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Masquerading Pulmonary Embolism: Fever as an Overlooked Clinical Manifestation Illustrated by Four Mini Case Series
Hitam Hagog Natour1, Izabella Elgardt1, Pnina Rotman-Pikielny2
1Department of Internal Medicine E, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract:
Pulmonary embolism (PE) is often underrecognized when presenting with atypical symptoms, such as fever, which can occur either alongside classic symptoms or as the sole manifestation. This presentation may lead to misdiagnosis and delays in appropriate management. We present 4 cases of patients who presented to the emergency department (ED) with fever as the primary symptom and no identifiable causes despite inconclusive initial laboratory evaluations. Further evaluation through computed tomography (CT) confirmed the presence of PE. Following diagnosis, anticoagulation therapy was initiated, leading to the rapid resolution of fever. It is imperative to consider pulmonary embolism in the differential diagnosis when evaluating patients presenting with high-grade fever and unclear etiologies, as recognizing this linkage may facilitate earlier diagnosis and treatment.
Insights
Pulmonary embolism (PE) can present with fever as the only symptom, delaying diagnosis. Recognizing PE in patients with unexplained fever is crucial for timely treatment and improved outcomes.
Area of Science:
- Medical Diagnostics
- Pulmonary Medicine
- Emergency Medicine
Background:
- Pulmonary embolism (PE) is frequently underdiagnosed when atypical symptoms like fever are present.
- Fever can be the sole presenting symptom of PE, leading to diagnostic delays.
Purpose of the Study:
- To highlight the importance of considering pulmonary embolism in patients presenting with fever of unknown origin.
- To emphasize the diagnostic challenges and potential for misdiagnosis of PE with atypical presentations.
Main Methods:
- Case series of four patients presenting to the emergency department with fever as the primary symptom.
- Initial evaluations were inconclusive; diagnosis was confirmed via computed tomography (CT).
Main Results:
- Computed tomography (CT) confirmed pulmonary embolism in all four cases.
- Anticoagulation therapy resulted in rapid resolution of fever in all patients.
Conclusions:
- Pulmonary embolism should be included in the differential diagnosis for patients with high-grade fever and unclear etiologies.
- Early recognition of PE presenting with fever can facilitate prompt diagnosis and treatment.
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