A patient presents to the ED with fever, malaise, and low back pain. What’s the diagnosis?

A 62-year-old-man presented to the emergency department with complaints of fever, malaise, abdominal and low back pain that presented earlier that day. He reported that the abdominal and back pain was very sharp and intense. The patient had a family history of abdominal aortic aneurysm, a personal history of non-small cell lung cancer (NSCLC), and he had taken nivolumab for over 7 months. He presented with these symptoms shortly after receiving a nivolumab infusion earlier that day. On physical examination, fever 100.3°F (37.9°C) and claudication were present. On laboratory examination, the patient had elevated C-reactive protein and ESR, and leukocytosis. The patient denied a history of recent trauma and illicit drug use but uses electronic cigarettes daily.

What’s the diagnosis?

A)     Acute appendicitis

B)     Aortic dissection

C)     Aortitis

D)     EVALI

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