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Pulmonary septic emboli: diagnosis with CT.

J E Kuhlman1, E K Fishman, C Teigen

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21205.

Radiology
|January 1, 1990
PubMed
Summary

Computed tomography (CT) effectively identifies pulmonary septic emboli, often revealing more disease extent than chest X-rays. Characteristic CT findings can suggest this diagnosis even when initial radiographs are negative.

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Infectious Disease

Background:

  • Pulmonary septic emboli are a serious complication of bloodstream infections.
  • Early and accurate diagnosis is crucial for effective treatment and patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic utility of computed tomography (CT) in identifying pulmonary septic emboli.
  • To characterize the CT features associated with pulmonary septic emboli.

Main Methods:

  • Retrospective review of CT scans from 18 patients with confirmed pulmonary septic emboli.
  • Analysis of CT findings including nodule characteristics, feeding vessel sign, cavitation, and pleural involvement.
  • Comparison of CT findings with chest radiography in a subset of patients.

Main Results:

  • CT demonstrated characteristic features in most patients, including peripheral nodules (83%), feeding vessel sign (67%), and cavitation (50%).
  • CT identified lesions compatible with septic emboli before radiography in 33% of cases.
  • CT revealed a greater extent of disease, including parenchymal and pleural involvement, compared to chest radiographs in 44% of patients.

Conclusions:

  • CT is a valuable imaging modality for confirming pulmonary septic emboli, especially when chest radiographs are inconclusive.
  • Specific CT features can suggest the diagnosis of septic emboli in the appropriate clinical context.
  • CT can detect a more extensive disease burden than conventional radiography.

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