Masquerading Pulmonary Embolism: Fever as an Overlooked Clinical Manifestation Illustrated by Four Mini Case Series and Literature Review

Pulmonary embolism (PE) is often underrecognized when presenting with atypical symptoms, such as fever, which can occur either alongside classic symptoms or as the sole manifestation. This presentation may lead to misdiagnosis and delays in appropriate management. We present 4 cases of patients who presented to the emergency department (ED) with fever as the primary symptom and no identifiable causes despite inconclusive initial laboratory evaluations. Further evaluation through computed tomography (CT) confirmed the presence of PE. Following diagnosis, anticoagulation therapy was initiated, leading to the rapid resolution of fever. It is imperative to consider pulmonary embolism in the differential diagnosis when evaluating patients presenting with high-grade fever and unclear etiologies, as recognizing this linkage may facilitate earlier diagnosis and treatment.