Okabe Masahiro, Kasai Kenji, Yokoo Takashi
Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Japan.
Fuji City General Hospital, Japan.
Intern Med. 2017 Dec 1;56(23):3243-3247. doi: 10.2169/internalmedicine.9050-17. Epub 2017 Oct 11.
Pneumothorax secondary to septic pulmonary embolism (SPE) is rare but life-threatening. We herein report a long-term hemodialysis patient with psoas abscess caused by methicillin-resistant Staphylococcus aureus, associated with other muscle and splenic abscesses and SPE. Intravenous vancomycin treatment and percutaneous drainage of the psoas abscess rapidly improved her condition. However, the SPE lesions continued to increase, and right-sided pneumothorax occurred 10 days after treatment. The pneumothorax resolved after two months and SPE and all abscesses after four months of treatment. Since late-onset pneumothorax caused by SPE can occur despite successful treatment of the primary infection, care should be taken with such patients.
脓毒性肺栓塞(SPE)继发气胸较为罕见,但危及生命。我们在此报告一名长期血液透析患者,其因耐甲氧西林金黄色葡萄球菌导致腰大肌脓肿,并伴有其他肌肉和脾脏脓肿以及SPE。静脉注射万古霉素治疗并对腰大肌脓肿进行经皮引流后,她的病情迅速好转。然而,SPE病灶持续增大,治疗10天后出现右侧气胸。气胸在两个月后消退,治疗四个月后SPE及所有脓肿均消失。由于尽管原发性感染已成功治疗,但仍可能发生由SPE引起的迟发性气胸,因此对此类患者应予以密切关注。