[A case of septic pulmonary embolism induced by urinary tract infection]

A 73-year-old male in whom diabetes mellitus and benign prostatic hypertrophy had been diagnosed was hospitalized with a urinary tract infection (UTI) showing urinary retention and a high grade fever. His symptoms worsened although several antibiotics were administered after admission. A chest radiograph shows multiple nodular lesions and cavity formations in both lung fields. Arterial blood gas analysis showed hypoxia and hypocapnia. Pulmonary perfusion scintigraphy revealed perfusion defects corresponding to the nodular lesions observed on the chest radiograph. Enhanced abdominal CT demonstrated abscesses in the liver and kidney; and in urine and blood cultures, Klebsiella pneumoniae was isolated. We therefore diagnosed septic pulmonary embolism (SPE) occurring secondary to UTI. After diagnosis, the patient was given intravenous imipenem/cilastatin, minocycline and ciprofloxacin, and recovered. Although SPE occurring secondary to UTI is very rare, the incidence of SPE has recently increased in patients with DM. Therefore, we should consider the possibility of SPE in patients with DM who have respiratory symptoms.