Metastatic nodular pneumonia due to septic embolism: a Staphylococcal infection
Journal Title: Journal of Advances in Internal Medicine - Year 2014, Vol 3, Issue 2
Abstract
Ill-defined lung nodules mimicking secondary metastasis caused by Staphylococcus aureus though defined, is uncommon. We report a 58 years male with chest pain, dry cough, fever and abscess over the nape of neck. Bilateral nodules in the chest x-ray resembled metastasis. Workup for malignancy was negative. Induced sputum grew Staphylococcus aureus resistant to penicillin group. The lesions cavitated and produced air-fluid levels. Computed tomography confirmed the peripheral location, right sided hydropneumothorax and loculated fissural collection. Recovery was favourable but delayed with injectable ceftriaxone and levofloxacin initially followed by oral levofloxacin. Review chest radiograph showed residual cavities with small pneumothorax. Follow-up after three months showed resolution of all cavities and pneumothorax. Literature review revealed both Methicillin sensitive and resistant staphylococcus aureus can cause metastatic nodular pneumonia. Rapidly necrosis occurs if the organisms are capable of producing the toxin: Panton-Valentine Leukocidin. But this tendency is more common with community-acquired methicillin resistant strains.
Authors and Affiliations
Sanjeet Krishna Shrestha*| DM resident, Pulmonary, Critical care and Sleep Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal, Brajendra Srivastava| Consultant, Department of Respiratory Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal, Rabindra Khunjeli| Consultant, Department of Respiratory Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal, Ushab Rana Mousin| Consultant, Department of Respiratory Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
Keywords
Related Articles
- EP ID EP4789
- DOI http://dx.doi.org/10.3126/jaim.v3i2.14068
- Views 478
- Downloads 21
Trends and in- hospital mortality of Acute Coronary Syndrome at Shahid Gangalal National Heart Centre, Kathmandu, Nepal during 2001-2012
Background and aims: Acute coronary syndrome (ACS), which comprises acute ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction and unstable angina is a major health problem and repre...
Gastrointestinal Mantle Cell Lymphoma: incidental finding on routine CT scan following pneumothorax
Gastric mantle cell lymphoma is a rare form of gastrointestinal tumor and represents 2.5–7% of all non-Hodgkin’s lymphomas. A 69-year-old maleadmitted with spontaneous pneumothorax was found to have a gastric masson CT...
Wellens’ Syndrome, a case report of an electrocardiographic warning sign
Introduction: Wellens’ syndrome is described as a characteristic biphasic or symmetrical electrocardiographic T-wave inversions in precordial leads seen in a subset of patients with unstable angina. It is associated with...
ROMANIAN HEALTH SYSTEM’S REORGANIZATION UNDER THE GLOBAL ECONOMIC CRISIS. ANALYSIS AT EUROPEAN, NATIONAL AND REGIONAL LEVEL
In the context of global economic crisis, Romanian health system is undergoing a reorganization process that presents controversial issues, both positive, and especially negative. According international statistics, Roma...
Changes in Heart Rate Variability and Glycosylated Hemoglobin in Prediabetics and Type 2 Diabetes Mellitus
Background: People with diabetes mellitus (DM) suffer from cardiac autonomic neuropathy (CAN), this may remain subclinical and reduced heart rate variability (HRV) is Objective: The present study was undertaken to invest...