A 78-year-old bedridden man was admitted for presumed aspiration pneumonia with a chest radiograph showing a patchy opacity in the right upper lung zone (Fig. 1), with the presentation of fever and dyspnea. An urgent CAT scan revealed a wedge-shaped opacity in the right upper lobe (Fig. 2) and filling defects in the distal right main pulmonary artery (Fig. 3), confirming the diagnosis of pulmonary embolism with distal pulmonary infarction (Hampton's hump). Further examination revealed a deep vein thrombosis involving both legs. He was successfully treated with anticoagulant therapy.

Figure 1

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Figure 2

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Figure 3

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The presence of high fever and radiographic pulmonary opacity may be compatible with pneumonia. In patients with risk factors for venous thromboembolism, only vigilant detection of the Hampton's hump on chest radiography could jump to the correct diagnosis of acute pulmonary embolism.