Septic pulmonary emboli

Case contributed by Dr Matthew Lukies


Fever for 3 days and cough.

Patient Data

Age: 35 years
Gender: Male

Chest x-ray shows a single small cavitating lesion in the left upper zone peripherally.

Bilateral nipple rings are also present.


CT acquired 4 days later shows:

  • large number of bilateral pulmonary cavitating lesions
  • dependent pulmonary consolidation and ground glass attenuation
  • pulmonary arterial filling defects (e.g. in the right lower lobar branch)
  • endotracheal tube with the tip in the right main bronchus
  • right axillary lymph node enlargement and fat stranding

Case Discussion

The findings, in this case, are most consistent with pulmonary septic emboli due to intravenous injecting drug use (recreation). The site of injection, in this case, is the right upper limb given the stranding and lymph node enlargement in the right axilla.

Case with thanks to Dr Corey Thompson

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Case information

rID: 76401
Published: 21st Apr 2020
Last edited: 4th May 2020
System: Chest
Inclusion in quiz mode: Included

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