Kelson Michael, Chaudhry Asaad, Nguyen Andrew, Girgis Sameh
Department of Medical Sciences, Hackensack Meridian School of Medicine, 123 Metro Boulevard, Nutley, NJ 07110, USA.
Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA.
Radiol Case Rep. 2022 Sep 15;17(11):4345-4349. doi: 10.1016/j.radcr.2022.08.057. eCollection 2022 Nov.
Septic pulmonary embolism is an obstruction of the pulmonary vasculature due to embolization of an infected thrombus. In many instances, the etiology is cardiac in origin, given the increased prevalence of intravenous drug users in the United States. This condition usually presents with fever, chest pain, dyspnea, and cough. In order to make the diagnosis, it is helpful to utilize tools like the modified Duke criteria when evaluating for infective endocarditis in the context of pulmonary emboli and septic shock. The gold standard method for establishing the diagnosis of this condition involves imaging modalities, including echocardiogram and computed tomography findings. This case report details a 36-year-old male with a history of drug abuse and hepatitis C, who was found to have an isolated vegetation on the pulmonic valve and septic pulmonary embolism. The patient experienced a rapidly deteriorating clinical course, however improved over the course of 2 weeks with supportive measures and appropriate antibiotic treatment. The purpose of this case report is to highlight the uncommon nature of pulmonary valve involvement in patients with infective endocarditis. Moreover, the goal of this report is to recognize the paralleled increase in septic pulmonary emboli with the rising incidence of patients using injectable opioids in the United States.
脓毒性肺栓塞是指由于感染性血栓栓塞导致的肺血管阻塞。在美国,鉴于静脉吸毒者的患病率增加,在许多情况下,病因源于心脏。这种情况通常表现为发热、胸痛、呼吸困难和咳嗽。在评估肺栓塞和脓毒性休克背景下的感染性心内膜炎时,使用改良的杜克标准等工具有助于做出诊断。确立这种疾病诊断的金标准方法包括成像方式,如超声心动图和计算机断层扫描结果。本病例报告详细介绍了一名36岁有药物滥用史和丙型肝炎的男性,他被发现肺动脉瓣有孤立性赘生物和脓毒性肺栓塞。患者临床病程迅速恶化,但经过2周的支持治疗和适当的抗生素治疗后有所改善。本病例报告的目的是强调感染性心内膜炎患者肺动脉瓣受累的罕见性。此外,本报告的目的是认识到在美国,随着注射用阿片类药物使用者发病率的上升,脓毒性肺栓塞也相应增加。