Septic pulmonary embolism in systemic sclerosis-associated intestinal pseudo-obstruction: A case report

Systemic sclerosis (SSc) is a syndrome characterised by excessive fibrosis in multiple organs. Intestinal pseudo-obstruction is one of the major gastrointestinal manifestations of SSc, characterised by long-standing symptoms suggesting obstruction without a lesion identified despite endoscopic and/or radiological examination. Septic pulmonary embolism is a rare type of pulmonary embolism in which emboli containing pathogens embolise into the pulmonary arteries and cause focal lung abscesses. The case of a 53-year-old man with SSc-associated intestinal pseudo-obstruction, who developed a septic pulmonary embolism, is described. Klebsiella pneumoniae was isolated from blood cultures. After 4 weeks of intravenous antibiotic therapy, follow-up computed tomography showed the complete disappearance of the pulmonary cavity lesions. This case suggests that patients with SSc-associated intestinal pseudo-obstruction are at risk of infection and highlights the importance of careful observation.