Aging Condition with a Novel Presentation
By
Hadi Roudsari
Gurpreet Dhaliwal
Anand D. Jagannath
Alan H. Baik
Sam Brondfield
September 28, 2026
Clinical Scorecard: Aging Condition with a Novel Presentation
At a Glance
Category Detail
Condition High-grade urothelial carcinoma with complications Key Mechanisms Immune checkpoint inhibitor therapy and associated immune-related adverse events Target Population Elderly patients with advanced cancer and comorbidities Care Setting Emergency department and inpatient hospital care
Key Highlights
81-year-old man with high-grade urothelial carcinoma presented with malaise and fever Prior treatment included atezolizumab and tiragolumab Evaluation for infection, autoimmune conditions, or malignancy was necessary CT imaging revealed pulmonary nodules and mild pulmonary edema Patient experienced renal dysfunction and heart failure symptoms Guideline-Based Recommendations
Diagnosis
Consider infections, autoimmune conditions, and recurrent malignancy in elderly patients with fever and malaise Management
Initiate broad-spectrum antibiotics in cases of suspected infection Monitor renal function and adjust treatment accordingly Monitoring & Follow-up
Regularly assess vital signs, laboratory values, and imaging results Risks
Increased susceptibility to infections due to advanced age and cancer history Potential for immune-related adverse events from checkpoint inhibitor therapy Patient & Prescribing Data
Elderly patients with advanced cancer and multiple comorbidities
Careful monitoring of renal function and cardiac status is essential
Clinical Best Practices
Evaluate for both infectious and non-infectious causes of fever in cancer patients Consider the impact of immune checkpoint inhibitors on patient health Utilize imaging and laboratory tests to guide diagnosis and management Related Resources & Content
