Methicillin-resistant Staphylococcus aureus sepsis presenting with septic pulmonary emboli

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.

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).

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.

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.