, acute kidney injury
10.3760/cma.j.cn112138-20240508-00293
- VernacularTitle:第510例——不明原因发热，急性肾损伤
- Author:
Yiran SHOU
1
;
Yulin MAI
;
Fuping GUO
;
Hua ZHENG
;
Congwei JIA
;
Xiaoyuan LI
;
Zhengyin LIU
;
Taisheng LI
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院感染内科，北京 100730
- Publication Type:Journal Article
- Keywords:
Fever of unknown origin;
Acute kidney injury;
Renal neoplasms
- From:
Chinese Journal of Internal Medicine
2025;64(1):83-87
- CountryChina
- Language:Chinese
-
Abstract:
A 65-year-old male was admitted to Peking Union Medical College Hospital. The patient had intermittent fever for 2 months with a maximum body temperature of 39.3 ℃ and elevated serum creatinine levels for 1 week. He had no other suggestive symptoms or positive signs. Laboratory test results suggested acute kidney injury and a sharp elevation in serum lactic dehydrogenase levels. Abdominal enhanced computed tomography (CT) revealed multiple low-density lesions, and further biopsy pathology demonstrated chronic inflammation. Thereafter, positron emission tomography (PET)/CT showed abnormally elevated uptake value for the bones throughout the entire body, in addition to the liver and brain. Repeated bone marrow biopsy finally confirmed metastatic bone cancer, which possibly originated from the kidney according to immunohistochemical staining. In this rare case of fever of unknown origin, the primary lesion was a renal tumor with bone, liver, and brain metastases. Enhanced CT and PET/CT provided negative results, and the diagnosis was eventually confirmed by repeated bone marrow pathology.
