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Cavitating nodules in a young male with acyanotic congenital heart disease

Description

A 23 year old male presented with history of fever and shortness of breath of five days' duration. Chest X Ray showed multiple nodular opacities. Subsequent HRCT (Figure) showed multiple random nodules, some of them, cavitating and with a feeding vessel sign, consistent with the diagnosis of septic thromboemboli. A 2D echocardiogram showed a ventricular septal defect with a left to right shunt and a vegetation measuring 2x1.5cms on the right ventricular side of the defective septum. A diagnosis of Infective endocarditis with septic emboli was made.

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