Large septic pulmonary embolus complicating streptococcus mutans pulmonary valve endocarditis

Large septic pulmonary embolus is a rare finding in right-sided endocarditis. The entity represents a challenging diagnosis due to its variable and nonspecific clinical and radiological presentation and similarities with other conditions. We present a case of a 41 year-old woman who developed a larg...

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Bibliographic Details
Published in:Journal of radiology case reports 2018-02, Vol.12 (2), p.18-27
Main Authors: Inchaustegui, Christian Andres, Wang, Kevin Yuqi, Teniola, Oluwadamilola, De Rosen, Veronica Lenge
Format: Article
Language:English
Subjects:
Adult
Computed Tomography Angiography
Contrast Media
Diagnosis, Differential
Endocarditis, Bacterial - diagnostic imaging
Endocarditis, Bacterial - microbiology
Female
Humans
Iohexol
Pulmonary Artery
Pulmonary Embolism - diagnostic imaging
Pulmonary Embolism - microbiology
Pulmonary Valve - diagnostic imaging
Pulmonary Valve - microbiology
Streptococcus mutans - isolation & purification
Thoracic Radiology
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Summary:Large septic pulmonary embolus is a rare finding in right-sided endocarditis. The entity represents a challenging diagnosis due to its variable and nonspecific clinical and radiological presentation and similarities with other conditions. We present a case of a 41 year-old woman who developed a large main pulmonary artery embolus and bilateral cavitary lung nodules in the setting of severe sepsis. Pulmonary artery exploration and clot retrieval ultimately revealed a large septic embolus from Streptococcus mutans native pulmonary valve endocarditis. The diagnosis of septic pulmonary emboli from right-sided endocarditis should be considered in patients with ancillary findings of septic embolic phenomenon, particularly the presence of multifocal cavitary nodules and in the setting of appropriate predisposing factors.
ISSN:1943-0922
1943-0922
DOI:10.3941/jrcr.v12i2.3240