Methicillin-resistant Staphylococcus aureus sepsis presenting with septic pulmonary emboli.
BACKGROUND
Septic pulmonary emboli are the result of infections that typically originate from an extrapulmonary source. Septic pulmonary embolus is a rare disorder that classically presents with fever, respiratory symptoms, and lung infiltrates.


OBJECTIVE
Our objective is to share our experience of a rare diagnosis that was the result of a very common bacterium seen in the Emergency Department (ED).


METHODS
We present a case of methicillin-resistant Staphylococcus aureus (MRSA) sepsis presenting as bilateral septic pulmonary emboli in a patient with undiagnosed acquired immunodeficiency syndrome. A 29-year-old Hispanic man presented to our ED with a history of abdominal pain and vomiting for 3 days and new onset of shortness of breath. The patient was seen 2 weeks prior for a simple abscess incision and drainage and was treated with trimethoprim/sulfamethoxazole. On the day of admission, a helical computed tomography scan of the chest was obtained, which revealed bilateral septic pulmonary emboli. The patient was admitted for intravenous antibiotic therapy and was subsequently found to have MRSA sepsis.


CONCLUSIONS
Septic pulmonary embolus is a rare finding that is most commonly seen in patients who are immunocompromised. The patient fully recovered after aggressive antibiotic therapy.
Kruse
Brian T
BT
Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Vadeboncoeur
Tyler F
TF
D000038:Abscess; D000328:Adult; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D011704:Pyelonephritis / Q000175:diagnosis / Q000382:microbiology; D011859:Radiography; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis; D014640:Vancomycin / Q000627:therapeutic use
D014640:Vancomycin