Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8658002 | Chest | 2018 | 4 Pages |
Abstract
A 24-year-old woman with ÎF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30%Â predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation. Two days after surgery, she developed acute respiratory failure requiring mechanical ventilation. On day 4 of mechanical ventilation, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was initiated for refractory respiratory failure. The following day, she was listed for bilateral lung transplant and was transplanted 4Â days later. Following transplantation, she was decannulated from ECMO; however, over the next 12 hours, oxygenation deteriorated requiring reinstitution of VV-ECMO for presumed severe primary graft dysfunction. Despite treatment with broad spectrum antimicrobial coverage with piperacillin/tazobactam, ciprofloxacin, linezolid, micafungin, voriconazole, and ganciclovir, she failed to improve and developed complex bilateral pleural effusions.
Keywords
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Authors
Whittney A. DO, Domingo MD, Christopher S. MD, Oksana A. MD, Steven D. MD, Shalika B. MD, Haresh MD, A. Whitney MD,