Pulmonary embolism and fever: an indication for urgent echocardiography not reported in clinical guidelines?
We report the case of a 39-year-old woman who developed worsening dyspnea and abdominal pain 4 days after subtotal gastroresection. She underwent thoracic computed tomography scan and lung scintigraphy and was diagnosed with pulmonary embolism. Despite the fact that she was feverish, she was treated by the insertion of a vena cava filter and transferred to our Emergency Department. Twelve hours later, a beta-haemolytic Streptococcus agalactiae was reported to be growing in both bottles of blood cultures that had been taken. The patient underwent transthoracic two- and three-dimensional echocardiography, which showed a large pulmonary valve vegetation prolapsing into the main and right pulmonary artery during systole.
Zakja
Edlira
E
Department of Cardiopulmonary Sciences, A. O. Santa Maria della Misericordia, Udine, Italy.
Badano
Luigi P
LP
Ventruto
Paola
P
Nucifora
Gaetano
G
Gianfagna
Pasquale
P
Fioretti
Paolo M
PM
D000328:Adult; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005334:Fever / Q000000981:diagnostic imaging*; D017408:Guidelines as Topic; D006801:Humans; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging; D013290:Streptococcal Infections / Q000150:complications / Q000000981:diagnostic imaging*; D013292:Streptococcus agalactiae