A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy

Jung, Jo Sung; Lee, Sang Mi; Kim, Hee Jin; Jang, Si‐Hyong; Lee, Jeong Won

doi:10.1007/s12149-014-0811-3

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…Sometimes, systemic antibiotics or chemotherapy treatment and short-term follow-up are necessary to differentiate abscess versus metastases. Similarly, focal renal infections like renal tuberculosis, acute pyelonephritis, xanthogranulomatous pyelonephritis, and renal abscesses have all been encountered on 18F-FDG PET/CT and may be mistaken for a neoplastic process [46][47][48][49]. Gonadal infection such as tubo-ovarian abscesses and orchitis has been mistaken for neoplasm on 18F-FDG PET/CT [50][51][52].…”

Section: Abdomen and Pelvismentioning

confidence: 99%

Acute Findings on FDG PET/CT: Key Imaging Features and How to Differentiate Them from Malignancy

Behr

2020

Curr Radiol Rep

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Purpose of review To review acute findings commonly encountered during routine clinical FDG PET/CT studies and present key imaging features to differentiate them from malignant counterparts. Recent findings FDG PET/CT is extensively used in routine clinical practice for oncology patients. Incidental acute findings in patients undergoing FDG PET/CT are increasingly common, and awareness of these findings and their mimics are important in delivering a clinically relevant and accurate radiological report for directing further management. Summary This article will review examples of common acute findings encountered during routine FDG PET/CT scans, compare them against examples of FDG-avid malignancy that can mimic these findings and emphasize key imaging findings to differentiate acute findings from their malignant mimics.

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Section: Abdomen and Pelvismentioning

confidence: 99%

Acute Findings on FDG PET/CT: Key Imaging Features and How to Differentiate Them from Malignancy

Behr

2020

Curr Radiol Rep

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“…The primary infectious sites of SPE include right-sided IE, pelvic thrombophlebitis, head and neck infections, vascular catheters, implantable devices, and soft tissue infections [2,4]. The risk factors for SPE include intravenous drug use, catheter insertion, and diabetes mellitus [5]. In addition, in the single-center retrospective analysis of 40 SPE patients, up to 25% of patients (10 patients) were hemodialysis patients [4]; thus, hemodialysis may be a risk factor for SPE.…”

Section: Discussionmentioning

confidence: 99%

A case of septic pulmonary embolism caused by P. aeruginosa in a hemodialysis patient and review of the literature

et al. 2020

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Background: Septic pulmonary embolism (SPE) is an uncommon but serious complication resulting from infection of the blood. Gram-positive cocci, including methicillin-susceptible Staphylococcus aureus and methicillin-resistant Staphylococcus aureus, are the most common causative organisms of SPE. Few case reports have been published on SPE caused by Pseudomonas aeruginosa (P. aeruginosa), and thus, the consensus treatment of SPE caused by P. aeruginosa infections remains undetermined. Management of P. aeruginosa infection can be challenging due to its poor prognosis and antimicrobial resistance. Here, we report a case of successful combination antibiotic therapy for SPE associated with infective endocarditis (IE) caused by P. aeruginosa in a hemodialysis patient, with a review of the literature. Case presentation: A 62-year-old man receiving maintenance hemodialysis as treatment for end-stage renal disease due to IgA nephropathy was admitted to our hospital with high fever and chills lasting 10 days. Chest computed tomography revealed multiple nodular shadows, and gram-negative rods were confirmed by blood culture obtained on admission. We suspected SPE and initiated meropenem (MEPM) treatment. P. aeruginosa was identified in blood cultures, and transesophageal echocardiography demonstrated vegetation on the tricuspid valve. Therefore, a diagnosis of SPE associated with IE caused by P. aeruginosa was made. P. aeruginosa isolates showed good susceptibility to MEPM, but no symptomatic improvement was observed. Thus, antibiotics were changed from MEPM to a combination of ceftazidime and tobramycin (TOB). The patient exhibited a favorable response to the combination therapy, although we discontinued TOB on day 23 because of tinnitus symptoms. Conclusions: We report a rare case of SPE associated with IE caused by P. aeruginosa in a hemodialysis patient. Combination antibiotic therapy may be effective in this situation.

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“…Only three cases of renal abscess as a primary source of SPE have been reported 30 – 32 . In the present study, we reported two cases of renal abscess as a primary source of SPE.…”

Section: Discussionmentioning

confidence: 99%

Septic Pulmonary Embolism Requiring Critical Care: Clinicoradiological Spectrum, Causative Pathogens and Outcomes

Chou¹,

Wu²,

Chung³

et al. 2016

Clinics

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OBJECTIVES:Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care.METHODS:The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed.RESULTS:Multiple organ dysfunction syndrome developed in 85% of the patients, and acute respiratory failure was the most common organ failure (75%). The most common computed tomographic findings included a feeding vessel sign (90%), peripheral nodules without cavities (80%) or with cavities (65%), and peripheral wedge-shaped opacities (75%). The most common primary source of infection was liver abscess (40%), followed by pneumonia (25%). The two most frequent causative pathogens were Klebsiella pneumoniae (50%) and Staphylococcus aureus (35%). Compared with survivors, nonsurvivors had significantly higher serum creatinine, arterial partial pressure of carbon dioxide, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and they were significantly more likely to have acute kidney injury, disseminated intravascular coagulation and lung abscesses. The in-hospital mortality rate was 30%. Pneumonia was the most common cause of death, followed by liver abscess.CONCLUSIONS:Patients with septic pulmonary embolism who require critical care, especially those with pneumonia and liver abscess, are associated with high mortality. Early diagnosis, appropriate antibiotic therapy, surgical intervention and respiratory support are essential.

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A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy

Cited by 8 publications

References 10 publications

Acute Findings on FDG PET/CT: Key Imaging Features and How to Differentiate Them from Malignancy

Acute Findings on FDG PET/CT: Key Imaging Features and How to Differentiate Them from Malignancy

A case of septic pulmonary embolism caused by P. aeruginosa in a hemodialysis patient and review of the literature

Septic Pulmonary Embolism Requiring Critical Care: Clinicoradiological Spectrum, Causative Pathogens and Outcomes

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