Septic pulmonary infarcts in an IV drug user

Discussion:

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 metastases (e.g. SCC) and granulomas (e.g. granulomatosis with polyangiitis).

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