Right-sided infective endocarditis with septic pulmonary emboli and secondary pneumothorax: A case report

Right-sided infective endocarditis (RSIE), particularly prevalent among intravenous drug users (IVDU) and often caused by Staphylococcus aureus , frequently leads to septic pulmonary emboli (SPE). While pneumothorax (PTX) is a rare but severe complication of SPE, its occurrence significantly complicates patient management and necessitates prompt recognition. We present the case of a 32-year-old male IVDU with RSIE and MRSA bacteremia who developed acute respiratory deterioration due to cavitating septic pulmonary emboli and a secondary pneumothorax. This case highlights the critical importance for radiologists to carefully evaluate for cavitary septic emboli and pneumothorax, especially when lesions are subpleural, in patients with RSIE and sudden respiratory worsening, underscoring the diagnostic and therapeutic challenges in this vulnerable population.