The Teaching Point

Pulmonary valve endocarditis with a resultant large septic embolus of the main pulmonary artery is a rare finding, often requiring a high index of suspicion to secure the proper radiological diagnosis for an underlying infectious pathoetiology. The presence of coexisting peripheral, lower lobe-predominant, randomly distributed cavitary nodules and consolidations should prompt the radiologist to strongly consider a source of hematogenous source of infection, including right sided endocarditis.






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From the manuscript

Large septic pulmonary embolus complicating streptococcus mutans pulmonary valve endocarditis

Free full text article: Large septic pulmonary embolus complicating streptococcus mutans pulmonary valve endocarditis

Abstract
Large septic pulmonary embolus is a rare finding in right-sided endocarditis. The entity represents a challenging diagnosis due to its variable and nonspecific clinical and radiological presentation and similarities with other conditions. We present a case of a 41 year-old woman who developed a large main pulmonary artery embolus and bilateral cavitary lung nodules in the setting of severe sepsis. Pulmonary artery exploration and clot retrieval ultimately revealed a large septic embolus from Streptococcus mutans native pulmonary valve endocarditis. The diagnosis of septic pulmonary emboli from right-sided endocarditis should be considered in patients with ancillary findings of septic embolic phenomenon, particularly the presence of multifocal cavitary nodules and in the setting of appropriate predisposing factors.






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1. Endocarditis

2. pulmonary valve

3. septic pulmonary embolism

4. septic pulmonary emboli

5. pulmonary artery

6. computed tomographic pulmonary angiography

7. computed tomography


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