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.
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
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.
