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Faraone A, Fortini A. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography. Case Rep Med. 2015;2015:801328doi: 10.1155/2015/801328.
Faraone, A., & Fortini, A. (2015). A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography. Case reports in medicine, 2015801328. https://doi.org/10.1155/2015/801328
Faraone, Antonio, and Fortini, Alberto. "A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography." Case reports in medicine vol. 2015 (2015): 801328. doi: https://doi.org/10.1155/2015/801328
Faraone A, Fortini A. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography. Case Rep Med. 2015;2015:801328. doi: 10.1155/2015/801328. Epub 2015 Oct 21. PMID: 26576159; PMCID: PMC4631869.
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Case Rep Med. 2015;2015:801328. doi: 10.1155/2015/801328. Epub 2015 Oct 21.

A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography.

Case reports in medicine

Antonio Faraone, Alberto Fortini

Affiliations

  1. Department of Internal Medicine, "San Giovanni di Dio" Hospital, Via di Torregalli 3, 50143 Florence, Italy.

PMID: 26576159 PMCID: PMC4631869 DOI: 10.1155/2015/801328

Abstract

We describe the case of a 23-year-old man presenting with recurrent pleuritic chest pain and prolonged fever after electrophysiology testing and placement of an implantable cardioverter-defibrillator because of a suspected arrhythmogenic right ventricular dysplasia. The clinical suspicion was initially directed toward pneumonia with pleural effusion and later toward an infection of the cardiac device complicated by septic pulmonary embolism. The definitive diagnosis of pulmonary embolism and infarction was suggested by a point-of-care thoracic sonography, performed at the bedside by a clinician caring for the patient, and then confirmed by contrast enhanced computed tomography, which also showed thrombosis of the left iliofemoral vein, site of percutaneous puncture for cardiac catheterization. Prolonged fever was attributable to a concomitant Epstein-Barr virus primary infection that acted as confounding factor. The present report confirms the value of bedside thoracic sonography in the diagnostic evaluation of patients with nonspecific respiratory symptoms.

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