Septic pulmonary infarcts in an IV drug user
Known IV drug user. Cough and fever with S.aureus cultured in blood. Recent cardiac murmur with tricuspid valve vegetations on echocardography
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Multiple peripherally-located, wedge-shaped mass lesions in the lung, many having central cavitation
The appearances are typical of infected pulmonary infarcts by way of the clinical history (IVDU)morphology (wedge-shaped), location (peripheral) and central cavitation. The presence of positive blood cultures confirms the diagnosis and excludes other possibilities including cavitating metatases (eg SCC) and granulomas (eg Wegener).