{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:39Z","timestamp":1756425819794,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,20]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2018-224702","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T02:04:20Z","timestamp":1539741860000},"page":"bcr-2018-224702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Complex regional pain syndrome type II arising from a gunshot wound (GSW) associated with infective endocarditis and aortic valve replacement"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-0058","authenticated-orcid":false,"given":"Vinicius","family":"Tieppo Francio","sequence":"first","affiliation":[{"name":"USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Barndt","sequence":"additional","affiliation":[{"name":"Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Towery","sequence":"additional","affiliation":[{"name":"USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis","family":"Allen","sequence":"additional","affiliation":[{"name":"USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat"},{"name":"Maricopa Medical Center, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeid","family":"Davani","sequence":"additional","affiliation":[{"name":"USAT College of Medicine, University of Science, Arts & Technology, Olveston, Montserrat"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,16]]},"reference":[{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2006.00169.x"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s41038-016-0066-4","article-title":"Complex regional pain syndrome: a recent update","volume":"5","author":"Goh","year":"2017","journal-title":"Burns Trauma"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.3","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200103000-00012"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.4","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12033"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.5","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318229bbee"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.6","first-page":"4598","article-title":"Local anesthetic sympathetic blockade for CRPS","volume":"19","author":"Stanton","year":"2013","journal-title":"Cochrane Database Sys Rev"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.7","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1016\/j.pain.2014.08.015","article-title":"Thoracic sympathetic block for the treatment of CRPS type I","volume":"155","author":"Rocha","year":"2014","journal-title":"Pain"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.8","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00068-011-0080-y","article-title":"Endoscopic thoracic sympathectomy for posttraumatic complex regional pain syndrome","volume":"37","author":"Demey","year":"2011","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.9","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21601"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000296"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.11","first-page":"242","article-title":"A retained bullet in pericardial sac: penetrating gunshot injury of the heart","volume":"16","author":"Kaya","year":"2016","journal-title":"Case Rep Cardiol"},{"key":"2025082802245400000_2018.oct16_1.bcr-2018-224702.12","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/BLO.0b013e31803df02c","article-title":"Gunshot wounds and other injuries of nerves. 1864","volume":"458","author":"Mitchell","year":"2007","journal-title":"Clin Orthop Relat Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-224702","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:25:06Z","timestamp":1756373106000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-224702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,16]]},"references-count":12,"alternative-id":["10.1136\/bcr-2018-224702"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-224702","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,10,16]]}}}