CT
Right hilar and subcarinal lymphadenopathy. Large area of pulmonary opacity in the lateral aspect right lower lobe, further large area anterior segment of right upper lobe but multiple further areas of abnormal pulmonary opacity bilaterally with several stellate appearing densities in left apex. No central endobronchial lesion. No definite superior mediastinal lymphadenopathy. Small bilateral pleural effusions, a little larger on the right.
Conclusion:
No pulmonary thrombo-embolic disease but multiple areas of pulmonary opacity concerning for septic emboli given the history of IV drug use.