Computed tomography in the diagnosis of pyrexia of unknown origin

Abstract

A 72-year-old Caucasian man presented to a medical clinic with a 6 month history of weight loss, epigastric discomfort, poor appetite, malaise and night sweats with low grade fever. In recent weeks he had become breathless and tired on minimal exertion, and had slight cough productive of yellow phlegm. He had complained of a peculiar sensation at the back of his mouth, but there was no visible lesion on ENT or dental examination. During the Second World War he had served in Burma and India for 4 years where he had malaria. He had never since travelled outside Europe. He had a left thoracoplasty for pulmonary tuberculosis in 1947. He had been a heavy smoker until he had a myocardial infarct 15 years previously. Since then he had had an aortobifemoral bypass for peripheral vascular disease and a mild stroke from which he had made an excellent recovery. He was taking dipyrimadole, ranitidine and frusemide—this latter for a few days because his ankles had been swollen. He did not drink alcohol.