A rare case report of a saddle pulmonary embolism presenting with high grade fevers, responsive to anticoagulation. Issue 9 (March 2018)

• Record Type: Journal Article
• Authors: Saad, Muhammad; Shaikh, Danial H.; Adrish, Muhammad
• Other Names: Li. Yan section editor.
• Is Part Of: Medicine. Volume 97:Issue 9(2018)
• Publication Date: 2018-03
• Subjects: anticoagulation -- fever of unknown origin -- fever in pulmonary embolism -- high grade fever -- pulmonary embolism -- saddle embolus -- unknown fever; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000010002
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Pulmonary embolism can manifest by a myriad of clinical symptoms. High grade fever is a rare presentation of thromboembolic phenomenon. Patient concerns: A middle aged woman presented with high grade fevers. Diagnoses: Patient remained febrile despite broad spectrum antibiotics. All cultures were negative. CT angiogram of the chest was done, eliciting a large saddle embolus. Interventions: Intravenous tissue plasminogen activator (t-PA) was administered and subsequently started on anticoagulation. Patient became afebrile 3 days after initiation of anticoagulation and all antibiotics were discontinued. Outcomes: We demonstrate a case of a saddle pulmonary embolism presenting with high grade fevers that responded to anticoagulation. Lessons: It is imperative to include pulmonary embolism in the differential diagnosis, when presented with high-grade fever in patients with unclear diagnosis.