Rare disease
Septic pulmonary embolism associated with a peri-proctal abscess in an immunocompetent host
1 Tzu-Chi General Hospital, Chest, Number 707, Section 3, Zhongyang Road, Hualien, 970, Taiwan, Province of China
2 Koo Foundation, Sun Yat-Sen Cancer Center, Chest, Number 125, Lide Road, Beitou District, Taipei, 112, Taiwan, Province of China
3 Taipei Veterans General Hospital, Chest, and School of Medicine, National Yang-Ming University, Number 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan, Province of China
Correspondence to:
kyyang{at}vghtpe.gov.tw
Septic pulmonary embolism is an uncommon disease in which septic thrombi are mobilised from an infectious nidus and transported in the vascular system of the lungs. It is usually associated with tricuspid valve vegetation, septic thrombophlebitis or infected venous catheters. We report an immunocompetent young man who presented with fever and pleuritic chest pain. Chest roentgenography and CT showed multiple ill-defined nodules, with central cavitation and feeding vessels. He was found to have a clinically infectious source of methicillin-resistant staphylococcus aureus (MRSA) cultured from the peri-proctal abscess with the same bacteraemia. Pulmonary septic embolism from peri-proctal abscess was diagnosed by image study and bacterial culture correlation. All of the clinical presentations improved after the incision of the peri-proctal abscess and anti-MRSA antibiotics treatment.
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