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Fever in acute pulmonary embolism
P D Stein1, A Afzal, J W Henry
1Henry Ford Heart and Vascular Institute, Detroit, MI 48202-3006, USA. pstein1@hfhs.org
Chest
|January 13, 2000
Summary
Low-grade fever is a common symptom in acute pulmonary embolism (PE), occurring in 14% of patients without other fever sources. Fever in PE does not require pulmonary hemorrhage or infarction and may be linked to deep venous thrombosis.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Diagnostic Imaging
Background:
- Fever is a reported symptom in acute pulmonary embolism (PE), but its direct attribution to PE versus associated conditions requires clarification.
- Understanding the frequency and severity of fever in PE is crucial for accurate diagnosis and to prevent misdiagnosis.
Purpose of the Study:
- To determine the extent to which fever is directly caused by acute pulmonary embolism (PE).
Main Methods:
- Analysis of temperature data from patients enrolled in the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study.
- Retrospective review of discharge summaries, PIOPED summaries, and diagnostic lists to exclude other causes of fever in patients with angiographically proven PE.
Main Results:
- Fever was present in 14% (43 of 311) of PE patients without other identifiable fever sources.
- Fever frequency was similar in PE patients with and without pulmonary hemorrhage or infarction (15% vs. 9%, not significant).
- Clinical evidence of deep venous thrombosis was frequently observed in PE patients with unexplained fever.
Conclusions:
- Low-grade fever is a common clinical finding in acute pulmonary embolism (PE).
- High fever can occur in PE, though it is rare.
- The presence of fever in PE does not necessitate pulmonary hemorrhage or infarction.