CRA35 AN ICEBERG IN A CASE OF POORLY CONTROLLED ASTHMA

Introduction:

The overall incidence of pulmonary embolism (PE) is approximately 112 cases per 100,000 populations. Despite the common incidence of pulmonary embolism, we often missed this diagnosis in our daily practice especially in patient who have definite lung disease in the first place. 

Case report:

This presentation describes the case of a 42-year-old woman just came back from a long road trip with a history of poorly controlled asthma, who initially presented with symptoms of cough, fever, and respiratory distress. Initially treated for severe asthma exacerbation, her condition later revealed a more complex scenario involving a PE, identified after further investigation with CT pulmonary angiography. 

Discussion: 

The significance of identification of risk factors, such as prolonged immobilization due to recent road travel is important. Venous thromboembolism cases in Malaysia are very rare with the incidence of 100 per 100,000 population per year, of which 70% are hospital acquired. No data of long travel has yet been study in view of its rarity. This underscores the necessity for additional research on how prolonged immobilization can lead to pulmonary embolism. 

Conclusion:

Considering patient history and maintaining a broad differential diagnosis, particularly when a patient's clinical response deviates from expected outcomes is very important to help in diagnose and treat patient accordingly.