title: Slowly progressive and painless thoracic aortic dissection presenting with a persistent Fever in an elderly patient: the usefulness of combined measurement of biochemical parameters.
abstract: Aortic dissection is a fatal medical condition that requires urgent diagnosis and appropriate intervention. Because acute aortic dissection often manifests as sudden onset excruciating chest pain, physicians can easily reach a proper diagnosis. However, some patients with aortic dissection present with varied clinical manifestations without exhibiting typical chest pain, leading to a delayed diagnosis and possible fatality. We herein present the case of an elderly subject with a fever of unknown origin who was ultimately diagnosed with aortic dissection. In the present case, a negative procalcitonin test, increased D-dimer and serum creatinine phosphokinase-BB levels, and reelevation of the CPR level led us to the correct diagnosis.
authors.affiliation: Division of Internal Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-Ku, Fukuoka 814-0193, Japan ; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamada
authors.forename: Masanori
authors.initials: M
authors.lastname: Tokumoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ohkuma
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kansui
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Wakisaka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Uchizono
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ooboshi