Article ; Online: Marked cachexia in probable invasive pulmonary aspergillosis with bronchopleural fistula.
BMJ case reports
2018 Volume 2018
Abstract: A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our ... ...
Abstract | A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation. This case demonstrates an atypical presentation of invasive pulmonary aspergillosis in a mildly immunodeficient individual. It highlights the challenges in assessment and management of critically ill patients' nutrition as well as optimal timing for surgical intervention. |
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MeSH term(s) | Bronchial Fistula/microbiology ; Cachexia/microbiology ; Fatal Outcome ; Humans ; Invasive Pulmonary Aspergillosis/complications ; Male ; Middle Aged ; Pleural Diseases/microbiology ; Respiratory Tract Fistula/microbiology |
Language | English |
Publishing date | 2018-01-17 |
Publishing country | England |
Document type | Case Reports ; Journal Article |
ISSN | 1757-790X |
ISSN (online) | 1757-790X |
DOI | 10.1136/bcr-2017-222143 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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