Faculty mentor/PI email address
jim010@aol.com
Is your research Teaching and Learning based?
1
Keywords
Septic pulmonary emboli, Infective endocarditis, Intravenous drug use, Cavitary lung nodules, Staphylococcus aureus bacteremia
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Septic embolism is a serious complication of systemic infection, most commonly arising from infective endocarditis. In patients with intravenous drug use (IVDU), right-sided endocarditis may lead to septic pulmonary emboli, often presenting with nonspecific or misleading symptoms. A 36-year-old female with recent intravenous fentanyl use presented with presumed opioid withdrawal, along with chest pain, dyspnea, and systemic symptoms. Initial evaluation revealed leukocytosis and bilateral pulmonary nodules on imaging. Computed tomography angiography demonstrated multiple cavitary and non-cavitary nodules consistent with septic pulmonary emboli. Blood cultures grew Staphylococcus aureus, and echocardiography revealed tricuspid valve vegetations with severe regurgitation. The patient required escalation of antimicrobial therapy and transfer for AngioVac intervention. This case highlights the diagnostic challenge of distinguishing substance withdrawal from underlying infectious pathology in high-risk patients. Septic pulmonary emboli should be considered in IVDU patients presenting with respiratory symptoms, even in the absence of fever or classic findings. Early recognition of septic emboli and prompt evaluation for infective endocarditis are critical in patients with IVDU, as delayed diagnosis may lead to significant morbidity and mortality.
Disciplines
Bacterial Infections and Mycoses | Medicine and Health Sciences | Substance Abuse and Addiction
Septic Pulmonary Emboli Revealing Tricuspid Valve Endocarditis in a Patient Presenting with Opioid Withdrawal Symptoms
Septic embolism is a serious complication of systemic infection, most commonly arising from infective endocarditis. In patients with intravenous drug use (IVDU), right-sided endocarditis may lead to septic pulmonary emboli, often presenting with nonspecific or misleading symptoms. A 36-year-old female with recent intravenous fentanyl use presented with presumed opioid withdrawal, along with chest pain, dyspnea, and systemic symptoms. Initial evaluation revealed leukocytosis and bilateral pulmonary nodules on imaging. Computed tomography angiography demonstrated multiple cavitary and non-cavitary nodules consistent with septic pulmonary emboli. Blood cultures grew Staphylococcus aureus, and echocardiography revealed tricuspid valve vegetations with severe regurgitation. The patient required escalation of antimicrobial therapy and transfer for AngioVac intervention. This case highlights the diagnostic challenge of distinguishing substance withdrawal from underlying infectious pathology in high-risk patients. Septic pulmonary emboli should be considered in IVDU patients presenting with respiratory symptoms, even in the absence of fever or classic findings. Early recognition of septic emboli and prompt evaluation for infective endocarditis are critical in patients with IVDU, as delayed diagnosis may lead to significant morbidity and mortality.