Background: Although fever has been reported in several
case series of acute pulmonary embolism (PE), the extent to which fever
may be caused by PE, and not associated disease, has not been
adequately sorted out. Clarification of the frequency and severity of
fever in acute PE may assist in achieving an accurate clinical
impression, and perhaps avoid an inadvertent exclusion of the
Purpose: The purpose of this investigation
is to evaluate the extent to which fever is caused by acute PE.
Methods: Patients participated in the Prospective
Investigation of Pulmonary Embolism Diagnosis (PIOPED). Temperature was
evaluated among patients with angiographically proven PE. A
determination of whether other causes of fever were present was based
on a retrospective analysis of discharge summaries, PIOPED summaries,
and a computerized list of all discharge diagnoses.
Results: Among patients with PE and no other source of
fever, fever was present in 43 of 311 patients (14%). Fever in
patients with pulmonary hemorrhage or infarction was not more frequent
than among those with no pulmonary hemorrhage or infarction, 39 of 267
patients (15%) vs 4 of 44 patients (9%; not significant). Clinical
evidence of deep venous thrombosis was often present in patients with
PE and otherwise unexplained fever.
Low-grade fever is not uncommon in PE, and high fever, although rare,
may occur. Fever need not be accompanied by pulmonary hemorrhage or