Ang AK

Boyle-Vavra S

Brenes JA

Brown CE

Cook RJ

David N Williams

Falagas ME

Gadkowski LB

Goldenberg NA

Gonzalez BE

Gopal V Punjabi

Gordon MA

Gorenstein A

Grace CJ

Hart RG

Holm K

Huang RM

Iwasaki Y

Jorge A Brenes

Lee SJ

Li JS

MacMillan JC

Michele M LeClaire

Naber CK

Nishimura RA

Rasmussen RV

Romano L

Stawicki SP

Umesh Goswami

Vos FJ

Open Respiratory Medicine Journal

Background:Septic pulmonary embolism is a serious but uncommon syndrome posing diagnostic challenges because of its broad range of clinical presentation and etiologies.Objective:To understand the clinical and radiographic associations of septic pulmonary embolism in patients presenting to an acute care safety net hospital.Methods:We conducted a retrospective analysis of imaging and electronic health records of all patients diagnosed with septic pulmonary embolism in our hospital between January 2000 and January 2013.Results:41 episodes of septic pulmonary embolism were identified in 40 patients aged 17 to 71 years (median 46); 29 (72%) were men. Presenting symptoms included: febrile illness (85%); pulmonary complaints (66%) including pleuritic chest pain (22%), cough (19%) and dyspnea (15%); and those related to the peripheral foci of infection (24%) and shock (19%). Sources of infection included: skin and soft tissue (44%); infective endocarditis (27%); and infected peripheral deep venous thrombosis (17%). 35/41 (85%) were bacteremic with staphylococcus aureus. All patients had peripheral nodular lesions on chest CT scan. Treatment included intravenous antibiotics in all patients. Twenty six (63%) patients required pleural drainage and/or drainage of peripheral abscesses. Seven (17%) patients received systemic anticoagulants. Eight (20%) patients died due to various complications.Conclusion:The epidemiology of septic pulmonary embolism has broadened over the past decade with an increase in identified extrapulmonary, non-cardiac sources. In the context of an extrapulmonary infection, clinical features of persistent fever, bacteremia and pulmonary complaints should raise suspicion for this syndrome, and typical findings on the chest CT scans confirm the diagnosis. Antibiotics, local drainage procedures and increasingly, anticoagulation are keys to successful outcomes.</jats:sec

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The Open Respiratory Medicine Journal

Associations and Outcomes of Septic Pulmonary Embolism

Associations and Outcomes of Septic Pulmonary Embolism

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