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J Emerg Med ; 55(3): 378-382, 2018 09.
Article in English | MEDLINE | ID: mdl-29773479

ABSTRACT

BACKGROUND: Septic pulmonary embolism (SPE) is a rare disorder caused by metastasis of infectious thrombi to the lungs. Most commonly, this occurs as a result of infectious endocarditis. This clinical entity may easily be confused for more common and less mortal diagnoses such as pneumonia, bronchitis, or pulmonary embolism. CASE REPORT: A 47-year-old woman presented in respiratory distress with a complaint of cough productive of rusty sputum, shortness of breath, and pleuritic chest pain. A bedside ultrasound suggested endocarditis and SPE. She was resuscitated and admitted to the hospital for surgical source control and continued i.v. antibiotics. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: SPE is a rare disorder that may be easily missed but carries a high mortality rate. Additionally, the presence of the embolic phenomena makes the diagnosis of infectious endocarditis more attainable in the emergency department (ED). To our knowledge, this case is the first in which ED bedside ultrasound was used to make the diagnosis of SPE due to infectious endocarditis.


Subject(s)
Endocarditis, Bacterial/diagnostic imaging , Endocarditis, Bacterial/microbiology , Point-of-Care Systems , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/microbiology , Ultrasonography/methods , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use , Candidiasis/diagnosis , Candidiasis/drug therapy , Diagnosis, Differential , Emergency Service, Hospital , Endocarditis, Bacterial/drug therapy , Female , Humans , Klebsiella Infections/diagnosis , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/isolation & purification , Middle Aged , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Pulmonary Embolism/drug therapy , Resuscitation
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