Septic emboli

Evidence of active pericarditis, endocarditis, septic emboli, current or recent pregnancy, and lactating women... 

Osier nodes are small (usually 2-15 mm), painful, tender subcutaneous nodules located on the pads of the fingers and toes (Fig. 71-3/i) caused primarily by either septic emboli or vasculitis. These nodes are rare in acute disease but are also nonspecific for IE despite occurring in 10% to 25% of all patients.1... 

Janeway lesions are small, painless hemorrhagic macular plaques on the palms of the hands or soles of the feet due to septic emboli and more commonly associated with acute S. aureus IE (Fig. 71-3F). 

Simmonds cachexia is often the consequence of anterior lobe necrosis due to its destruction by shock or septic emboli. The septic emboli may result from ascending pyelonephritis or from pyemia. Simmonds cachexia is observed more often in women than in men because obstetric shock seems to cause it frequently. But a progressive inflammatory process, the development of a chromophobe adenoma (often associated with compression of the chiasma and seizures), or hemorrhage within the gland should be considered as possible causes of Simmonds cachexia. 

Obstetric shock Septic emboli Ascending pyelonephritis Diabetes mellitus... 

Fig. 27.9. The bilateral ill-defined nodules with cavitation appeared like fungal pneiunonia. After taking the patients actual complaint into consideration, the patients suffered from port related infection with Staphylococcus aureus. The true disease septic emboli then became obvious...

A 62-year-old man had bleeding gastric varices injected with enbucrilate (Histoacryl ) and 4 weeks later developed hepatic impairment associated with cyanoacrylate in the aorta and iliac arteries [39 ]. He then developed a diffuse ascending spondylodiscitis, with osteolysis of the fifth lumbar vertebra, probably as a result of septic emboli and died 10 months later. 

The difference between AVF and AVG is that infection in autogenous accesses can be treated successfully with antibiotics (and potential drainage) with the exception of those infections involving the anastomosis because of the risk of suture line bleeding and those complicated with septic emboli necessitating access ligation. 

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