Takayasu arteritis manifesting as pyrexia of unknown origin and massive splenomegaly.
Saubhagya Kumar Rout, Sourav Ranjan Parija, Anup Diliprao Bhuskat et al.
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Case in brief
A male patient in his early 20s presented with a three-month history of pyrexia of unknown origin, significant weight loss, a left carotid bruit, and massive splenomegaly. CT angiography revealed concentric mural thickening and stenosis of the aorta and its major branches, leading to a diagnosis of Type V Takayasu arteritis. Following immunosuppressive therapy, the patient became apyrexial and his constitutional symptoms resolved.
What made this case unusual
The case is notable for the atypical presentation of Takayasu arteritis in a male patient, characterized by prolonged high-grade fever and massive splenomegaly, which are uncommon features of this condition.
Diagnostic / clinical pearl
Clinicians should consider Takayasu arteritis in cases of pyrexia of unknown origin, especially when accompanied by significant splenomegaly, even in male patients.
Why it matters
This case emphasizes the importance of thorough vascular evaluation in patients with unexplained chronic fever, which can lead to timely diagnosis and management of rare conditions like Takayasu arteritis.