Septic Pulmonary Embolism Associated with Klebsiella spp. Infection in a Patient with Previous ASD Operation

Septic pulmonary embolism (SPE) is an uncommon disease caused by thromboembolism associated with microorganisms. A 57-year old woman patient who was monitored for a prediagnosis of subileus suffered from sudden respiration problems in the hospital ward. The patient's history included atrial fibrillation and atrioseptal defect (ASD) operation. The patient was admitted to the intensive care unit (ICU) in order to apply non-invasive mechanical ventilation and keep her under observation because of low saturation and loss of consciousness. In the ICU, the patient's temperature was 38.8 degrees C, which led to the diagnosis of sepsis. The chest X-ray showed bilateral and multiple patchy infiltrates. The thorax CT showed right lower pulmonary consolidation and left pulmonary pleuroparenchymal density with nodular shapes. The electrocardiogram showed mild pulmonary hypertension and third-degree tricuspid failure. These features indicated SPE because of the ASD operation in the past. The blood culture showed the presence of Klebsiella spp., which is uncommon. A characteristic CT sign is very important for the early diagnosis and treatment of SPE.