Yusuf Mohamud Mohamed Farah, Mukhtar Mahad Sadik
Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia.
Int J Gen Med. 2022 May 25;15:5223-5235. doi: 10.2147/IJGM.S364522. eCollection 2022.
Septic pulmonary embolism (SPE) is an unusual condition characterized by the implantation of infected thrombi into the pulmonary vasculature from a variety of infectious sources. This study aimed to illustrate the clinicoradiological features, microbiological spectrum, and clinical course of patients with SPE, as well as to promote the early identification, diagnosis, and prognosis of this unusual disease.
Nineteen patients with SPE collected from the electronic medical records of our hospital were retrospectively reviewed during three years.
The study included twelve men and seven women with a mean age of 49 (15-78). The most common presenting features were fever (79%) and shortness of breath (73.7%). Chronic kidney disease (68.4%) and diabetes (36.8%) were the most common comorbidities. The most common source of infection was venous catheters (58%). was the most predominant pathogen in about 52.6% of the cases. According to the CT findings, bilateral opacities were detected in all cases, flowing by nodular in 73.9% and cavitations in 57.9%. Central distributions were the most patterns regarding the location of the lesion seen in 47.4% of the patients. All patients received antimicrobial treatment, while 13 cases administered systemic anticoagulant. Most of the patients (73.7%) recovered from their illness, while 26.3% died. The median duration of hospitalization was 11.5 days. Oxygen saturation level and altered mental status were significantly associated with the mortality rate of SPE patients.
The study's findings presented that altered mental status and low oxygen saturation are associated with a high mortality rate in SPE patients, especially those requiring critical care. Early diagnosis of an embolic phenomenon to other organ systems like the central nervous system can greatly influence the patient's outcome.
脓毒性肺栓塞（SPE）是一种罕见病症，其特征是感染性血栓从各种感染源植入肺血管系统。本研究旨在阐明SPE患者的临床放射学特征、微生物谱和临床病程，以及促进对这种罕见疾病的早期识别、诊断和预后评估。
回顾性分析我院三年电子病历中收集的19例SPE患者。
该研究包括12名男性和7名女性，平均年龄49岁（15 - 78岁）。最常见的临床表现为发热（79%）和呼吸急促（73.7%）。慢性肾病（68.4%）和糖尿病（36.8%）是最常见的合并症。最常见的感染源是静脉导管（58%）。在约52.6%的病例中 是最主要的病原体。根据CT检查结果，所有病例均检测到双侧肺部混浊，73.9%伴有结节，57.9%有空洞形成。47.4%的患者病变部位以中央分布最为常见。所有患者均接受了抗菌治疗，13例患者接受了全身抗凝治疗。大多数患者（73.7%）康复，26.3%死亡。中位住院时间为11.5天。氧饱和度水平和精神状态改变与SPE患者的死亡率显著相关。
该研究结果表明，精神状态改变和低氧饱和度与SPE患者的高死亡率相关，尤其是那些需要重症监护的患者。早期诊断栓塞现象对其他器官系统如中枢神经系统的影响可极大地影响患者的预后。
