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October 11, 1976

Dissecting Aortic Aneurysm Manifested as Fever of Unknown Origin

Author Affiliations

From the Medical Service, Veterans Administration Hospital (Drs Mackowiak, Lipscomb, and Smith), and the departments of internal medicine (Drs Mackowiak, Lipscomb, and Smith) and surgery (Dr Mills), University of Texas Southwestern Medical School, Dallas.

JAMA. 1976;236(15):1725-1727. doi:10.1001/jama.1976.03270160047030

A patient with a dissecting aneurysm of the ascending aorta had fever of unknown origin. Although his clinical picture included a number of classical features of his disorder, these were initially misinterpreted, largely because fever was the patient's chief complaint. Polymorphonuclear leukocytes sequestered within the aortic hematoma probably produced the patient's fever by releasing endogenous pyrogen as they disintegrated. This case emphasizes the protean nature of the dissecting aortic aneurysm, adding yet another distinct clinical manifestation, fever of unknown origin, with which it may be associated.

(JAMA 236:1725-1727, 1976)