Associations and Outcomes of Septic Pulmonary Embolism

Abstract

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.

Septic Pulmonary Embolism

“…IV drug usage, tricuspid lid endocarditis, end-stage kidney failure, chronic liver diseases, diabetes mellitus, and alcoholism, and immune deficiencies like HIV infection can be given as predisposing factors of SPE. [8,9] The case in this study was a 52-year-old female, and she had a cough, chest pain, shortness of breath, and high fever. Especially, the chest pain that started suddenly with a high fever and increased with breathing caused a noisy clinic.…”

“…In the same study, sub-pleural wedge-like lesions and pleural fluid were seen in 73% and 67% of patients, respectively. [9,10] Staphylococcus infections are the most common factors that have been reported so far. A growth of Staphylococcus was also detected in the blood sample of the patient in this study.…”

Clinical case report: discitis osteomyelitis complicated by inferior vena cava venous thrombosis and septic pulmonary emboli

“…A few cases in adults have been recently reported where septic thrombophlebitis with contiguous infection resulted in septic pulmonary emboli [22], [23]. However, most of these cases are either due to S aureus or rarely Fusobacterium necrophorum ; both bacteria produce thrombogenic toxins [22], [23]. No case of septic thrombophlebitis associated with viridans streptococcus has been reported.…”

In vitro antischistosomal activity of venom from the Egyptian snake Cerastes cerastes

“…Previous studies have explored the use of toxins as potential therapeutic agents for treating various conditions such as hypertension (5) (6) , thrombosis (7) (8) , and cancer (9) (10) (11) (12) (13) (14) . Among these studies, the initial interest in snake venom was to evaluate how combat the effects of snakebites in humans and to study how snakebite toxins exert their effects.…”