Pulmonary Embolism Masquerading as Severe Pneumonia: A Case Report

Area of Science:

• Pulmonology
• Cardiology
• Diagnostic Imaging

Background:

• De novo pulmonary embolism (DNPE) occurs without deep vein thrombosis (DVT), often linked to chest trauma.
• Atypical presentations of DNPE can mimic other serious conditions, complicating diagnosis.

Observation:

• A patient presented with fever, dyspnea, and pleuritic chest pain, resembling severe pneumonia.
• Despite oxygen and antibiotics, the patient exhibited persistent respiratory failure and consolidative chest X-ray findings.
• Doppler ultrasound ruled out DVT, and D-dimer levels were normal, initially obscuring a pulmonary embolism (PE) diagnosis.

Findings:

• Computed tomography pulmonary angiography confirmed PE in the absence of DVT or preceding trauma.
• The patient successfully responded to anticoagulation therapy.

Implications:

• This case highlights the diagnostic challenges posed by atypical DNPE presentations that mimic severe pneumonia.
• Increased clinical suspicion is vital for timely diagnosis and management of such rare PE cases.