Widysanto Allen, Liem Maranatha, Puspita Karina Dian, Pradhana Cindy Meidy Leony
Department of Respiratory Medicine Siloam Hospital Lippo Village Tangerang Indonesia.
Faculty of Medicine Pelita Harapan University Tangerang Indonesia.
Respirol Case Rep. 2020 Sep 15;8(8):e00662. doi: 10.1002/rcr2.662. eCollection 2020 Nov.
We report the case of a 53-year-old male that presented to our hospital with a history of a brain tumour. He was hospitalized 10 days prior in another hospital. Before surgery, he complained of mild cough. Routine chest radiography demonstrated right upper lobe consolidation which was diagnosed as hospital-acquired pneumonia. Broad-spectrum empirical antimicrobial was initiated. After surgery, his clinical condition deteriorated and he felt breathlessness. Chest radiography and computed tomography (CT) scan without contrast revealed necrotizing and cavitating pneumonia complicated by bronchopleural fistula (BPF) and hydropneumothorax. Sputum culture revealed infection of multidrug-resistant (MDRAB). Despite optimal antibiotic therapy, BPF and hydropneumothorax failed to resolve and surgical approach was performed to debride the necrotic area and seal the fistula. After a month in the hospital, he was discharged and the serial chest X-ray showed good recovery of the lung.
我们报告了一例53岁男性病例，该患者因脑肿瘤病史前来我院就诊。他在10天前曾入住另一家医院。手术前，他主诉轻度咳嗽。常规胸部X线检查显示右上叶实变，诊断为医院获得性肺炎。开始使用广谱经验性抗菌药物治疗。手术后，他的临床状况恶化，出现呼吸困难。胸部X线和非增强计算机断层扫描（CT）显示坏死性和空洞性肺炎，并伴有支气管胸膜瘘（BPF）和气胸。痰培养显示为多重耐药鲍曼不动杆菌（MDRAB）感染。尽管进行了最佳抗生素治疗，BPF和气胸仍未缓解，遂采取手术方法清除坏死区域并封闭瘘管。住院一个月后，他出院了，系列胸部X线检查显示肺部恢复良好。
