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Clinical Manifestations of 6 Cases of Septic Pulmonary Embolism at Increased Risk Recently

Article information

Kosin Med J. 2012;27(2):99-103
Publication date (electronic) : 2012 December 27
doi : https://doi.org/10.7180/kmj.2012.27.2.99
Su-Min Park1, Kyung-Han Kim1, Neul-Bom Yoon1, Il-Hwan Jeong1, Hye-won Lee1, Soo-Keol Lee1, Ki-Nam Lee2, Choonhee Son1, Soo-Jung Um1
1Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
2Department of Radiology, College of Medicine, Dong-A University, Busan, Korea.
Corresponding Author: Soo-Jung Um, Department of Internal Medicine, College of Medicine, Dong-A University, Dongdaesin-dong 3-ga, Seo-gu, Busan, 602-715, Korea. TEL: +82-51-240-2769, FAX: +82-51-242-5842, sjum@dau.ac.kr
Received 2012 March 07; Revised 2012 May 08; Accepted 2012 May 15.

Abstract

Objectives

The aim of this study was to investigate the clinico-radiologic features and microbiologic data of patients with SPE in a tertiary care hospital in Busan.

Methods

We retrospectively analyzed clinical and radiologic features of 6 cases with septic pulmonary embolism that occurred from March 2009 to March 2011 in Dong-A university medical center.

Results

The mean age of the study population was 58 years, and two men and four women were included. Clinical symptoms included general weakness (5 patients), febrile sensation (4 patients) and pleuritic chest pain (2 patients). Underlying conditions were chemoport infection (4 patients), dental abscess (1 patients), and cellulitis of hip (1 patient). Chest computed tomography revealed bilateral multiple nodular opacities in most patients, and cavitation, central necrosis, feeding vessels were identified. All patients received parenteral antimicrobial therapy with or without central catheter removal, drainage of the extrapulmonary infection. Causative organisms were Pseudomonas aeruginosa (2 patients), Candida albicans (1 patient), Bacillus species (1 patient), and Klebsiella pneumonia (1 patient).

Conclusions

Clinical and radiologic features of septic pulmonary embolism were various and nonspecific. The diagnosis was usually suggested by the presence of a predisposing factor of septic pulmonary embolism and CT findings of bilateral multiple nodular opacities in patients with infectious signs and symptoms. Most important underlying condition was intravascular device infection.

Keywords: Computed tomography; Infection; Catheter-related; Pulmonary embolism; Septicemia

References

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Article information Continued

Copyright © 2012 Kosin University College of Medicine

Fig. 1

Fig. 1

A: computed tomography of the chest demonstrates multiple nodular or non-nodular infiltration, one of which is cavitated, in a 74-year old man with chemo-port infection and SPE. Note subpleural cavitary nodule and feeding vessels in the right lung (arrow). B: computed tomography of the chest shows two subpleural nodules with central necrosis in a 50-year old woman with periodontal abscess and SPE.

SPE: septic pulmonary embolism

Table 1

Epidemiologic, clinical, and microbiologic features of 6 patients

Table 1

AGC: Advanced gastric cancer, DM: Diabetes mellitus, NA; Not applicable

Table 2

Radiologic findings of 6 patients

Table 2

CT: computed tomography