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1-Minute Consult

Should you use compression duplex ultrasonography to detect deep vein thrombosis to evaluate unexplained fevers?

Daniel Rozenbaum, MD, Anirudh Yalamanchali, MD, MS and Deborah Hornacek, MD, FSVM
Cleveland Clinic Journal of Medicine October 2023, 90 (10) 611-614; DOI: https://doi.org/10.3949/ccjm.90a.23018
Daniel Rozenbaum
Clinical Fellow, Department of Critical Care Medicine, Stanford Health Care, Stanford, CA
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  • For correspondence: [email protected]
Anirudh Yalamanchali
Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH
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Deborah Hornacek
Department of Cardiovascular Medicine, Section of Vascular Medicine, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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    Figure 1

    The left panel shows the right internal jugular vein with a scant amount of thrombus adherent to the anterior wall of the vessel (arrow). The right panel shows essentially complete compression of the right internal jugular vein on compression duplex ultrasonography.

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    TABLE 1

    Fever characteristics in case series of VTE

    StudySample size (n)VTE siteTemperature for fever definitionFrequency of fever/VTE-related fever aExclusion of other causesbFever grade
    Barba et al, 2011614,814DVT≥ 38.0°C4.9%No
    Stein et al, 20007363PE≥ 37.8°C26.2%/11.8%Yes> 38.9°C was seen in 1.4%
    Saad et al, 20188245PE≥ 38.0°C25.7%/24.1%Yes
    Kazmers et al, 20009175DVT≥ 37.8°C9.1%No> 38.3°C was seen in 4.6%
    Calvo-Romero et al, 200410154PE≥ 37.0°C18.2%/18.2%Yes> 39.0°C was seen in 0.6%
    Kokturk et al, 200511117PE≥ 37.2°C53.0%/33.3%Yes> 37.9°C and > 39°C were seen in 13.7% and 4.3%
    • ↵a When no attempt was made to exclude alternative causes, only the total frequency of fever is listed.

    • ↵b This was done in varied ways, including querying discharge documentation, review of culture/radiographic data, and careful review of the entire chart.

    • DVT = deep vein thrombosis; PE = pulmonary embolism; VTE = venous thromboembolism

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Cleveland Clinic Journal of Medicine: 90 (10)
Cleveland Clinic Journal of Medicine
Vol. 90, Issue 10
1 Oct 2023
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Should you use compression duplex ultrasonography to detect deep vein thrombosis to evaluate unexplained fevers?
Daniel Rozenbaum, Anirudh Yalamanchali, Deborah Hornacek
Cleveland Clinic Journal of Medicine Oct 2023, 90 (10) 611-614; DOI: 10.3949/ccjm.90a.23018

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Should you use compression duplex ultrasonography to detect deep vein thrombosis to evaluate unexplained fevers?
Daniel Rozenbaum, Anirudh Yalamanchali, Deborah Hornacek
Cleveland Clinic Journal of Medicine Oct 2023, 90 (10) 611-614; DOI: 10.3949/ccjm.90a.23018
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  • Article
    • VENOUS THROMBOEMBOLISM AND FEVERS: CAUSATION VS MERE ASSOCIATION?
    • YIELD OF COMPRESSION DUPLEX ULTRASONOGRAPHY IN EVALUATING UNEXPLAINED FEVERS
    • UPPER-EXTREMITY COMPRESSION DUPLEX ULTRASONOGRAPHY
    • EVIDENCE SUMMARY
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