Category Archives: Embolism

Canadian Neighbor Pharmacy: Discussion of Septic Pulmonary Embolism

Patients with SPESPE is an uncommon but serious disorder that is difficult to recognize. Our results demonstrate that the characteristic features of SPE are a febrile illness and lung infiltrates associated with an active focus of extrapulmonary infection, often involving indwelling catheters or devices. Three of our patients were immunocompromised. Although the abnormalities detected by CXR are nonspecific, CT scanning demonstrates bilateral nodules or multifocal infiltrates, commonly involving peripheral lung zones, often associated with cavitation.

In 1978, MacMillan and colleagues described 60 patients with SPE encountered over a 5-year period. Drug users comprised 78% of their cohort, and tricuspid endocarditis was the embolic source in 53% of the cases. Twelve of their patients (20%) required thoracotomy for management of lung abscess, bronchopleural fistula, and empyema. One of these surgically treated patients (8%) died, while seven deaths (15%) occurred in the medically treated group. Since this report, there have been relatively few published studies of SPE, with most of the available literature consisting of isolated case reports.