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Case of the Week 450



What is the most likely diagnosis?

  • 29 year-old male with hemoptysis



Coronal Reformatted Chest CT

  1. Metastatic Nodules
  2. Castlemann Disease
  3. Septic Emboli
  4. Tracheomegaly
  5. Congestive Heart Failure

Additional Image - Axial CT Chest

 

Additional Images

 

Axial CT of Chest


Answer:

.


3. Septic Emboli

.

.

More (Click Discussion Tab)

 

 

Septic Emboli

 

General Considerations

  • Age
    • Majority <40 years
  • Predisposed
    • IV drug abusers
    • Alcoholism
    • Immunodeficiency
    • CHD
    • Dermal infection (cellulitis, carbuncles)
  • Sources
    • Tricuspid valve endocarditis
      • Most common cause in IV drug abusers
    • Pelvic thrombophlebitis
    • Infected venous catheter or pacemaker wire
    • Arteriovenous shunts for hemodialysis
    • Drug abuse producing septic thrombophlebitis (eg, heroin addicts)
    • Peritonsillar abscess
    • Osteomyelitis
  • Organism
    • S. aureus
    • Streptococcus

MORE . . .

 


.

This Week
29 year-old male with hemoptysis
 
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Some of the fundamentals of interpreting chest images
 
The top diagnostic imaging diagnoses that all medical students should recognize according to the Alliance of Medical Student Educators in Radiology
 
Recognizing normal and  key abnormal intestinal gas patterns, free air and abdominal calcifications
 
Recognizing the parameters that define a good chest x-ray; avoiding common pitfalls
 
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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.