Symptomatic arterial hypertension in a patient with fever of unknown origin
Abstract. This article, based on archived data from N.A. Semashko Kursk Regional Clinical Infectious Diseases Hospital, presents a clinical case of symptomatic arterial hypertension in a patient with fever of unknown origin. Arterial hypertension required a comprehensive approach to diagnosis and treatment. The disease began acutely after hypothermia, and previous outpatient treatment was ineffective. According to the research data, the patient was finally diagnosed with acute respiratory viral infection, acute nasopharyngitis (moderate severity), carbuncle of the right kidney, symptomatic arterial hypertension. Despite the ineffectiveness of previous antihypertensive therapy, the medication of enalaprilat resulted in a blood pressure decrease. The patient was recommended further examination and treatment in the urology department. Such clinical situations give rise to a number of additional problems associated not only with an unclear diagnosis and indefinite delay in treatment, but also with a longer hospital stay and a more extensive examination of the patients.A.V. Lukashenko, V.A. Khachatryan, E.V. Khlebodarova
Keywords
symptomatic arterial hypertension
fever of unknown origin
renal carbuncle
References
1. Аксенова А.В., Сивакова О.А., Блинова Н.В., Данилов Н.М., Елфимова Е.М., Кисляк О.А. с соавт. Консенсус экспертов Российского медицинского общества по артериальной гипертонии по диагностике и лечению резистентной артериальной гипертонии. Терапевтический архив. 2021;93(9):1018–1029. (Aksenova AV, Sivakova OA, Blinova NV, Danilov NM, Elfimova EM, Kisliak OA et al. Consensus of experts of the Russian Medical Society for Arterial Hypertension on the diagnosis and treatment of resistant arterial hypertension. Terapevticheskiy arkhiv = Therapeutic Archive. 2021;93(9):1018–1029 (In Russ.)).
EDN HVNZDV. https://doi.org/10.26442/00403660.2021.09.201007
2. Дворецкий Л.И. Лихорадка неясного генеза – междисциплинарная проблема. Медицинский вестник Северного Кавказа. 2018;13(2):422–426. (Dvoretsky LI. Fever of unknown origin is an interdisciplinary problem. Meditsinskiy vestnik Severnogo Kavkaza = Medical Bulletin of the North Caucasus. 2018;13(2):422–426 (In Russ.)).
EDN: UUQUUP. https://doi.org/10.14300/mnnc.2018.13068
3. Покровский А.В., Богатов Ю.П. Вазоренальная гипертония. В кн.: Руководство по артериальной гипертонии. Под ред. Е.И. Чазова, И.Е. Чазовой. М.: МедиаМедика. 2005; с. 95–117. (Pokrovsky AV, Bogatov YuP. Vasorenal hypertension. In: Guidelines for arterial hypertension. Ed. by Chazov EI, Chazova IE. Moscow: MediaMedika. 2005; pp. 95–117 (In Russ.)). ISBN: 5-9900251-3-0.
4. Самсон А.А. Лихорадка неясного генеза: прошлое, настоящее, будущее. Медицина неотложных состояний. 2005;(1):34–39. (Samson AA. Fever of unknown genesis: past, present, and future. Emergency medicine. 2005;(1):34–39 (In Russ.))
5. Хапаев Б.А., Тамбиева З.Н. Симптоматические артериальные гипертензии. Учебно-методическое пособие для обучающихся 4, 5 курсов специальности 31.05.01 «Лечебное дело», 31.05.02 «Педиатрия». Черкесск: БИЦ СКГА. 2023; 60 с. (Khapaev BA, Tambieva ZN. Symptomatic arterial hypertension: An educational and methodological guide for 4.5-year students of specialty 05/31/01 “Medical care”, 05/31/02 “Pediatrics”. Cherkessk: BIC SKGA. 2023; 60 pp. (In Russ.)).
6. Цогоева Л.М., Снопков Ю.П., Лаврова Е.В., Павлова Е.А. Лихорадка неясного генеза (в помощь практикующему врачу). Медицина неотложных состояний. 2014;(5):40–45. (Tsogoyeva LM, Snopkov YuP, Lavrova YeV, Pavlova YeA. Fever of unknown origin (to help the practitioner). Meditsina neotlozhnykh sostoyaniy = Emergency Medicine. 2014;(5):40–45 (In Russ.)). EDN TKTBUP.
7. Чазова И.Е., Жернакова Ю.В. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019;16(1):6–31. (Chazova IE, Zhernakova YuV. Clinical recommendations. Diagnosis and treatment of arterial hypertension. Sistemnyye gipertenzii = Systemic Hypertension. 2019;16(1):6–31 (In Russ.)).
EDN: AEZOAN. https://doi.org/10.26442/2075082X.2019.1.190179
8. Чазова И.Е., Чихладзе Н.М., Блинова Н.В., Белая Ж.Е., Данилов Н.М., Елфимова Е.М. с соавт. Евразийские клинические рекомендации по диагностике и лечению вторичных (симптоматических) форм артериальной гипертонии (2022). Евразийский кардиологический журнал. 2023;(1):6–65. (Chazova IE, Chikhladze NM, Blinova NV, Belaya ZhE, Danilov NM, Elfimova EM et al. Eurasian clinical guidelines for the diagnosis and treatment of secondary (symptomatic) forms of arterial hypertension (2022). Yevraziyskiy kardiologicheskiy zhurnal = Eurasian Journal of Cardiology. 2023;(1):6–65 (In Russ.)).
EDN ZQYNUQ. https://doi.org/10.38109/2225-1685-2023-1-6-65
9. Чихладзе Н.М. Симптоматические (вторичные) артериальные гипертонии: диагностика и лечение. М.: Медицинское информационное агентство. 2018; 168 с. (Chikhladze NM. Symptomatic (secondary) arterial hypertension: Diagnosis and treatment. Moscow: Medical Information Agency. 2018; 168 pp. (In Russ.))
ISBN: 978-5-907098-01-5.
10. Cobb M, Pacitti D. The importance of sodium restrictions in chronic kidney disease. J Ren Nutr. 2018;28(5):37–40.
PMID: 29706262. https://doi.org/10.1053/j.jrn.2018.02.001
11. Egan BM, Kjeldsen SE, Grassi G, Esler M, Mancia G.The global burden of hypertension exceeds 1.4 billion people: Should a systolic blood pressure target below 130 become the universal standard? J Hypertens. 2019;37(6):1148–53.
PMID: 30624370. https://doi.org/10.1097/HJH.0000000000002021
About the Authors
Artem V. Lukashenko, 6 year student of the Faculty of general medicine, Kursk State Medical University, Kursk, Russian Federation.E-mail: artem.lukasheneo.02@bk.ru
ORCID: https://orcid.org/0009-0001-7585-2115
Valentina A. Khachatryan, 6 year student of the Faculty of general medicine, Kursk State Medical University, Kursk, Russian Federation.
E-mail: valentina777.ru@mail.ru
ORCID: https://orcid.org/0000-0002-7134-1959
Elena V. Khlebodarova, MD, PhD (Medicine), associate professor of the Department of internal medicine No. 1, Kursk State Medical University, Kursk, Russian Federation.
E-mail: xlebodarovaev@kursksmu.net
ORCID: https://orcid.org/0009-0006-4041-3848
Similar Articles
