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Medicine (Baltimore). 2020 Jan;99(1):e18647. doi: 10.1097/MD.0000000000018647. [h=1]Necrotizing tracheobronchitis causing airway obstruction complicated by pandemic 2009 H1N1 influenza: A case report.[/h]
Chang J[SUP]1[/SUP], Kim TO[SUP]2[/SUP], Yoon JY[SUP]2[/SUP], Kho BG[SUP]2[/SUP], Shin HJ[SUP]2[/SUP], Kwon YS[SUP]2[/SUP], Kim YI[SUP]2[/SUP], Lim SC[SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Internal Medicine, Mokpo Hankook Hospital, Jeollanamdo. 2 Department of Pulmonology and Critical Care Medicine, Chonnam National University Hospital, Gwangju, South Korea.
[h=3]Abstract[/h] [h=4]RATIONALE:[/h] Influenza is an infection caused by the influenza virus, and its symptoms are mostly mild and self-limiting. However, influenza can cause severe or fatal complications in high-risk patients. Although tracheobronchitis is one of the common complications of influenza, necrotizing tracheobronchitis is very rare. Herein, we describe a case of necrotizing tracheobronchitis causing airway obstruction complicated by pandemic 2009 H1N1 influenza.
[h=4]PATIENT CONCERNS:[/h] A 60-year-old man presented with fever and dyspnea. On arrival at the emergency room (ER), the patient received oxygen 4 L/minute via a nasal prolong owing to mild hypoxemia. And invasive mechanical ventilation was needed 5 hours after arrival at the ER due to progressive hypoxemia.
[h=4]DIAGNOSES:[/h] Fiberoptic bronchoscopy was performed owing to bloody secretion in the endotracheal tube and revealed diffuse tracheobronchitis with necrotic and hemorrhagic materials obstructing the trachea and bronchus. The pandemic 2009 H1N1 influenza virus was detected from the bronchial washing sample; no other microorganism was detected.
[h=4]INTERVENTION:[/h] He received peramivir plus oseltamivir and broad-spectrum antibiotics.
[h=4]OUTCOMES:[/h] The bloody secretion continued. He developed cardiac arrest due to airway obstruction on the 6th day of admission. After cardiac arrest, his condition progressed to multi-organ failure, and the patient died on the 10th day of admission.
[h=4]LESSONS:[/h] We suggest that necrotizing tracheobronchitis be considered in patients with influenza who present with unexplained hypoxemia.
PMID: 31895828 DOI: 10.1097/MD.0000000000018647
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Chang J[SUP]1[/SUP], Kim TO[SUP]2[/SUP], Yoon JY[SUP]2[/SUP], Kho BG[SUP]2[/SUP], Shin HJ[SUP]2[/SUP], Kwon YS[SUP]2[/SUP], Kim YI[SUP]2[/SUP], Lim SC[SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Internal Medicine, Mokpo Hankook Hospital, Jeollanamdo. 2 Department of Pulmonology and Critical Care Medicine, Chonnam National University Hospital, Gwangju, South Korea.
[h=3]Abstract[/h] [h=4]RATIONALE:[/h] Influenza is an infection caused by the influenza virus, and its symptoms are mostly mild and self-limiting. However, influenza can cause severe or fatal complications in high-risk patients. Although tracheobronchitis is one of the common complications of influenza, necrotizing tracheobronchitis is very rare. Herein, we describe a case of necrotizing tracheobronchitis causing airway obstruction complicated by pandemic 2009 H1N1 influenza.
[h=4]PATIENT CONCERNS:[/h] A 60-year-old man presented with fever and dyspnea. On arrival at the emergency room (ER), the patient received oxygen 4 L/minute via a nasal prolong owing to mild hypoxemia. And invasive mechanical ventilation was needed 5 hours after arrival at the ER due to progressive hypoxemia.
[h=4]DIAGNOSES:[/h] Fiberoptic bronchoscopy was performed owing to bloody secretion in the endotracheal tube and revealed diffuse tracheobronchitis with necrotic and hemorrhagic materials obstructing the trachea and bronchus. The pandemic 2009 H1N1 influenza virus was detected from the bronchial washing sample; no other microorganism was detected.
[h=4]INTERVENTION:[/h] He received peramivir plus oseltamivir and broad-spectrum antibiotics.
[h=4]OUTCOMES:[/h] The bloody secretion continued. He developed cardiac arrest due to airway obstruction on the 6th day of admission. After cardiac arrest, his condition progressed to multi-organ failure, and the patient died on the 10th day of admission.
[h=4]LESSONS:[/h] We suggest that necrotizing tracheobronchitis be considered in patients with influenza who present with unexplained hypoxemia.
PMID: 31895828 DOI: 10.1097/MD.0000000000018647
Free full text