TOPICS

Septic Pulmonary Embolism

By Dr Deepu
Septic Pulmonary Emboli.
GOLDEN POINT: The most common sources of septic pulmonary emboli are infected venous catheters, including pacemaker wires, tricuspid valve endocarditis, septic thrombophlebitis and indwelling prosthetic devices. The diagnosis is usually established by positive blood cultures and the presence of an infected source for the emboli.
Watch the HRCT video showing septic emboli.

GOLDEN PEARL: The usual radiographs and CT scan demonstrate multiple pulmonary opacities. The opacities may occur in any portion of the lungs but are usually maximal in the lower zones. The lesions are usually either round in shape or show the shape of a pulmonary infarct, namely a wedge-shaped density base on the pleura and pointing to the hilum. They may have any size and frequently cavitate, a feature more easily recognized on CT. Air-bronchograms are frequently seen, particularly on CT, in all types of opacity, including the nodular lesions. The combination of multiple peripheral nodules or wedge-shaped consolidations, some of which are cavitated, and a distinct feeding vessel in the appropriate clinical setting is highly suggestive of the diagnosis of septic emboli.