“Pyrexia of Unknown Origin” – Differential Diagnosis?

Abstract

A 68-year-old man presented with a 3-week history of pyrexia of unknown origin. He also suffered from malaise, night sweats, rigors and weight loss but had no localizing symptoms. Pyrexia of unknown origin has a wide array of differential diagnoses and it can be challenging to find the correct diagnosis promptly. Examination of the patient indicated pallor and features of long-standing aortic regurgitation, but was otherwise unremarkable. Due to his history of valvular disease and a recent dental extraction, his investigations were tailored towards infective endocarditis. Blood cultures and echocardiography confirmed this diagnosis by Dukes’ criteria. He promptly received antibiotics, made a full recovery and was discharged.