Caso Clínico/Case Report
Embolia séptica pulmonar – A propósito de um caso clínico
Septic pulmonary embolism – Case report
Luís Coentrão1,
, Jorge Oliveira2
Corresponding author
luis_coentrao@yahoo.com
Correspondência: Luís Coentrão, Faculdade de Medicina da Universidade do Porto, Instituto de Farmacologia e Terapêutica, Al. Prof. Hernâni Monteiro, 4200-319 Porto.
Correspondência: Luís Coentrão, Faculdade de Medicina da Universidade do Porto, Instituto de Farmacologia e Terapêutica, Al. Prof. Hernâni Monteiro, 4200-319 Porto.
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João, Porto, Serviço de Medicina Interna (Director: Professor Doutor Paulo Bettencourt)" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar de Medicina Interna, Hospital S. João, Porto, Serviço de Medicina Interna (Director: Professor Doutor Paulo Bettencourt)" "etiqueta" => "2" "identificador" => "af0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Correspondência:</span> Luís Coentrão, Faculdade de Medicina da Universidade do Porto, Instituto de Farmacologia e Terapêutica, Al. Prof. Hernâni Monteiro, 4200-319 Porto." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Septic pulmonary embolism – Case report" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-03-12" "fechaAceptado" => "2008-06-17" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570077" "palabras" => array:3 [ 0 => "Embolia séptica pulmonar" 1 => "endocardite infecciosa" 2 => "infiltrados pulmonares" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570076" "palabras" => array:3 [ 0 => "Septic pulmonary embolism" 1 => "infectious endocarditis" 2 => "pulmonary infiltrates" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">A embolia séptica pulmonar (ESP) é frequentemente a apresentação clínica de variadas doenças de etiologia infecciosa, por vezes subdiagnosticadas na prática clínica. Esta entidade foi descrita há cerca de 30 anos, quase sempre associada a toxicodependentes com endocardite infecciosa da válvula tricúspide. Ao longo das últimas três décadas, a epidemiologia desta síndroma sofreu alterações relevantes. No entanto, carece a existência na literatura de critérios de diagnóstico de ESP validados. Os autores apresentam um caso clínico de endocardite infecciosa da válvula tricúspide em toxicodependente, cuja forma de apresentação foi a ESP. O doente apresentava sintomas constitucionaise febre com um mês de evolução. A radiografia de tórax (RXT) apresentava múltiplos infiltrados alveolares no terço inferior do campo pulmonar direito. O diagnóstico inicial foi pneumonia da comunidade, persistente. O ecocardiograma transtorácico revelou a presença de uma vegetação na válvula tricúspide. Foi isolada em hemoculturas espécie de <span class="elsevierStyleItalic">Staphylococcus aureus</span> meticilino-sensível. O doente realizou antibioterapia dirigida com sucesso terapêutico.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Perante estes achados clínicos e após revisão da literatura, os autores propõem critérios de diagnóstico de ESP.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 881-885</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">SPE is a rare syndrome, although a frequent clinical presentation of several disorders, many times misdiagnosed in medical practice. It was described 30 years ago, almost always associated with intravenous drug abuse. Recent reports indicate that the epidemiology of patients with septic pulmonary embolism has changed over the past 30 years. We report a case of septic pulmonary embolism associated with tricuspid valve endocarditis. The patient had a personal history of intravenous drug abuse. The chief complaints were fever, anorexia and weight loss for 30 days. A chest radiograph revealed multiple pulmonary infiltrates in the lower third of the right lung. Antimicrobial agents were instituted in order to treat pneumonia, with no success. Blood cultures were positive for methicilin-susceptible <span class="elsevierStyleItalic">Staphylococcus aureus</span>. Transthoracic ecocardiography revealed a vegetation in the tricuspid valve. Oriented antimicrobial therapy was introduced, successfully. We have reviewed the literature, suggesting thereafter diagnostic criteria for septic pulmonary embolism.