Computed Tomographic Features of Pulmonary Septic Emboli

Kwon, Woon Jung; Jeong, Yeon Joo; Kim, Kun-Il; Lee, In Sook; Jeon, Ung Bae; Lee, Sun Hee; Kim, Young Dae

doi:10.1097/01.rct.0000243455.23308.a9

Cited by 43 publications

(26 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3D). Furthermore, cavitation within nodules is commonly observed in patients with Gram-positive septic emboli (9). In the current case, CT findings, including bilateral nodular opacity with cavitation, right pleural effusion and mediastinal lymphadenopathy, were consistent with those observed in cases of SPE (Fig.…”

Section: Discussionsupporting

confidence: 75%

“…In the present case, however, no pathogens were detected in the blood or removed catheter. Commonly accepted principles for the treatment of SPE include the prompt empiric administration of intravenous antibiotics (8), the detection and removal of any potentially infected devices and surgical intervention to remove the collection purulent fluid (9). We herein report a rare case of SPE caused by infection-associated catheter removal in a patient with Hodgkin's lymphoma.…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

A Rare Case of Septic Pulmonary Embolism Caused by Infection-associated Catheter Removal in a Patient with Hodgkin's Lymphoma

Morichika¹,

Nakachi²,

Tomoyose³

et al. 2014

Intern. Med.

View full text Add to dashboard Cite

As a reflection of the considerable increase in the number of cancer patients treated with chemotherapy, indications for the use of implanted venous catheters are rapidly growing. However, in some cases, implanted venous catheters induce unwelcome complications. We herein report a rare case of septic pulmonary embolism (SPE) caused by local infection-associated catheter removal during the administration of ABVd combination chemotherapy consisting of adriamycin, bleomycin, vinblastine and dacarbazine in a patient with Hodgkin's lymphoma of the mixed cellularity type. During the course of treatment with chemotherapy administered via implanted venous catheters, think it is crucial to monitor for the potential occurrence of SPE.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 97%

A Rare Case of Septic Pulmonary Embolism Caused by Infection-associated Catheter Removal in a Patient with Hodgkin's Lymphoma

Morichika¹,

Nakachi²,

Tomoyose³

et al. 2014

Intern. Med.

View full text Add to dashboard Cite

show abstract

“…It is noteworthy that KWON et al [185] recently reported that the size of the nodules in gram-positive septic emboli was larger than those in gram-negative. Cavitation and air bronchogram within the nodules were seen more frequently in the grampositive emboli, while a ground-glass attenuation halo around a nodule and a feeding vessel sign were more commonly observed in gram-negative emboli.…”

Section: Diagnosismentioning

confidence: 99%

“…A thrombus containing microorganisms embedded in fibrin mobilised from an infectious nidus is implanted in the pulmonary arteries, leading to an infarction inciting a metastatic abscess ( fig. 3a) [176,185]. Cavitary parenchymal nodules may be caused by septic occlusion of small peripheral PA branches [186].…”

Section: Pathophysiologymentioning

confidence: 99%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

Eur Respir J

162

127

View full text Add to dashboard Cite

Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

show abstract

“…This sign may represent hematogenous spread to the lungs and may also be seen in metastasis. The prevalence of this sign varies from 67-100% in various series and the heterogeneous sub pleural wedge-shaped opacities are seen in 70-75% of patients (Kwon et al, 2007). Multi-detector CT is faster and superior to the classical CT technology for detection of this sign (Dodd et al, 2006).…”

Section: Diagnosismentioning

confidence: 99%