Unexplained fever in a young man with Crohn's disease: a case report and review of literature

Acta Clin Belg. 2021 Feb;76(1):60-64. doi: 10.1080/17843286.2019.1646515. Epub 2019 Jul 26.

Abstract

A 23-year-old man with a known history of Crohn's disease (CD), who underwent an ileocaecal resection for localized disease activity three months ago, suffered from persistent fever with chills since 10 days. Despite the empirical antibiotic therapy that was started, his fever remained. A computed tomography (CT) angiography of the thorax and abdomen revealed a thrombosis of the iliacal veins bilateral and a pulmonary embolism (PE) in the right lower lobe with adjacent infiltrate. Venous thromboembolism (VTE) can be a life-threatening extraintestinal manifestation of inflammatory bowel disease (IBD). The risk that IBD patients develop a VTE is three times higher in comparison with healthy controls. They have a higher risk of recurrence and a higher mortality ratio. The pathogenesis of VTE in IBD is complex and until now not fully understood. More awareness should be raised, given the fact that it can be prevented by appropriate thromboprophylaxis.

Keywords: Crohn’s disease; Thromboembolism; inflammatory bowel disease; pulmonary embolism; thromboprophylaxis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Crohn Disease / complications*
  • Fever of Unknown Origin / etiology*
  • Humans
  • Male
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / prevention & control
  • Thorax / diagnostic imaging
  • Tomography, X-Ray Computed
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / etiology*
  • Venous Thromboembolism / prevention & control
  • Young Adult

Substances

  • Anticoagulants