Percutaneous thrombectomy of fat embolism in-transit.

We report the case of a previously independent 82-year-old female who experienced acute hemodynamic and respiratory deterioration requiring inotropic support due to a fat embolism during revision hip arthroplasty. Computed tomography pulmonary angiography demonstrated fat embolism, and transesophageal echocardiogram showed evidence of right ventricle strain and fat embolism in-transit in the right heart, as well as a moderate patent foramen ovale. Under transesophageal echocardiogram and intravascular ultrasound guidance, the Inari FlowTriever thrombectomy device was used successfully to retrieve the fat embolism with immediate hemodynamic improvement, no complications, and uneventful recovery.

North American blastomycosis in an immunocompromised patient.

Blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus, Blastomyces dermatitidis, that generally produces a pulmonary form of the disease and, to a lesser extent, extrapulmonary forms, such as cutaneous, osteoarticular, and genitourinary. Both immunocompetent and immunocompromised individuals can be infected, but more severe disease occurs in the immunocompromised. Blastomycosis can be diagnosed by culture, direct visualization of the yeast in affected tissue, antigen testing, or a combination of these methods.