Pulmonary Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Pulmonary Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
BMJ Case Rep. 2022 Jun 28;15(6):e249147. doi: 10.1136/bcr-2022-249147.
A man in his early 40s presented with a 1-month history of fever after accidental diesel aspiration. He had received treatment with intravenous antibiotics, steroids and supportive care. Contrast-enhanced CT of the thorax revealed a right middle lobe lung abscess and bronchoscopy revealed hyperaemia around the middle lobe bronchus. The abscess was initially managed by drainage using a pigtail catheter and intravenous antibiotics. However, only partial drainage of the abscess was achieved and fever persisted. The cardiothoracic surgery team performed drainage of lung abscess through a right posterolateral thoracotomy. Postprocedure, the patient's symptoms improved and the patient was discharged in good health. This case demonstrates a rare complication of hydrocarbon aspiration pneumonitis and lung abscess. Post acute management of diesel aspiration, patients should be advised to return for medical assessment immediately, should symptoms like persistent fever and chest pain recur or persist as these symptoms may herald the development of post-hydrocarbon-aspiration lung abscess.
一位 40 岁出头的男性，因意外吸入柴油后出现发热 1 个月。他曾接受过静脉抗生素、类固醇和支持性治疗。胸部增强 CT 显示右中叶肺脓肿，支气管镜检查显示中叶支气管周围充血。脓肿最初通过使用猪尾导管和静脉抗生素进行引流来治疗。然而，仅实现了脓肿的部分引流，并且发热持续存在。心胸外科团队通过右后外侧开胸术对肺脓肿进行引流。手术后，患者症状改善，健康状况良好出院。该病例展示了碳氢化合物吸入性肺炎和肺脓肿的罕见并发症。急性柴油吸入后管理，应建议患者如有持续发热和胸痛等症状复发或持续存在，立即返回进行医疗评估，因为这些症状可能预示着发生碳氢化合物吸入后肺脓肿。
