Avtor/Urednik     Vlaović, Janko; Voga, Gorazd
Naslov     Spontaneous pulmonary hematoma in a patient with sepsis treated with dual antiplatelet therapy
Tip     članek
Vol. in št.     Letnik 128, št. suppl. 7
Leto izdaje     2016
Obseg     str. S553-S556
ISSN     0043-5325 - Wiener klinische Wochenschrift
Jezik     eng
Abstrakt     A 72-year-old patient was admitted to the medical intensive care unit due to a right-sided, hospital-acquired pneumonia and septic shock with respiratory failure and deterioration of chronic renal failure. During hospitalization the patient required hemodynamic support with norepinephrine and dobutamine, mechanical ventilation and hemodialysis. The patient suffered a non-ST segment elevation myocardial infarction (NSTEMI) and received dual antiplatelet therapy. After 14 days an acute intrapulmonary infiltrate of unknown origin developed, accompanied by fever and a significant increase of the C-reactive protein (CRP) level. Chest radiography and a computed tomography (CT) scan showed a well-defined, round, high-attenuation lesion in the lungs and a suspected infected pulmonary hematoma, which was confirmed by percutaneous aspiration biopsy. There was no evidence of trauma and it is believed that the hematoma occurred spontaneously, probably because of the dual antiplatelet therapy. Double antibiotic treatment was started but no surgery was performed after consultation with a thoracic surgeon. The antiplatelet drugs were temporarily withdrawn until the size of the hematoma showed no further increase and then antiplatelet therapy was continued. After stabilization the patient was discharged from hospital and 6 months later a follow-up chest X-ray showed almost complete resolution of the hematoma.
Deskriptorji     Pneumonia
Shock, septic
Pulmonary edema
Pljučnica
Septični šok
Pljučni edem