PMC9997473_01
(a) Chest CT showing multiple peripherally based nodules (b) TEE showing a 1 x 0.9 cm vegetation in the TV
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F1
A Computer topography (CT) of the chest exhibited multiple peripherally based nodules on both lungs, some with cavitation suggestive of septic emboli [Figure 1a]. He was started on empiric antibiotic therapy and a transesophageal echocardiography (TEE) was performed, revealing a 1 x 0.9 cm mobile vegetation in the TV [Figure 1b].
PMC9997473_02
(a) Chest CT showing multifocal ground glass opacities with internal cavitation (b) TEE showing a 1.5 x 1.1 cm vegetation on the TV
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F2
A CT of the chest was obtained that showed multifocal ground-glass and nodular opacities with internal cavitation in a peripherally predominant distribution concerning for septic emboli [Figure 2a]. An initial transthoracic echocardiography was unremarkable, but a follow up TEE revealed moderate-to-severe tricuspid regurgitation along with a 1.5 x 1.1 cm vegetation on the TV [Figure 2b].
PMC9997473_03
(a) Chest CT showing multifocal nodular opacities with a complex loculated pleural effusion (b) TEE showing a 1m x 1.5 cm vegetation on the TV
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F3
A CT of the chest was performed that exhibited multifocal nodular and consolidative opacities, some with central cavitation, and a complex loculated pleural effusion on the right pleura [Figure 3a]. TEE was performed that showed a 1 x 1.5 cm vegetation on the TV with moderate tricuspid regurgitation [Figure 3b]. The patient's blood results returned positive for methicillin-resistant S. aureus for two out of two.