A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation
Abstract Background With the following report we want to present an unusual case of a patient suffering from acute respiratory distress syndrome with early discovery of bacterial pathogens in bronchoalveolar liquid samples that developed a fatal undiscovered disseminated fungal infection. Case prese...
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doaj-db5080b38ba64c9da5027b9a5f20de442020-11-25T03:23:27ZengBMCBMC Anesthesiology1471-22532020-05-012011710.1186/s12871-020-01031-9A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenationStefanie Prohaska0Philipp Henn1Svetlana Wenz2Leonie Frauenfeld3Peter Rosenberger4Helene A. Haeberle5Department of Anesthesiology and Intensive Care Medicine, Intensivstation 39, Tübingen University Hospital, Eberhard-Karls-UniversityDepartment of Anesthesiology and Intensive Care Medicine, Intensivstation 39, Tübingen University Hospital, Eberhard-Karls-UniversityDepartment of Pathology, Tübingen University Hospital, Eberhard-Karls-UniversityDepartment of Pathology, Tübingen University Hospital, Eberhard-Karls-UniversityDepartment of Anesthesiology and Intensive Care Medicine, Intensivstation 39, Tübingen University Hospital, Eberhard-Karls-UniversityDepartment of Anesthesiology and Intensive Care Medicine, Intensivstation 39, Tübingen University Hospital, Eberhard-Karls-UniversityAbstract Background With the following report we want to present an unusual case of a patient suffering from acute respiratory distress syndrome with early discovery of bacterial pathogens in bronchoalveolar liquid samples that developed a fatal undiscovered disseminated fungal infection. Case presentation A 67-year-old man was admitted to our university hospital with dyspnea. Progressive respiratory failure developed leading to admission to the intensive care unit, intubation and prone positioning was necessary. To ensure adequate oxygenation and lung protective ventilation veno-venous extracorporeal membrane oxygenation was established. Despite maximal therapy and adequate antiinfective therapy of all discovered pathogens the condition of the patient declined further and he deceased. Postmortem autopsy revealed Mucor and Aspergillus mycelium in multiple organs such as lung, heart and pancreas as the underlying cause of his deterioration and death. Conclusion Routine screening re-evaluation of every infection is essential for adequate initiation and discontinuation of every antiinfective therapy. In cases with unexplained deterioration and unsuccessful sampling the possibility for diagnostic biopsies should be considered.http://link.springer.com/article/10.1186/s12871-020-01031-9MucormycosisARDSECMO |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefanie Prohaska Philipp Henn Svetlana Wenz Leonie Frauenfeld Peter Rosenberger Helene A. Haeberle |
spellingShingle |
Stefanie Prohaska Philipp Henn Svetlana Wenz Leonie Frauenfeld Peter Rosenberger Helene A. Haeberle A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation BMC Anesthesiology Mucormycosis ARDS ECMO |
author_facet |
Stefanie Prohaska Philipp Henn Svetlana Wenz Leonie Frauenfeld Peter Rosenberger Helene A. Haeberle |
author_sort |
Stefanie Prohaska |
title |
A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation |
title_short |
A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation |
title_full |
A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation |
title_fullStr |
A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation |
title_full_unstemmed |
A case report of fatal disseminated fungal sepsis in a patient with ARDS and extracorporeal membrane oxygenation |
title_sort |
case report of fatal disseminated fungal sepsis in a patient with ards and extracorporeal membrane oxygenation |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2020-05-01 |
description |
Abstract Background With the following report we want to present an unusual case of a patient suffering from acute respiratory distress syndrome with early discovery of bacterial pathogens in bronchoalveolar liquid samples that developed a fatal undiscovered disseminated fungal infection. Case presentation A 67-year-old man was admitted to our university hospital with dyspnea. Progressive respiratory failure developed leading to admission to the intensive care unit, intubation and prone positioning was necessary. To ensure adequate oxygenation and lung protective ventilation veno-venous extracorporeal membrane oxygenation was established. Despite maximal therapy and adequate antiinfective therapy of all discovered pathogens the condition of the patient declined further and he deceased. Postmortem autopsy revealed Mucor and Aspergillus mycelium in multiple organs such as lung, heart and pancreas as the underlying cause of his deterioration and death. Conclusion Routine screening re-evaluation of every infection is essential for adequate initiation and discontinuation of every antiinfective therapy. In cases with unexplained deterioration and unsuccessful sampling the possibility for diagnostic biopsies should be considered. |
topic |
Mucormycosis ARDS ECMO |
url |
http://link.springer.com/article/10.1186/s12871-020-01031-9 |
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