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Septic pulmonary embolism resulting from soft tissue infection in a 5-year-old child

Other Title
소아에서 연조직 감염에 의한 패혈성 폐색전증 1예
Gil, L | Jeong, K  | Kim, HG  | Lee, HD  | Cho, JH  | Lee, S
Allergy asthma & respiratory disease, 5(1). : 56-60, 2017
Journal Title
Allergy asthma & respiratory disease
Septic pulmonary embolism occurs when septic material becomes detached from its origin and infiltrates into the pulmonary parenchyma causing significant clinical symptoms. It is uncommon in children and mostly related to intravascular catheterization, endocarditis, pelvic thrombophlebitis, and soft tissue infection. We report a case of a 5-year-old boy who experienced septic pulmonary embolism originating from a left shoulder abscess after traumatic injury. Magnetic resonance imaging of the shoulder revealed a multifocal subcutaneous and intramuscular abscess with septic arthritis. The initial chest radiograph showed suspicious pneumonic infiltration with nodular opacities. A percutaneous catheter was inserted to drain the shoulder abscess, and cefazedone, a first-generation cephalosporin, was administered intravenously. Two days later, a chest radiograph taken for the follow-up of the initial pneumonic infiltration with nodular opacities demonstrated aggravation of multifocal nodular lesions in bilateral lung fields, with one of the nodular cavities containing an air-fluid level. Despite the absence of significant respiratory symptoms, chest computed tomography showed multifocal necrotic nodules and cavity lesions with feeding vessel signs dominantly in the left lower lung field, which is characteristic of septic pulmonary embolism. Methicillin-susceptible Staphylococcus aureus was isolated from the shoulder abscess, whereas repeated blood and sputum cultures did not reveal any bacterial growth. With resolution of clinical symptoms as well as the finding of chest computed tomography, the patient was discharged 18 days after admission in a stable condition. Regression of the multifocal pulmonary nodular lesions was noticed on the subsequent chest imaging studies performed 45 days after the treatment.

Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pediatrics & Adolescent Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
Ajou Authors
김, 현지  |  이, 수영  |  이, 한동  |  정, 경욱  |  조, 재호
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