A computed tomography (CT) scan of the chest
revealed multiple areas of pulmonary consolidation and
cavitary lesions, suggestive of septic emboli. Interestingly,
the CT scan also noted a large filling defect near
the tricuspid valve suggesting a large vegetation [see
Additional file 8: Image 5]. It was presumed in the ED
that the lesions to the patient's lungs and legs were the
result of septic emboli from the heart. A patent foramen
ovale, allowing a right-sided cardiac lesion to reach the
left-sided systemic circulation, was hypothesized as the
cause of these emboli. A comprehensive echocardiography
study performed by the cardiology service was
requested to evaluate these findings.