Respir Case Rep. 2014; 3(3): 134-137 | DOI: 10.5505/respircase.2014.60252

A case of ARDS due to Legionella Pneumonia treated with ECMO

Özlem Ediboðlu, Sami Cenk Kýraklý, Dursun Tatar, Fatma Fevziye Tuksavul
Izmir,dr.suat Seren Chest Diseases And Surgery Training And Research Hospital

Acute respiratory distress syndrome (ARDS) is characterized by hypoxemic respiratory failure and bilateral radiographic infiltration. A 38-year-old female was admitted to the emergency room with coughing, sore throat, fever, and dyspnea for the last three days. The physical examination revealed that the patient had dyspnea, tachypnea, tachycardia, and crackles were heard on auscultation. The patient’s hemogram was normal, C-reactive protein was 30mg/dL, and procalcitonin was 19.8ng/mL. The patient had signs of hypoxemic respiratory failure in the arterial blood gas analysis. The chest x-ray showed bilateral alveolar opacities consistent with ARDS. The legionella antibody was positive in the urine sample. The patient was intubated due to unresponsiveness to non-invasive ventilation. Afterwards, extracorporeal membrane oxygenation (ECMO) was performed for six days. The patient was extubated on the seventh day. The case is presented because due to the novel use of ECMO for ARDS in our center.

Keywords: ARDS, extracorporeal membranous oxygenation, Legionella pneumonia

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ECMO Ýle Tedavi Edilen Lejyonella Pnömonisine Baðlý ARDS Olgusu

Özlem Ediboðlu, Sami Cenk Kýraklý, Dursun Tatar, Fatma Fevziye Tuksavul
Dr.suat Seren Göðüs Hastalýklarý Ve Cerrahisi Eðitim Ve Araþtýrma Hastanesi,izmir

Akut Respiratuar Distres Sendromu (ARDS), bilateral radyolojik infiltrasyon ve hipoksemik solunum yetmezliði ile karakterizedir. Otuz sekiz yaþýnda ev hanýmý,öksürük, boðaz aðrýsý, ateþ ve son 3 gündür nefes darlýðý ile acil servise baþvurdu. Fizik muayenesinde hasta dispneik, takipneik, taþikardik olup dinlemekle bilateral inspiryum sonunda raller mevcuttu. Laboratuar incelemesinde hemogram normal, C-Reaktif Protein: 30 mg/dL, Prokalsitonin: 19,8 ng/mL, arter kan gazý analizinde hipoksik solunum yetmezliði mevcuttu. Toraks radyografisinde ARDS ile uyumlu bilateral alveoler opasite izlendi. Ýdrar legionella antijeni pozitif saptandý. Noninvazif ventilasyona yanýt alýnmayan hasta entübe edildi. Ardýndan hastaya 6 gün süreyle ECMO (ekstrakorporeal membran oksijenasyon) tedavisi uygulandý. Yedinci günde ekstübe edildi. ARDS tedavisinde kliniðimizde ECMO tedavisinin ilk kez kullanýlmasý sebebiyle bu olgu sunulmuþtur.

Anahtar Kelimeler: ASSS, ekstrakorporeal membranöz oksijenasyon, Lejyonella pnömonisi

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