Candida dubliniensis Fungemia Leading to Infective Endocarditis and Septic Pulmonary Emboli

Abstract

Illicit drugs, especially those injected intravenously, are becoming increasingly more common worldwide. Individuals who use intravenous drugs often reuse or share needles which predisposes them to life-threatening infections. We present the case of a patient who was injecting intravenous drugs into her internal jugular vein, which eventually led to acutely worsening sepsis secondary to fungal infective endocarditis and bilateral septic pulmonary emboli. Transthoracic echocardiogram demonstrated multilobulated and spherical vegetations on the tricuspid and mitral valves, respectively. On computed tomography of the thorax, numerous cavitary lesions and ground-glass opacities were present in both lungs. Multiple hyperdense, linear structures consistent with broken needles were seen on chest radiography. It is important for radiologists to recognize the possibility of broken needles in patients with a history of intravenous drug use as astute recognition of broken needles may lead to better source control and improved outcomes.