Asymptomatic tachycardia and acute pulmonary embolism in a case of tuberculosis spondylodiscitis

Spinal Cord Series and Cases
Fatimah AhmedyJulia Patrick Engkasan

Abstract

Tachycardia, or elevated heart rate is one of the important clinical parameters considered when diagnosing pulmonary embolism (PE) based on Wells' criteria. However, tachycardia is not highly specific and commonly presents in many other conditions. A 29-year-old female with incomplete paraplegia secondary to tuberculosis (TB) spondylodiscitis presented with asymptomatic sinus tachycardia. The related medical conditions, including anaemia, acute coronary syndrome, hyperthyroidism and other infective causes had been ruled out. Deep venous thrombosis was not on the list of differentials as she showed improvements in neurological and mobility functions with no clinical signs of calf pain or swelling. She had moderate risk of acute PE based on Wells' criteria with positive D-dimer testing and computed tomography pulmonary angiography (CTPA) showing thrombus formation in the left-ascending pulmonary artery. Acute PE may present solely with asymptomatic sinus tachycardia in TB spondylodiscitis. This caveat should provide a high index of suspicion to prevent delay in diagnosis and prevention of more sinister complications. Early stratification based on Wells' criteria for a possible diagnosis of acute PE is proven to be a useful approa...Continue Reading

References

Nov 3, 2004·Annals of Emergency Medicine·Stephen J WolfDorothy M Adcock
Jul 31, 2008·Current Opinion in Pulmonary Medicine·David Jiménez, Roger D Yusen
Feb 15, 2012·The Journal of Spinal Cord Medicine·Steven C KirshblumWilliam Waring
May 18, 2013·Journal of Thrombosis and Thrombolysis·Navin BajajJames A Pippim
Dec 3, 2014·The Journal of Infection·Liesbeth M KagerTom van der Poll
Jan 31, 2015·Internal and Emergency Medicine·Karsten KellerJörn Oliver Balzer

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Citations

Jan 29, 2022·Journal of Clinical Laboratory Analysis·Liyi ChenXinli Zhan

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