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A Porcine Model of Acute Autologous Pulmonary Embolism

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Pulmonary Embolism Mimicking Infectious Pleuritis.

Kenichi Tetsuhara¹, Satoshi Tsuji¹, Satoko Uematsu¹

¹From the Division of Emergency Service and Transport Medicine and.

Pediatric Emergency Care

|March 29, 2017

Summary

Pulmonary thromboembolism (PE) in children can be misdiagnosed as pleuritis, delaying critical treatment. Early consideration of PE risk factors is vital for accurate pediatric diagnosis.

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Area of Science:

Pediatric Medicine
Cardiology
Radiology

Background:

Pulmonary thromboembolism (PE) diagnosis is often delayed, commonly misdiagnosed as pneumonia or deep vein thrombosis.
This case highlights a 14-year-old girl initially diagnosed with viral pleuritis despite presenting with pleuritic chest pain and fever.

Observation:

The patient experienced recurrent symptoms including dyspnea and exacerbated pain, with evolving pleural effusion on echography.
Initial diagnostic workup, including electrocardiogram and echography, did not reveal PE.
Subsequent presentation with gastrointestinal and respiratory symptoms, hypoalbuminemia, and proteinuria prompted further investigation.

Findings:

Contrast-enhanced chest computed tomography revealed pulmonary artery filling defects, confirming PE.
An S1Q3T3 pattern on electrocardiogram was observed.
The PE was attributed to underlying nephrotic syndrome, an unusual association.

Implications:

Pulmonary thromboembolism can present atypically, mimicking infectious pleuritis in pediatric patients.
Delayed diagnosis of PE can lead to adverse outcomes.
Clinicians should maintain a high index of suspicion for PE in children with symptoms suggestive of pleuritis, considering potential underlying risk factors like nephrotic syndrome.