76year old female presents with dyspnea  sepsis and bacteremia

CXR
Thick Walled Cystic lesions

76year old female presents with dyspnea  sepsis and bacteremia,  Frontal CXR reveals thick walled cystic changes clustered in the right apex and similar single thick walled cystic spaces in the right costophrenic angle and alongside the left heart border.  There is silhouetting of the left hemidiaphragm.  Echo showed tricuspid valve vegetations.  Diagnosis is consistent with cavitating septic emboli
Ashley Davidoff TheCommonVein.net 33005
76year old female presents with dyspnea  sepsis and bacteremia, 
Frontal CXR reveals thick walled cystic changes clustered in the right apex (red ring a and c)   and similar single thick walled cystic spaces in the right costophrenic angle yellow ring, magnified in a and b) and alongside the left heart border (green ring in a and d).  There is silhouetting of the left hemidiaphragm.  Echo showed tricuspid valve vegetations.  Diagnosis is consistent with cavitating septic emboli
Ashley Davidoff TheCommonVein.net 33005cL

CT
Thick Walled Cystic Lesions
Bacteremia – Septic Emboli

76year old female presents with dyspnea  sepsis and bacteremia, 
Axial CT  reveals multiple small thick walled cystic changes clustered in the apices bilaterally, and thickening of the interlobular septa There is a large right pleural effusion.   Echo showed tricuspid valve vegetations.  Diagnosis is consistent with cavitating septic emboli
Ashley Davidoff TheCommonVein.net 33011
76year old female presents with dyspnea  sepsis and bacteremia, 
Axial CT  reveals a thick walled complex cystic nodule alongside a solid nodule clustered in the right apex, and thickening of the interlobular septa There is a large right pleural effusion.   Echo showed tricuspid valve vegetations.  Diagnosis is consistent with cavitating septic emboli
Ashley Davidoff TheCommonVein.net 33010

Wedge Shaped Cystic Complex with
Feeding Bronchovascular Bundle

76year old female presents with dyspnea  sepsis and bacteremia, 
Axial CT  reveals a large wedge shaped thick walled complex multicystic lesion associated with a feeding bronchovascular bundle (feeding vessel sign) in the right apex consistent with a cavitating infarction (cavitating Hampton’s hump).  In addition there is a second smaller unilocular thick-walled cyst with a small air fluid level suggesting infection.  There is a right pleural effusion.   Echo showed tricuspid valve vegetations.  Diagnosis is consistent with cavitating septic emboli
Ashley Davidoff TheCommonVein.net 33012