Septic pulmonary emboli from pulmonic valvular endocarditis demonstrated by serial ventilation-perfusion lung imaging.
The evolution of multiple ventilation-perfusion mismatches on serial lung scintigraphy in a fully anticoagulated, bacteremic patient with small pulmonary infiltrates and repeatedly negative Doppler ultrasonography of the lower extremities suggested pulmonary emboli from right-sided valvular endocarditis. The demonstration of pulmonic valvular vegetations on follow-up transesophageal echocardiography supported this diagnosis. In the proper clinical setting, septic pulmonary emboli should be included in the differential diagnosis of high-probability ventilation-perfusion lung imaging.
Mehta
T
T
Department of Radiology, New England Medical Center Hospitals, Boston, Massachusetts.
Achong
D M
DM
Oates
E
E
D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000382:microbiology; D011664:Pulmonary Valve; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D014692:Ventilation-Perfusion Ratio; D014980:Xenon Radioisotopes
D013668:Technetium Tc 99m Aggregated Albumin; D014980:Xenon Radioisotopes