The MTS has poor discriminative ability to predict the presence of SBIs in children presenting with fever to the paediatric ED. Important predictors of SBI are represented within the MTS, but are used in a different way to classify urgency.

No abstract

A 42-year old man attended our emergency department with sudden onset of nausea, fever and cold sweats. In the days prior to presentation, he had developed a radiating pain in the thoracic spine. Furthermore, he had been suffering from dyspnoea on exertion for several weeks. He was a smoker, but had no significant past medical history.

The patient underwent transthoracic echocardiography which confirmed the presence of a calcified intracardiac mass in the right atrium, with significant tricuspid insufficiency and compression of the left atrium (Figure 2). CT angiography of the thorax revealed the tumour was 7.2×5.3×4.4 cm. Initially, no pulmonary vascular abnormalities were seen.