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Pulmonary Embolus

Allan R. Tunkel, MD, PhD; Samy Badawy; Steven Vaganos, MD
Arch Intern Med. 1985;145(9):1741. doi:10.1001/archinte.1985.00360090217043.
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To the Editor.  —The recent case reports by Dreyfuss and Weiland1 in the October Archives described chest wall tenderness as the predominant sign of pulmonary emboli in two patients. We recently saw a patient who also had chest wall tenderness as a clinical manifestation of pulmonary emboli.

Report of a Case.  —A 40-year-old woman with a history of lower extremity deep venous thrombosis was seen in the emergency department with complaints of three days of right-sided chest pain, fever, shaking chills, and diaphoresis. Simultaneously, she had noted the onset of a cough, productive, initially, of clear sputum that became blood-streaked over the two subsequent days. She denied chest trauma, but her medical history included tuberculosis exposure (for which she received one year of therapy with isoniazid), a hysterectomy, and a 25-pack-year history of cigarette smoking. The patient's temperature was 38 °C, her heart rate was 94 beats per minute,


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