Septic Pulmonary Embolism: A Contemporary Profile

Area of Science:

• Medicine
• Infectious Diseases
• Pulmonology

Background:

• Septic pulmonary embolism (SPE) is a rare condition distinct from non-septic pulmonary embolism.
• It presents in patients with sepsis or acute inflammatory reactions showing pulmonary symptoms.

Purpose of the Study:

• To provide a contemporary profile of septic pulmonary embolism.
• To propose a clinical management algorithm for suspected or confirmed SPE cases.

Main Methods:

• Diagnostic criteria include specific radiologic findings: multiple, peripheral, nodular, possibly cavitated lesions.
• Identifying the primary infection source is critical, with common origins including infective endocarditis and device infections.
• Broad-spectrum antimicrobial therapy is recommended, especially if blood cultures are negative.

Main Results:

• In-hospital mortality for SPE can be as high as 20% in reported series.
• Increasing incidence may be driven by the opioid epidemic, widespread use of cardiac implantable electronic devices, and rising septic thrombophlebitis cases.
• The efficacy and safety of anticoagulation in associated thrombophlebitis remain undefined.

Conclusions:

• SPE requires a high index of suspicion in patients with sepsis and pulmonary signs.
• Prompt diagnosis, source control, and appropriate antimicrobial therapy are essential for management.
• Further research is needed to clarify anticoagulation's role and understand incidence trends.