A Case of Septic Pulmonary Embolism Secondary to Primary Iliopsoas Abscess

A 59-year-old man was admitted to our hospital, complaining of fever and left lumbago. He was diagnosed with primary left iliopsoas abscess and treated with draining the abscess percutaneously and antibiotics. Chest x-rays taken on admission showed multiple round nodules in both lung fields. CT scans of the chest revealed a wedgeshaped lesion abutting the pleura in the left lower lung field and multiple nodules of various sizes in both peripheral lung fields. Some nodules had cavities with thin walls and feeding vessels. Follow-up CT scans to the chest demonstrated that some old nodules had vanished and new nodules developed in both lung fields. The diagnosis of septic pulmonary embolism secondary to iliopsoas abscess was established, because organized pneumonia was detected in the transbronchial lung biopsy specimens and the cultures of the pus from the abscess and the sputum on admission showed Enterococcus faecium.