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CASE REPORT
Complex regional pain syndrome type II arising from a gunshot wound (GSW) associated with infective endocarditis and aortic valve replacement
  1. Vinicius Tieppo Francio1,
  2. Brandon Barndt2,
  3. Chris Towery1,
  4. Travis Allen1,3,
  5. Saeid Davani1
  1. 1USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat
  2. 2Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
  3. 3Maricopa Medical Center, Phoenix, Arizona, USA
  1. Correspondence to Vinicius Tieppo Francio, vinicius.francio{at}usat.edu

Summary

A 34-year-old man with a history of gunshot wound (GSW) to the right upper chest developed secondary aortic valve endocarditis (AVE) and was treated with an artificial valve placement (AVP). Three months after, he presented to an outpatient pain management clinic right arm pain and was diagnosed with complex regional pain syndrome type II (CRPS II). The patient underwent a diagnostic sympathetic ganglion block, before undergoing endoscopic thoracic sympathectomy surgery. Successful outcomes revealed decreased pain, opioid utilisation and improved tolerance to therapy and activities of daily living. To our knowledge, this is the first case reporting CRPS II arising from a GSW complicated by AVE followed by AVP, which emphasises how unforeseen syndromes can arise from the management of seemingly unrelated pathology. This case demonstrates the importance of timely and proper diagnosis of uncharacterised residual pain status post-trauma and differential diagnosis and management of chronic pain syndromes.

  • pain (neurology)
  • peripheral nerve disease
  • rehabilitation medicine
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Footnotes

  • Contributors VTF, BB, TA, CT and SD equally contributed to the manuscript. VTF contributed with patient information gathering, clinician, treatment, planning, conduction, reporting, conception and design, acquisition of patient data and discussion of results, analysis and interpretation of findings, clinical guidelines and literature review. BB contributed with design, syntactical review and grammar, discussion of results, analysis and interpretation of findings, clinical guidelines and literature review. TA contributed with patient information, treatment, differential diagnosis, cardiology consult, discussion, planning, conduction, reporting, conception and design, acquisition of patient data and discussion of results, analysis and interpretation of findings, clinical guidelines and literature review. CT contributed with grammar review, english writing, proper formatting, reference review, design, discussion of results, analysis and interpretation of findings, clinical guidelines and literature review. Saeid Davani contributed with discussion of results, analysis and interpretation of findings, clinical guidelines and literature review. SD contributed with patient information, treatment, differential diagnosis, discussion, planning, conduction, reporting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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