Abstrait

Septic pulmonary embolism associated with self-inflicted wound.

Masaki Fujioka, Kiyoko Fukui, Satoko Ishiyama, Taro Masuda

Septic pulmonary embolism (SPE) is uncommon but associated with a high mortality. SPE is usually related to deep tissue infections, and reports of SPE after mild injuries are rare. A 46-yearold male complained of fever and dyspnea 10 days after self-infliction of a left forearm. The wound showed purulence with the presence of Staphylococcus aureus. Computed tomography showed multiple lung nodules, which suggested SPE. After immediate debridement, high-dose antibiotics were initiated. The patient underwent free skin grafting 12 days later. The main problem with this case was that infection of the self-infliction wound was overlooked until he developed a high fever and dyspnea due to SPE, because the wound care was performed by a psychiatrist and nurses. Even a mild soft-tissue infection can be a potential source of SPE. Thus, clinicians who treat acute wounds should pay increased attention to the self-inflicted wounds.