| Popis: |
Septic pulmonary embolism, is a phenomenon characterized with hematogenous spread of coagulated blood containing microorganisms from right heart to the lungs, and infarct and abscess formations in lungs. It is associated with some precipitating situations such as congenital heart disease, IV drug use, long-term catheter use. Septic pulmonary emboli has high morbidity and mortality. Early diagnosis and broad-spectrum antibiotics are the main factors determining the prognosis. From this point, here we offer a septic pulmonary emboli case. 60-year-old female patient, who was treated by nephrology clinic with hemodialysis because of chronic renal failure, was referred to our clinic due to new onset of dyspnea and low SpO2. It was seen that the patient had a central catheter. In physical examination of the respiratory system, fine crackles were heard at bilateral bases. Whereupon bilateral multifocal nodular densities were observed in the chest X-ray, thorax CT was performed. In thorax CT, multiple nodular densities, being more prominent in the upper lobes of both lungs and which were the largest of 12x20mm in size, were monitored. It was learned that patient had no history of any immunosuppressive therapy. Although those radiological lesions were resembling the metastatic lesions, the lack of described lesions in the 5 days prior chest X-ray turned away us from a possible metastasis. Than, it was learned that E.coli MSSA were found in the catheter tip culture received 2 days prior. With those existing findings, the patient was diagnosed with septic pulmonary embolism. Clinical improvement was provided with broad-spectrum antibiotics, held in accordance with the microbiological resistance profile. Significant decline in the lesions were observed in the thorax CT drawn on 20th day of treatment. We shared this phenomenon with original radiological presentation to remind septic emboli in clinical differential diagnosis. |
