Septic pulmonary emboli: a case discussion

This article examines a case study from clinical practice from the perspective of a final-year trainee advanced clinical practitioner (ACP) working within the hospital out-of-hours team in an acute hospital. To maintain privacy and patient confidentiality in accordance with the Nursing and Midwifery Council (2018)Code, the patient will be given the pseudonym James.

James was a 38-year-old man with a past medical history of recreational intravenous drug use of approximately 13 years, asthma and a previous deep vein thrombosis (DVT). James had been prescribed an anticoagulant, oral apixaban 2.5 mg twice daily, to prevent the re-occurrence of the DVT; however, he admitted that his concordance with self-administering this was often poor. James had been admitted under general medicine with an infected groin abscess, caused by injecting into the femoral veins within the groin, and was commenced on a 6-week course of the intravenous antibiotic, benzyl-penicillin, via a central venous access device (CVAD) as his peripheral veins were inaccessible. This treatment regimen had been advised by the microbiologist, following discussions with the parent team on admission.