Right ventricular pacing wire thrombus presenting as pyrexia of unknown origin

Pacing wire thrombosis may be invisible echocardiographically while producing severe symptoms. We report a patient whose pacing wire thrombosis presented as a pyrexial illness 5 months after its insertion. Treatment with tissue plasminogen activator provoked cardiovascular collapse; therefore, we recommend that such thrombosis be treated surgically. Copyright © 1989 Wiley Periodicals, Inc.