i think it is endocarditis (new murmur, fever, embolic event to kidney leading to infarct causing pain) and he should get TEE. PAN is not likely given that he dosen't meet ACR criteria. New varicoceles is adults/elder should raise suspicion of abdominal mailgnancy but his CT dosen't show anything suspicious. Same for HD, nothing on CT and no LNpathy on exam. Rest are unlikely.
Heart is one of the most common cause of renal infarct. Atrial fibrillation, LV thrombus, endocaditis etc. Vascular etiology like renal artery dissection is possible if they have sudden and severe flank pain. This patients renal vessels are normal. renal infarct itself can cause fever. I do think endocarditis is likely in this patient.
i think it is endocarditis (new murmur, fever, embolic event to kidney leading to infarct causing pain) and he should get TEE.
ReplyDeletePAN is not likely given that he dosen't meet ACR criteria.
New varicoceles is adults/elder should raise suspicion of abdominal mailgnancy but his CT dosen't show anything suspicious. Same for HD, nothing on CT and no LNpathy on exam.
Rest are unlikely.
Heart is one of the most common cause of renal infarct. Atrial fibrillation, LV thrombus, endocaditis etc. Vascular etiology like renal artery dissection is possible if they have sudden and severe flank pain. This patients renal vessels are normal. renal infarct itself can cause fever. I do think endocarditis is likely in this patient.
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