Septic pulmonary embolism following necrotizing fasciitis of the upper limb

Mullick, Parul; Sachdeva, Harish C; Bundela, Pankaj; Prakash, Smita; Gogia, Anoop Raj

doi:10.4103/0970-9185.117080

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…In SPE, non-thrombotic microorganism-containing emboli disseminating from extrapulmonary primary infectious sources obstruct the small pulmonary vasculature, causing sepsis and multiple small lung abscesses [6]. The primary infectious foci include right-sided infective endocarditis [7,8], soft tissue infections, such as necrotising fasciitis [9,10], implantable device-and catheter-related infections [11][12][13], and odontogenic lesions [3,14]. Due to its nonspecific clinical presentations, diagnosis of SPE remains challenging for clinicians despite its high mortality [15].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study

et al. 2020

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Septic pulmonary embolism (SPE) is a rare yet serious infectious disorder with nonspecific clinical findings due to microorganism-containing emboli disseminating from extrapulmonary infectious foci. It is unknown whether a positive blood culture correlates with a worse clinical outcome. We compared the clinical and microbiologic characteristics of patients with SPE divided into the culture-positive group and the culture-negative one. This study was a retrospective observational study of the patients diagnosed with SPE and treated in an academic hospital from April 2010 to May 2020. We identified six culture-positive and four culture-negative patients with SPE during the study period. The culture-positive group had significantly longer periods of hospitalization (median: 75 days, range: 45–125 days) than the culture-negative group (median: 14.5 days, range: 3–43 days) (p < 0.05), as well as significantly elevated serum C-reactive protein and procalcitonin. Patients with culture-negative SPE more commonly had odontogenic infections as the primary infectious foci. Our study highlights the importance of giving extra attention to SPE patients who have a positive blood culture, as they may have worse clinical outcomes. Physicians need to collaborate with dentists when faced with patients with culture-negative SPE, since they may have primary odontogenic infections.

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Section: Introductionmentioning

confidence: 99%

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study

et al. 2020

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A case of septic pulmonary embolism caused by P. aeruginosa in a hemodialysis patient and review of the literature

et al. 2020

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Background: Septic pulmonary embolism (SPE) is an uncommon but serious complication resulting from infection of the blood. Gram-positive cocci, including methicillin-susceptible Staphylococcus aureus and methicillin-resistant Staphylococcus aureus, are the most common causative organisms of SPE. Few case reports have been published on SPE caused by Pseudomonas aeruginosa (P. aeruginosa), and thus, the consensus treatment of SPE caused by P. aeruginosa infections remains undetermined. Management of P. aeruginosa infection can be challenging due to its poor prognosis and antimicrobial resistance. Here, we report a case of successful combination antibiotic therapy for SPE associated with infective endocarditis (IE) caused by P. aeruginosa in a hemodialysis patient, with a review of the literature. Case presentation: A 62-year-old man receiving maintenance hemodialysis as treatment for end-stage renal disease due to IgA nephropathy was admitted to our hospital with high fever and chills lasting 10 days. Chest computed tomography revealed multiple nodular shadows, and gram-negative rods were confirmed by blood culture obtained on admission. We suspected SPE and initiated meropenem (MEPM) treatment. P. aeruginosa was identified in blood cultures, and transesophageal echocardiography demonstrated vegetation on the tricuspid valve. Therefore, a diagnosis of SPE associated with IE caused by P. aeruginosa was made. P. aeruginosa isolates showed good susceptibility to MEPM, but no symptomatic improvement was observed. Thus, antibiotics were changed from MEPM to a combination of ceftazidime and tobramycin (TOB). The patient exhibited a favorable response to the combination therapy, although we discontinued TOB on day 23 because of tinnitus symptoms. Conclusions: We report a rare case of SPE associated with IE caused by P. aeruginosa in a hemodialysis patient. Combination antibiotic therapy may be effective in this situation.

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Septic pulmonary embolism following necrotizing fasciitis of the upper limb

Cited by 2 publications

References 4 publications

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study

Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study

A case of septic pulmonary embolism caused by P. aeruginosa in a hemodialysis patient and review of the literature

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