Septic pulmonary embolism in Somali children: a retrospective study from a tertiary hospital.

Background: Septic pulmonary embolism (SPE) is an under-recognized cause of severe infection in children, particularly in low-resource settings. Evidence from Somalia is absent, despite high rates of skin and soft-tissue infection and limited diagnostic capacity. This study described the clinical characteristics, microbiology, radiological features, management, and outcomes of pediatric SPE in a Somali tertiary hospital. Methods: We conducted a retrospective review of children aged < 18 years diagnosed with SPE between 2021 and 2025. Data on demographics, clinical presentation, laboratory parameters, radiological findings, microbial isolates, treatments, and outcomes were extracted. Continuous variables were summarized as mean ± SD or median (IQR) and categorical variables as counts and percentages. ICU and non-ICU groups were compared using Results: Fifteen children met diagnostic criteria for SPE; median age was 12 years and 80% were male. Skin and soft-tissue infections, trauma-related sepsis, and septic thrombophlebitis were the most common sources. Conclusion: Pediatric SPE in Somalia is predominantly staphylococcal in origin and commonly arises from skin, soft-tissue, or trauma-related infections. Despite limited imaging and microbiology resources, characteristic radiological patterns and marked inflammation facilitate diagnosis. Younger age, higher leukocytosis, and prolonged hospitalization were associated with ICU admission, but overall outcomes were favorable with timely antimicrobial therapy, anticoagulation, and procedural interventions. These findings provide urgently needed baseline evidence for SPE in Somali children and underscore the importance of early recognition in resource-limited settings.