Massive pulmonary embolism as a rare complication of a stab in the inguinal region in a HIV-positive patient: a case report

D. Sermoneta, V. Gentili, P. Nucera, C. Raso, M. Iozzino, P. Rabuffi, M. Mellacina

Department of Emergency Medicine, Ospedale Santa Maria Goretti, Latina, Italy. daniel.sermoneta@gmail.com

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• Cardiology

OBJECTIVE: Venous thromboembolism (VTE) is a severe preventable disease; HIV-infection represents a prothrombotic condition, because of specific factors due to the virus itself, the host response and the antiretroviral therapy. Our aim is to raise awareness of thromboembolic risk when dealing with HIV-positive patients presenting to the Emergency Department for treatment of injuries, even though small.

CASE REPORT: We present a case of a 33-year-old woman suffering from HIV-infection who presented to the Emergency Department with two small stab wounds. Laboratory tests and radiologic examinations were normal. About 8 hours after admission the patient developed a syncopal attack: a CT scan performed after hemodynamic stabilization revealed a massive pulmonary embolism (PE); the patient was then transferred to the Intensive Care Unit and treated with systemic thrombolysis.

CONCLUSIONS: This case confirms that HIV-positive patients carry a higher risk for VTE and PE compared to general population, similarly to patients suffering from cancer: emergency physicians must be aware even in case of minor wounds.

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