SEPTIC EMBOLI

An embolism is a piece of material traveling thru the blood stream that is usually not found in the blood, e.g. blood clot, infected tissue, foreign material etc. A septic embolus is embolic tissue that is infected with a bacteria. Any chronic focus of infection may be suspect. Infectious endocarditis or an infected intravenous access sited are common examples.

In patients with septicemia from Staphylococcus, vasculitis may or may not be present. Thus, both terms septic vasculitis and septic vasculopathy respectively have been used.

Clinical

The patient is usually quite ill. Fever, signs of sepsis, and positive blood cultures are typical. With regard to the skin, retiform purpura, petechiae and ecchymoses, vesicopustules, hemorrhagic bullae, necrotic lesions and ulcerations may all occur.

Diagnosis

Skin biopsy is usually in order for any necrotic skin lesion. Tissue sent for special stains and culture, bacterial, fungal and viral is in order. For more information on work-up for necrotic skin lesions, see necrosis.

Treatment

Treatment by an infectious disease specialist is in order.

References

Unilateral stellate purpura on the ankle of a patient with infectious endocarditis. JAMA Derm 2015;151;1125

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