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Due to life-threatening bleeding, anticoagulation was temporarily withheld and an inferior vena cava filter was placed. The patient was managed conservatively with supportive care and antibiotics with gradual clinical and radiological improvement. Anticoagulation was successfully restarted later during hospitalisation, and follow-up imaging demonstrated progressive resolution of the infarction. This case highlights the diagnostic and therapeutic challenges of pulmonary infarction following massive PE and illustrates that even large infarcts can resolve with careful conservative management.<\/jats:p>","DOI":"10.1136\/bcr-2026-273374","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:55:33Z","timestamp":1779195333000},"page":"e273374","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Massive pulmonary embolism complicated by pulmonary infarction, haemoptysis and hemothorax"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7119-0660","authenticated-orcid":false,"given":"Shihla","family":"Shireen Kanamgode","sequence":"first","affiliation":[{"name":"Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6291-4461","authenticated-orcid":false,"given":"Sarah","family":"Reid","sequence":"additional","affiliation":[{"name":"UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-6022","authenticated-orcid":false,"given":"Kyle","family":"Halligan","sequence":"additional","affiliation":[{"name":"UMass Chan Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"2026051905552085000_19.5.e273374.1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1055\/s-0036-1592310","article-title":"Pulmonary Infarction: An Often Unrecognized Clinical Entity","volume":"42","author":"Miniati","year":"2016","journal-title":"Semin Thromb Hemost"},{"key":"2026051905552085000_19.5.e273374.2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2443060846"},{"key":"2026051905552085000_19.5.e273374.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(82)90458-2"},{"key":"2026051905552085000_19.5.e273374.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2021.03.022"},{"key":"2026051905552085000_19.5.e273374.5","first-page":"305","article-title":"Correlation of postmortem chest teleroentgenograms with autopsy findings, with special reference to pulmonary embolism and infarction","volume":"43","author":"Hampton","year":"1940","journal-title":"Am J Roentgenol"},{"key":"2026051905552085000_19.5.e273374.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.rti.0000187433.06762.fb"},{"key":"2026051905552085000_19.5.e273374.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-067579","article-title":"Clinical outcomes and factors associated with pulmonary infarction following acute pulmonary embolism: a retrospective observational study at a US academic centre","volume":"12","author":"Lio","year":"2022","journal-title":"BMJ Open"},{"key":"2026051905552085000_19.5.e273374.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2012.03.012"},{"key":"2026051905552085000_19.5.e273374.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197706232962503"},{"key":"2026051905552085000_19.5.e273374.10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.4.1178"},{"key":"2026051905552085000_19.5.e273374.11","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1968.03640060009002"},{"key":"2026051905552085000_19.5.e273374.12","unstructured":"Tapson VF , Weinberg AS . Treatment, prognosis, and follow-up of acute pulmonary embolism in adults. Waltham, MA UpToDate; 2021."},{"key":"2026051905552085000_19.5.e273374.13","doi-asserted-by":"crossref","first-page":"e117","DOI":"10.1016\/j.athoracsur.2020.05.085","article-title":"Successful Resection of Rapidly Growing Cavitary Infarction After Pulmonary Emboli","volume":"111","author":"Yutaka","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2026051905552085000_19.5.e273374.14","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/00005792-198509000-00006","article-title":"Pulmonary cavitation following pulmonary infarction","volume":"64","author":"Libby","year":"1985","journal-title":"Medicine (Baltimore)"},{"key":"2026051905552085000_19.5.e273374.15","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.thromres.2023.04.005","article-title":"Impact of pulmonary infarction in pulmonary embolism on presentation and outcomes","volume":"226","author":"Kaptein","year":"2023","journal-title":"Thromb Res"},{"key":"2026051905552085000_19.5.e273374.16","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.85a.17132"},{"key":"2026051905552085000_19.5.e273374.17","doi-asserted-by":"crossref","DOI":"10.1186\/s13019-025-03418-6","article-title":"Pulmonary endarterectomy and lung resection achieving therapeutic success in rarely encountered large cavitary infarctions following pulmonary embolism: a case report","volume":"20","author":"Bakr","year":"2025","journal-title":"J Cardiothorac Surg"},{"key":"2026051905552085000_19.5.e273374.18","article-title":"An Unusual Case of Cavitary Lung Lesion and a Brief Review of Literature","volume":"12","author":"Khanal","year":"2020","journal-title":"Cureus"},{"key":"2026051905552085000_19.5.e273374.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)01253-2"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:55:37Z","timestamp":1779195337000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bcr-2026-273374"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273374","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}