Septic Pulmonary Embolism

Abstract

Septik akciğer embolisi, vücuttaki herhangi bir enfeksiyon kaynağından köken alan mikroorganizma içeren trombüsün pulmoner arterlerde oluşturduğu enfakt sonucu akciğerin enfektif hastalığıdır. Ateş yüksekliği, öksürük ve göğüs ağrısı gibi nonspesifik semptomlar ve akciğerlerde bilateral infiltrasyonlar ile karakterizedir. Morbidite ve mortalitesi yüksek olup prognozda en önemli nokta, düşünmek ve erken dönemde geniş spektrumlu antibiyotik tedavisi başlamaktır. Birincil enfeksiyon odağı ve ateş yüksekliği ile birlikte akciğerlerde bilateral periferik multipl nodüler, kaviter infiltrasyonlar görüldüğünde septik akciğer embolisi akla getirilmelidir. Hematojen metastazlar başta olmak üzere maligniteler, bakterimantar-paraziter enfeksiyonlar, vaskülitler ve romatizmal hastalıklar ayırıcı tanıda düşünülmesi gerekir. Bu makalede kalıcı kateteri olan rektum kanserli bir septik akciğer emboli olgusu nadir görülmesi nedeniyle literatür eşliğinde sunulmuştur.

A Case of Septic Pulmonary Embolism with an Initial Diagnosis of Tuberculosis

“…2), infiltrates, wedge-shaped lesions adjacent to the pleura, pleural effusion, focal consolidation, and abscess [6][7][8]. The most critical factor for disease prognosis is to consider SPE and start broad-spectrum antibiotic therapy early [3][4][5]. This case, who was referred with an initial diagnosis of tuberculosis due to cavitary lung lesions and whose empirical antibiotic therapy was delayed at the time of referral, was presented together with the literature to highlight SPE in the differential diagnosis of multiple cavities and to draw attention to the removal of the catheter, which is thought to be the source of infection, and to the initiation of early antibiotic therapy.…”

“…Treatment principles for SPE include early intravenous broad-spectrum antibiotic therapy and removal of potential sources of infection (such as intravenous catheters). In SPE, mortality is between 10 and 20% and is mainly caused by septic shock and multi-organ failure [3][4][5][6].…”

“…SPE should be considered when the primary focus of infection is found to be accompanied by high fever and nodules and/or cavities located in the area close to the multiple peripheral vessel endings in the lungs. While the finding of a feeding vessel indicates that the lesion is of hematogenous origin, the presence of cavitation is an indicator of infarction [5]. Although these findings support the SPE diagnosis, they can also be seen in other lung diseases.…”

“…The diagnosis is mostly made with the presence of clinical findings associated with the infection, the presence of predisposing factors, and CT findings. Thorax CT is superior to chest X-ray in both diagnosis and differential diagnosis [5]. Typical CT findings may include nodules and/or cavities located mostly in the area close to peripheral vessel terminations (a sign of feeding vessel; Fig.…”

“…The mortality rate in SPE is between 10 and 20% and is mainly caused by septic shock and multiorgan failure. Early diagnosis and prompt antibiotic therapy determine the prognosis of the disease [1][2][3][4][5][6][7][8].…”