Pneumonia and concealed pulmonary embolism: A case report and literature review

医学 肺炎 肺栓塞 胸痛 深静脉 放射科 血栓形成 大叶性肺炎 外科 内科学
作者
Mohammed Sadeq Ahmed,Mohammed Khalid Farooqui,Youseef Sadiq
出处
期刊:Journal of the Royal College of Physicians of Edinburgh [Royal College of Physicians of Edinburgh]
卷期号:52 (2): 142-146 被引量:4
标识
DOI:10.1177/14782715221103670
摘要

Pneumonia is one of the illnesses for which pulmonary embolism (PE) is most often mistaken because of the considerable overlap in their clinical picture. Moreover, pneumonia may occasionally mask PE, particularly in patients with predominant systemic symptoms such as fever, and with no evidence of deep vein thrombosis (DVT) or trauma. In this report, we presented a 35-year-old male patient with pneumonia and PE in whom pneumonia initially masked the diagnosis of PE. The patient presented with fever, productive cough associated with streaks of blood and pleuritic chest pain for 3 days duration, and was admitted as a case of lobar pneumonia based on his clinical presentation as well as on chest X-ray and non-enhanced computed tomography chest. He had an initial improvement in response to antibiotics; however, during his follow-up at the clinic, he appeared sick, complaining of right-sided persistent pleuritic chest pain and persistent cough, occasionally associated with streaks of blood and breathlessness on exertion. The patient was readmitted and PE was confirmed by computed tomography pulmonary angiography. Anticoagulation initiated with noticeable clinical improvement. This case highlights the importance of considering PE in patients with pneumonia when there was an initial therapeutic response followed by worsening of the condition during the treatment of pneumonia.
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