Septic pulmonary emboli

Case contributed by Dr Matthew Lukies

Presentation

Fever for 3 days and cough.

Patient Data

Age: 35 years
Gender: Male
X-ray

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

Bilateral nipple rings are also present.

CT

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

PlayAdd to Share

Case information

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

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.