Septic Pulmonary Embolism Causing Recurrent Pneumothorax in an Intravenous Drug User without Right-Sided Valvular...

Area of Science:

• Pulmonology
• Infectious Diseases
• Cardiology

Background:

• Septic pulmonary embolism (SPE) is a serious complication often linked to infective endocarditis (IE) and intravenous drug use (IVDU).
• Pneumothorax (PTX) is a rare but known complication of SPE, typically associated with right-sided IE and indwelling catheters.

Observation:

• A 36-year-old male with IVDU-induced septic thrombophlebitis presented with recurrent, unilateral pneumothoraces.
• The patient had no detectable right-sided valvular vegetation in infective endocarditis.
• The pneumothorax was refractory to multiple chest tube placements.

Findings:

• This case represents a rare instance of recurrent, unilateral pneumothorax secondary to SPE in an IVDU patient.
• SPE-induced pneumothorax can occur even in the absence of evident right-sided valvular vegetations in IE.
• The findings underscore the complex pulmonary manifestations of SPE in IVDU.

Implications:

• The absence of visible vegetations on echocardiography does not exclude the risk of SPE-induced PTX in IVDU.
• This case expands the understanding of infectious and pulmonary complications associated with SPE and IVDU.
• Clinicians should consider SPE-induced PTX in IVDU patients presenting with unexplained recurrent pneumothorax, regardless of valvular findings.