Ferhan KARATAŞ, Ali FİDAN, Coşkun DOĞAN, Sevda CÖMERT ŞENER, Benan ÇAĞLAYAN

SEPTİK PULMONER EMBOLİ; ÜÇ OLGU NEDENİ İLE

Septik pulmoner emboli herhangi bir enfeksiyon odağına ikincil olarak gelişen akciğer infiltrasyonları, ateş, göğüs ağrısı, öksürük gibi non spesifik akciğer semptomları ile karakterize bir hastalıktır. İkincil enfeksiyon odağından hareket eden fibrin içine yerleşmiş mikroorganizmaları iceren bir trombus pulmoner arterlere yerleşir ve bilateral akciğer parankiminde genellikle periferik ve damar komşulğunda yerleşen genellikle multipl ve bilateral nodüler, kaviter veya kama şeklinde infiltrasyonlara yol açar. Akciğerlerde bilateral ve multipl yerleşimli nodüller için tetkik edilirken septik pulmoner emboli tanısı alan ve ileri tetkik sırasında iki olgunun dental enfeksiyona, bir olgununda enfektif endokardite ikincil septik emboli tanısı aldığı ortaya çıkan üç olguyu nadir görüldüğü için literatür eşliğinde paylaştık.

SEPTIC PULMONARY EMBOLISM: THREE CASES

Septic pulmonary embolism is a non-specific lung disease developing secondary to any source of infection characterized by symptoms such as pulmonary infiltrates, fever, chest pain and cough. A thrombus that includes microorganisms embedded in fibrin moving from a secondary focus of infection settles in the pulmonary arteries. It leads to generally multiple and bilateral, nodular, wedgeshaped or cavitary infiltrations in the lung parenchyma, usually located adjacent to the peripheral vessels. Herein three cases who were presented with bilateral and multiple pulmonary nodules, diagnosed as septic pulmonary embolism at the beginnig During further investigation, it was realized that two cases have findings were secondary to dental infection, the other case was secondary to infective endocarditis.

PDF

___

1. Jorens PG, Van Marck E, Snoeckx A. Parizel Eur Respir. 2009; 34: 452-74.
2. Cook RJ, Ashton RW, Aughenbaugh GL,et al. Septic pulmonary embolism: Presenting features and clinical course of 14 patients. Chest. 2005; 128(1): 162-6.
3. Takeda K, Tanaka K, Kumamoto T, et al. Septic pulmonary embolism originated from subcutaneous abscess after living donor liver transplantation: a pitfall af postoperative management. Clin Gastroenterol 2013; 6:378- 82.
4. MacMillan JC, Milstein SH, Samson PC. Clinical spectrum of septic pulmonary embolism and infarction. J Thorac Cardiovasc Surg. 1978; 75: 67079.
5. Ye R, Zhao L, Wang C, et al. Clinical characteristics of septic pulmonary embolism in adults: A systematic review. Respir Med. 2013 Oct 17. pii: S0954-6111(13)00422-8.
6. Iwasaki Y, Nagata K, Nakanishi M, et al. Spiral CT findings in septic pulmonary embolism. Eur J Radiol. 2001; 37(3): 190-4.
7. Mullick P, Sachdeva HC, Bundela P, et al. Septic pulmonary embolism following necrotizing fasciitis of the upper limb. J Anaesthesiol Clin Pharmacol. 2013 29(3): 416-8.
8. Doğan C, Şener Cömert S, Kıral N, ve ark. Diş çekimine ikincil gelişen septik pulmoner emboli. J Kartal TR 2011; 22(2): 79-83.
9. Prakash V, Krishnamurthy S, Mahadevan S, et al. Infective endocarditis and septic pulmonary embolism following scorpion sting envenoming in an 11-year-old child. Paediatr. Int Child Health. 2013 Nov 6. [Epub ahead of print]
10. Megarbane B, Chevillard L. The large spectrum of pulmonary complications following illicit drug use: Features and mechanisms. Chem Biol Interact. 2013 5; 206(3): 444-51.
11. Okada H, Taira K, Tokunaga S, et al. A case of a septic pulmonary embolism-related implanted central venous port. Gan To Kagaku Tyoho. 2013; 40(3): 389-92.
12. Shiota Y, Taniguchi A, Yuzurio S, et al. Septic pulmonary embolism induced by dental infection. Acta Med Okayama. 2013 Aug; 67(4); 253-8.
13. Sakuma M, Sugimura K, Nakamura M, et al. Unusual pulmonary embolism: Septic pulmonary embolism and amniotic fluid embolism. Circ J 2007; 71: 772-5.