RT Journal Article
SR Electronic
T1 Acute respiratory distress syndrome (ARDS) - Manifestation of onset in an immunocompetent patient with pleuropulmonary tuberculosis (TB)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2543
VO 40
IS Suppl 56
A1 Emilia Tabacu
A1 Roxana Nemes
A1 Ligia Puiu
A1 Mihaela Mitrea
A1 Niculae Galie
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2543.abstract
AB INTRODUCTION: The association TB – ARDS is very rare, data from the literature saying that 4,9% of ARDS were admitted in ICU (intensive care unit) wards had TB, and the forms of TB were the most common cases of miliary to people with HIV, mortality is very high.PURPOSE: the description of active pleuropulmonary TB started with ARDS.METHOD: The authors present a clinical case of pleuropulmonary TB and ARDS.RESULTS: Young patient, 38 years, smoker (25 pack-year), is hospitalized in emergency with fever 39.8 °C, polipnea, dyspnoea on minimal effort (SaO2 = 77%) not corrected after administration of O2, hypotension (blood pressure = 80/60 mmHg), tachycardia (heart rate = 120/min), left thoracic stabbing. Admission chest Xray: opacities highlight-ulcerated nodular infiltrative nature and opacity right upper lobe and posterobazal fluid secluded on left. At 6 hours after admission, the general condition worsens (SaO2 = 40%, PaO2 = 35mmHg), and chest Xray and CT scan shows bilateral pulmonary infiltrates ("white lung"). Sputum exam for tuberculosis is negative in microscopy and culture is positive. Pleural biopsies reveal the presence of tuberculosis follicles. Test for HIV was negative.The patient was intubated and mechanically ventilated for 3 days, then improved clinical course and radiological image become the same as admission. After biopsy confirmation of TB patient received tuberculostatic treatment with favorable clinical and radiological evolution.Conclusions: to improve the prognosis of ARDS of unknown cause we should think of tuberculosis etiology, especially in people with impaired immunity.