MRSA Septic Thrombophlebitis and Pulmonary Embolism: A Case Report Highlighting the Tight Bond With Infective...

Septic pulmonary embolism in adults is usually associated with right-sided endocarditis. We report a 27-year-old male with 14 days of fever, dyspnea, and hemoptysis. CT chest showed bilateral peripheral cavitating nodules consistent with septic pulmonary emboli. Blood cultures yielded MRSA; transesophageal echocardiography showed no vegetations. CT abdomen-pelvis identified a thrombus in the inguinal venous system compatible with septic thrombophlebitis. Management included IV antibiotics and anticoagulation. His case highlights the close interplay between septic thrombophlebitis and infective endocarditis. As well as the utility of prompt extra-thoracic imaging when endocarditis work up is negative. Central discussion points include the devastating consequences of persistent bacteremia, urging the clinician to take action and the controversial use of anticoagulation for septic pulmonary embolism, which in this case was completely beneficial.