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (6): 881-885</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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ISSN: 08732159Original language: Portuguese
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| 2023 May | 495 | 74 | 569 |
| 2023 April | 398 | 71 | 469 |
| 2023 March | 371 | 74 | 445 |
| 2023 February | 276 | 76 | 352 |
| 2023 January | 261 | 69 | 330 |
| 2022 December | 259 | 68 | 327 |
| 2022 November | 402 | 93 | 495 |
| 2022 October | 669 | 122 | 791 |
| 2022 September | 291 | 108 | 399 |
| 2022 August | 268 | 110 | 378 |
| 2022 July | 241 | 94 | 335 |
| 2022 June | 212 | 76 | 288 |
| 2022 May | 250 | 130 | 380 |
| 2022 April | 189 | 81 | 270 |
| 2022 March | 159 | 108 | 267 |
| 2022 February | 104 | 98 | 202 |
| 2022 January | 130 | 171 | 301 |
| 2021 December | 113 | 84 | 197 |
| 2021 November | 104 | 90 | 194 |
| 2021 October | 148 | 106 | 254 |
| 2021 September | 105 | 99 | 204 |
| 2021 August | 90 | 78 | 168 |
| 2021 July | 113 | 111 | 224 |
| 2021 June | 121 | 112 | 233 |
| 2021 May | 223 | 106 | 329 |
| 2021 April | 373 | 198 | 571 |
| 2021 March | 243 | 135 | 378 |
| 2021 February | 167 | 58 | 225 |
| 2021 January | 84 | 49 | 133 |
| 2020 December | 140 | 50 | 190 |
| 2020 November | 99 | 57 | 156 |
| 2020 October | 104 | 49 | 153 |
| 2020 September | 131 | 63 | 194 |
| 2020 August | 116 | 56 | 172 |
| 2020 July | 118 | 57 | 175 |
| 2020 June | 94 | 46 | 140 |
| 2020 May | 120 | 85 | 205 |
| 2020 April | 92 | 52 | 144 |
| 2020 March | 63 | 53 | 116 |
| 2020 February | 50 | 92 | 142 |
| 2020 January | 58 | 58 | 116 |
| 2019 December | 55 | 67 | 122 |
| 2019 November | 57 | 63 | 120 |
| 2019 October | 44 | 70 | 114 |
| 2019 September | 56 | 73 | 129 |
| 2019 August | 73 | 36 | 109 |
| 2019 July | 53 | 28 | 81 |
| 2019 June | 100 | 28 | 128 |
| 2019 May | 93 | 63 | 156 |
| 2019 April | 70 | 38 | 108 |
| 2019 March | 72 | 23 | 95 |
| 2019 February | 53 | 24 | 77 |
| 2019 January | 71 | 28 | 99 |
| 2018 December | 31 | 13 | 44 |
| 2018 November | 8 | 2 | 10 |
| 2018 October | 18 | 9 | 27 |
| 2018 September | 16 | 8 | 24 |
| 2018 August | 40 | 20 | 60 |
| 2018 July | 35 | 18 | 53 |
| 2018 June | 40 | 15 | 55 |
| 2018 May | 62 | 26 | 88 |
| 2018 April | 65 | 38 | 103 |
| 2018 March | 57 | 37 | 94 |
| 2018 February | 30 | 7 | 37 |
| 2018 January | 46 | 18 | 64 |
| 2017 December | 46 | 13 | 59 |
| 2017 November | 32 | 14 | 46 |
| 2017 October | 23 | 7 | 30 |
| 2017 September | 32 | 22 | 54 |
| 2017 August | 26 | 20 | 46 |
| 2017 July | 16 | 11 | 27 |
| 2017 June | 28 | 14 | 42 |
| 2017 May | 37 | 15 | 52 |
| 2017 April | 10 | 6 | 16 |
| 2017 March | 21 | 11 | 32 |
| 2017 February | 15 | 3 | 18 |
| 2017 January | 13 | 4 | 17 |
| 2016 December | 13 | 3 | 16 |
| 2016 November | 9 | 6 | 15 |
| 2016 October | 11 | 17 | 28 |
| 2016 September | 1 | 1 | 2 |
| 2016 August | 3 | 0 | 3 |
| 2016 July | 4 | 3 | 7 |
| 2016 June | 0 | 2 | 2 |
| 2016 May | 3 | 10 | 13 |
| 2016 April | 1 | 2 | 3 |
| 2016 March | 1 | 3 | 4 |
| 2016 February | 11 | 5 | 16 |
| 2016 January | 3 | 7 | 10 |
| 2015 December | 7 | 2 | 9 |
| 2015 November | 5 | 3 | 8 |
| 2015 October | 3 | 2 | 5 |
Show all
