Presentation
Fever, chest pain and hemoptysis. The patient was found to be a heroin addict.
Patient Data
Age: 30 years old
Gender: Male
From the case:
Septic pulmonary emboli
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Axial lung window
Multiple small peripheral cavitating pulmonary nodules that display typical feeding vessel sign and left pleural effusion both free and loculated form. Small mediastinal lymph node is also noted.
Case Discussion
IV heroin injection leads to infected DVT of the lower limb which may fragment and migrate to the right atrium --> right ventricle and then the lungs resulting in septic pulmonary emboli and microabscesses.
The differential includes other cavitary lung nodules e.g. Wegener's granulomatosis, multiple hydatic cysts, necrobiotic nodules and cavitating metastatic deposits.
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