Septic Pulmonary Embolism: Clinical Analysis Of 11 Cases

Background Septic pulmonary embolism (SPE) is an uncommondisorder that generally presents with an insidious onset of fever, respiratory symptoms, and lung infiltrates. Clinical and radiologic features atpresentation are usually nonspecific, and the diagnosis of this disorder is frequently delayed.Objective To characterize the presenting features and clinical course of patients with SPE and to guide the diagnosis and treatment of this disease.Methods and Results The data of 11 patients with SPE(contain : acute SPE 3cases , chronic SPE 8 cases) was retrospectively analyzed. The age of these patients was 39.12±0.36 years. Presenting symptoms included fever (100%), cough (45%), dyspnea (36%), pleuritic chest pain (18%), and hemoptysis (18%). A potential source or underlying condition that predisposed to SPE was identified in all 11 patients and included native valve infective endocarditis (5 patients), central venous catheter infection (2 patients), prosthetic cardiac valve (1 patients), pacemaker infection (lpatients),and a focal extrapulmonary infection (lpatients).Most common pathogens were Staphylococcal species (6 patients) .Chest radiographic presentation was usually nonspecific, but CT was more helpful and revealed multiple nodular opacities peripherally, often with cavitation, echocardiography was performed in 11 patients and demonstrated infectious vegetations in 8 cases. Aside from antimicrobial therapy and removal of infected devices, the management of these patients included cardiac surgery (2 patients). 9 patients recovered from their illness expect 2 patients.Conclusions We conclude that SPE presents with variable and often nonspecific clinical and radiographic features. The diagnosis is usually suggested by the presence of a predisposing factor, febrile illness, and CT findings of multiple, nodular lung infiltrates peripherally, with or without cavitation. With early diagnosis, appropriate antimicrobial therapy, and control of the infectious source, resolution of the illness can be expected for most patients with avoidance of potential complications.