CTICasesCavitating Septic Emboli with Bronchopleural Fistula
Imaging findings
CT chest shows multiple cavitating septic pulmonary emboli at the lung periphery, one of which has ruptured into the pleural space, forming a visible bronchopleural fistula and a large, air-fluid-containing pleural empyema.
Key takeaways
Septic emboli (e.g., from MRSA bacteremia) classically locate peripherally and undergo cavitation. A serious complication is rupture into the pleural space, leading to a bronchopleural fistula and a secondary pleural empyema. Characteristically, pleural fluid collections are elongated, whereas parenchymal abscesses are spherical.
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