Septic pulmonary embolism in Korea: Microbiology, clinicoradiologic features, and treatment outcome

Summary Objectives The aim of this study was to investigate the clinicoradiologic features, microbiologic data, primary sites of infection, and treatment results for patients with septic pulmonary embolism (SPE) in Korea. Methods We retrospectively analyzed 21 SPE patients including “definite” and “probable” cases. Results On CT scan, peripheral nodules were the most common lesions (89.0%), followed by non-nodular infiltrates (7.0%) and wedge-shaped peripheral lesions (3.2%). Cavitation and feeding vessel sign, more specific to SPE were identified in 10.4% and 6% of all the lesions, respectively. Transthoracic echocardiography revealed significant abnormalities in three of 13 patients with an additional finding of vegetation in only one of five patients when studied by transesophageal echocardiography. In 15 patients, primary sites of infection were found, and three causative organisms were isolated in 16: K. pneumoniae (8); S. aureus (6); and viridans streptococci (2). All patients received parenteral antimicrobial therapy with or without drainage of the extrapulmonary infection and 18 recovered. Conclusions Although the pathogens of SPE may differ depending on the primary foci of infection, early diagnosis and prompt antimicrobial therapy with radiologic or surgical intervention can lead to a successful treatment outcome.