A Case of Septic Pulmonary Embolism in Neonate

Lee, Sang Hee; Lee, In Hoon; Kim, Jin Kuk; Nam, Byung Do; Lee, Ju Seok; Park, Jae Hong

Abstract

Septic pulmonary embolization is an uncommon condition in which the clot or fibrin matrix, contaminated with micro-organisms, lodge in the pulmonary arterial tree, leading to infarction, suppuration and other complications. The septic emboli reach the lung from a variety of sources, including acute suppurative pelvic thrombophlebitis, infective endocarditis involving tricuspid and pulmonary valve, osteomyelitis, suppurative lesions of the neck, infected venous catheters or pacemaker wires and sepsis. Early clinical detection, along with prompt administration of broad- spectrum antibiotics, is an important factor in the prognosis of patients, but the initial clinical diagnosis is often difficult because of nonspecific findings in clinical and laboratory data. Recently, the characteristic appearance of septic emboli by chest computed tomography (CT) has been described, and chest CT is an important modality for confirming the presence of septic pulmonary emboli. We experienced a case of septic pulmonary embolism in a 14-day-old neonate with cough, fever dyspnea. Initial conventional chest radiogaphs revealed bilateral infilterate, but chest CT revealed the presence of multiple peripheral nodules, cavitation of nodules and a distinct vessel leading to a pulmonary nodule which is referred to as a feeding vessel sign, which diagnosis suggests. Coagulase negative staphylococcus was cultured in the blood stream and clinical and radiologic improvement was achieved after adminstration of antibiotics.