Case Report
Acute Respiratory Distress Syndrome in Lemierre’s Syndrome
Table 1
Summary of relevant case characteristics.
| | | Case 1 | Case 2 |
| | Patient characteristics | | | | Age (years) | 23 | 23 | | Sex | Male | Male | | Duration of stay (hospital/ICU) | 23 days/20 days ICU | 28 days/23 days ICU | | Causative organism | F. necrophorum | F. necrophorum | | Disease characteristics | | | | Multifocal cavitary pneumonia | Yes | Yes | | Mechanical ventilation (duration) | Intubated, 8 days | Intubated, 14 days | | Pleural effusions/thoracostomy | Loculated pleural effusion, bilateral thoracostomy | Pleural effusion/hemothorax, bilateral thoracostomy | | Renal failure | Yes | Yes | | Liver dysfunction | Yes | Yes | | Extrapulmonary manifestations | Pyomyositis, splenic infarction, tricuspid valve endocarditis | Peritonsillar abscess | | Labs, peak values | | | | WBC count (k) | 20.9 | 42.4 | | Hemoglobin/HCT (g/dL) | 7.4 | 6.6 | | Platelets (trough/peak, k/uL) | 60/618 | 18/1070 | | INR | 2.3 | 2.9 | | GFR (mL/min) | 28 | 28 | | Ventilation | | | | Max PEEP (cmH2O) | 5 | 10 | | Max FiO2 (%) | 40 | 50 | | Patient positioning | Fowler’s/Semi-Fowler’s | Fowler’s/Semi-Fowler’s | | Inhaled therapies | Albuterol/ipratropium bromide | Albuterol/ipratropium bromide | | Weaning time (days) | 7 | 5 | | Interventions | | | | Antibiotics | Metronidazole/aztreonam | Metronidazole/Zosyn | | Anticoagulation | Heparin (d/c anemia) | Heparin (d/c hemothorax), warfarin on discharge | | Blood products | Transfused PRBC’s | Transfused PRBC’s | | Vasopressor | — | Yes | | Surgical interventions | Right deltoid abscess drainage/debridement | Unsuccessful peritonsillar abscess drainage |
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