Associations and Outcomes of Septic Pulmonary Embolism
نویسندگان
چکیده
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.
منابع مشابه
Periodontal Pockets as a Potential Source of Infection: a Case of Possible Odontogenic Septic Pulmonary Embolism
Although dental foci can be sources of bacteremia and bacterial endocarditis, hematogenous spread of infection presented with septic pulmonary embolism apparently is rare. The occurrence of septic pulmonary embolism in patients with periodontal disease without suppurative thrombophlebitis of the great vessels of the neck is well documented but to our knowledge, there is no report on septic pulm...
متن کاملگانگرن کامل روده باریک ناشی از آمبولی سپتیک شریان مزانتریک سوپریور در شیرخوار 16 ماهه
Abstract Background: Thrombo-embolism occurs due to a lot of different etiologies and has a high rate of mortality. But septic embolus is a very uncommon type of embolism and this patient is reported as a septic mesenteric embolism. Case Report: A 16 month patients was referred to the hospital with signs and symptoms of intestinal obstruction and septicemia. After clinical and Para-clinical eva...
متن کاملSeptic Pulmonary Embolism Requiring Critical Care: Clinicoradiological Spectrum, Causative Pathogens and Outcomes
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 2...
متن کاملLemierre Syndrome: A Case Report
life-threatening disease that occurs after an episode of pharyngotonsilitis. It consists of septic thrombosis of the internal jugular vein and bacteremia, and this can lead to septic pulmonary emboli and metastatic abscesses. In the preantibiotic era, Lemierre syndrome was common and it often followed a fulminant course with a mortality rate of 90% (1). The incidence of Lemierre syndrome has si...
متن کاملPrognostic Impact of Thrombolysis in Myocardial Infarction Risk Index on Hospitalization Mortality of Patient with Acute Pulmonary Embolism
Introduction: Acute pulmonary embolism (PE) is one of the deadly cardiovascular diseases. One of the indexes proposed in these patients for risk stratification is the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI), which includes three parameters of systolic blood pressure, age, and heart rate. This study aimed to evaluate the predictive value of TRI on in-hospit...
متن کامل