Spontaneous Pneumothorax as a Complication of Septic Pulmonary Embolism in an Intravenous Drug User: A Case Report

Sheu, Chau‐Chyun; Hwang, Jhi-Jhu; Tsai, Jong-Rung; Wang, Tung-Heng; Chong, Inn‐Wen; Huang, Ming-Shyan

doi:10.1016/s1607-551x(09)70226-8

Cited by 19 publications

(19 citation statements)

References 7 publications

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“…Pneumothorax secondary to SPE is rare and only seven cases have been reported in English language literature 10–15. The pneumothorax caused by SPE was thought to be due to rupture of subpleural lesions.…”

Section: Discussionmentioning

confidence: 99%

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis

Nishizawa

Kanemura²,

Jinta

et al. 2019

BMJ Case Rep

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A 26-year-old healthy patient had a fever and chest pain three days after nasal carbon dioxide (CO2) laser surgery for chronic and allergic rhinitis. In the emergency room, he was diagnosed as a right pneumothorax and managed as outpatients with oral antibiotic therapy and close follow-up. Six days later, in follow-up clinic, his presenting signs and symptoms included right chest pain, tachypnoea and elevated levels of white blood cell count and C reactive protein. He was diagnosed as septic pulmonary embolism (SPE) by the detection of multiple nodules with cavitation on chest CT. Culture of pleural fluids showed Pseudomonas aeruginosa. Intravenous antibiotic treatment and drainage of the pleural effusion improved his condition. Since SPE occurred after nasal CO2 laser surgery in this case, careful attention should be paid to infectious complications of nasal CO2 laser surgery.

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Section: Discussionmentioning

confidence: 99%

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis

Nishizawa

Kanemura²,

Jinta

et al. 2019

BMJ Case Rep

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“…It was thought to be a spontaneous pneumothorax, because he had not undergone any invasive procedure before its occurrence. Pneumothorax is a possible lethal complication of septic pulmonary embolism in intravenous drug users with right-sided endocarditis and should be considered in such patients when respiratory distress occurs acutely during their hospitalization [12]. It must be due to progression of septic pulmonary infiltrates with subsequence leakage of air in the pleural cavity.…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis Related to Intravenous Drug User: Report of Four Cases

Muco¹,

Harxhi²,

Hasa³

et al. 2018

TOIDJ

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Objective:To describe the clinical, laboratory, microbiological, and echocardiographic findings in four intravenous drug users with endocarditis hospitalized and followed in our Infectious Disease Service, a tertiary university hospital as well as to determine the efficacy of medical treatment. Methods:From a database of 35 subjects with endocarditis during five years, we made a retrospective analysis of data for four cases between the age of 24-33 years old which were intravenous drug users. Results:Infective endocarditis was encountered in four drug users with positive blood cultures (Staphylococcus aureus was present in all the cases), vegetations in the tricuspid native valve in ultrasound, high fever (more than 38 o C). The four cases were male and the mean age was 29 years (range 24-33 years). Three out of the four cases presented with pulmonary involvement and only one with femoral and popliteal vein thrombosis. Two out of four cases had acute renal and hepatic failure and only one had acute cutaneous vasculitis. Transesophageal Echocardiography (TEE) was also performed in two cases. For all of them medical management consisted of antibiotic therapy and two out of them underwent surgery because of the persistence of valvular vegetations after antibiotic therapy. The prognosis was good with 0% mortality. Conclusion:Infective endocarditis should be considered in the differential diagnosis of intravenous drug users presenting with various clinical scenarios. Echocardiography remains the main modality and should be used serially to facilitate early diagnosis. The successful management of a complicated case often requires the close cooperation of an infectious disease physician, a cardiologist, an addiction physician and occasionally a cardiac surgeon.

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“…As with any other type of pulmonary embolism (PE), SPE can be life threatening [85][86][87]. It is important to note that it may be initially difficult to differentiate between the two types of PE.…”

Section: Pulmonary Circulationmentioning

confidence: 99%

Septic Embolism in Endocarditis: Anatomic and Pathophysiologic Considerations

Yellapu¹,

Ackerman²,

Longo³

et al. 2018

Advanced Concepts in Endocarditis

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Septic embolism is a relatively common and potentially severe complication of infective endocarditis (IE). Septic emboli (SE), most often described as consisting of a combination of thrombus and infectious material-either bacterial or fungal-can be caused by hematogenous spread from virtually any anatomic site; however, it most commonly originates from cardiac valves. During the past two decades there has been a confluence of various risk factors that, both alone and in combination, led to greater incidence of both IE and SE, including increasing population age, greater use of prosthetic valves, implantation of various intracardiac devices, escalating intravenous drug use, and the high incidence of healthcare associated infections with antibiotic resistant microorganisms. From a clinical standpoint, SE can present at any time during the course of IE and may even be the initial presenting sign. SE may affect virtually any location in the human body, but some organs (e.g., liver, spleen, brain) and anatomic regions (e.g., lower extremity) tend to be more frequently involved. The most important aspect of management involves prompt recognition and proactive therapeutic approach. Given the broad spectrum of clinical presentations, symptoms and complications, SE can be challenging to diagnose and treat. Following the identification of SE, appropriate antibiotic coverage should be immediately instituted followed by supportive and/or interventional management, depending on the severity of presentation and the associated complications. In this chapter we explore the pathophysiology, anatomic origins, diagnostic tools, therapeutic measures, and new developments in SE, focusing predominantly on bacterial infections of cardiac origin.

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Spontaneous Pneumothorax as a Complication of Septic Pulmonary Embolism in an Intravenous Drug User: A Case Report

Cited by 19 publications

References 7 publications

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis

Infective Endocarditis Related to Intravenous Drug User: Report of Four Cases

Septic Embolism in Endocarditis: Anatomic and Pathophysiologic Considerations

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Spontaneous Pneumothorax as a Complication of Septic Pulmonary Embolism in an Intravenous Drug User: A Case Report

Cited by 19 publications

References 7 publications

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO2laser surgery for rhinitis

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO2laser surgery for rhinitis

Infective Endocarditis Related to Intravenous Drug User: Report of Four Cases

Septic Embolism in Endocarditis: Anatomic and Pathophysiologic Considerations

Contact Info

Product

Resources

About

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis

Septic pulmonary embolism caused byPseudomonas aeruginosaafter a CO₂laser surgery for rhinitis