Journal Information
Vol. 56. Issue 7.
Pages 457 (July 2020)
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Spontaneous Pneumothorax due to Septic Pulmonary Embolism Caused by Methicillin-resistant Staphylococcus aureus
Neumotórax espontáneo secundario a embolias sépticas pulmonares por Staphylococcus aureus resistente a meticilina
Horacio Matías Castro
Corresponding author

Corresponding author.
, Clara Lucia Torres Cabreros, Esteban Javier Wainstein
Sección de Neumonología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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We report the case of a 41-year-old woman with a history of kidney transplantation with chronic graft dysfunction, who was undergoing hemodialysis 3-times-weekly via temporary jugular catheter. The patient was admitted with a diagnosis of catheter sepsis with positive blood cultures for methicillin-resistant Staphylococcus aureus. She developed sudden dyspnea and chest pain 72h after admission. A chest computed tomography was performed that showed right pneumothorax associated with cavitary pulmonary nodules (Fig. 1), some of which were peripheral. A diagnosis of spontaneous pneumothorax following rupture of septic cavitary emboli in the pleural space was established. The pneumothorax was treated with pleural drainage for 4 days. A 4-week course of antibiotic therapy with vancomycin was indicated, with good clinical progress.

Fig. 1.

Chest computed tomography: (A) coronal slice; (B and C) transversal slice. Peripheral cavitary pulmonary nodules (arrows) in the right and left upper lobe and right pneumothorax.


Catheter-associated infection is a frequent cause of septic pulmonary embolism.1 The causative microorganism is usually Staphylococcus aureus. Lesions are cavitary in 56% of cases1 and, when they occur in a peripheral site, they can open to the pleural space, triggering secondary spontaneous pneumothorax.2 This complication is rare and usually occurs between 5 and 15 days after starting antibiotic treatment.2

R. Ye, L. Zhao, C. Wang, X. Wu, H. Yan.
Clinical characteristics of septic pulmonary embolism in adults: a systematic review.
Respir Med, 108 (2014), pp. 1-8
M. Okabe, K. Kasai, T. Yokoo.
Pneumothorax secondary to septic pulmonary emboli in a long-term hemodialysis patient with psoas abscess.
Intern Med, 56 (2017), pp. 3243-3247

Please cite this article as: Castro HM, Torres Cabreros CL, Wainstein EJ. Neumotórax espontáneo secundario a embolias sépticas pulmonares por Staphylococcus aureus resistente a meticilina. Arch Bronconeumol. 2020;56:457.

Copyright © 2019. SEPAR
Archivos de Bronconeumología

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