Large-vessel giant cell arteritis fever of unknown origin in a patient with a prosthetic valve

摘要

A 64-year-old male with a mechanical aortic valve was referred with a 4-month history of fever of unknown origin (FUO), weight loss and shortness of breath. His vague headache remained unclear after EEG and imaging. The jaw pain he experienced was diagnosed as a temporomandibular joint dysfunction. Initial extensive diagnostic work-up for infective or blood culture negative endocarditis remained negative. In order to exclude malignancy or inflammatory disease, a ~(18)F-FDG PET CT was performed. This suggested thickening and increased metabolic activity in the wall of the aortic arch, descending aorta, carotid and subclavian arteries.