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No Room for Error: Empiric Treatment for Fulminant Pneumonia
Early antibiotic administration is critical in cases of sepsis and severe community-acquired pneumonia, which is frequently due to Streptococcus pneumoniae, Staphylococcus aureus, Legionella species, or influenza. We describe the case of a 29-year-old previously healthy man who presented to an urban...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965415/ https://www.ncbi.nlm.nih.gov/pubmed/29849375 http://dx.doi.org/10.5811/cpcem.2017.1.33213 |
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author | Prekker, Matthew E. Smith, Stephen W. |
author_facet | Prekker, Matthew E. Smith, Stephen W. |
author_sort | Prekker, Matthew E. |
collection | PubMed |
description | Early antibiotic administration is critical in cases of sepsis and severe community-acquired pneumonia, which is frequently due to Streptococcus pneumoniae, Staphylococcus aureus, Legionella species, or influenza. We describe the case of a 29-year-old previously healthy man who presented to an urban emergency department (ED) in the North Central U.S. with fever, hip pain, severe hypoxemia, and diffuse pulmonary infiltrates. He was intubated and received piperacillin/tazobactam, levofloxacin, vancomycin, and oseltamivir; given his fulminant presentation and predicted high mortality, doxycycline, methylprednisolone, and amphotericin B were also administered empirically in the ED. A respiratory culture eventually grew Blastomyces dermatitidis, and the patient survived. Severe acute respiratory distress syndrome due to fulminant pneumonitis carries a high mortality. Faced with this scenario and no room for error, it is important that the emergency physician cover for all possible pathogens, including zoonotic bacteria and endemic fungi. |
format | Online Article Text |
id | pubmed-5965415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-59654152018-05-30 No Room for Error: Empiric Treatment for Fulminant Pneumonia Prekker, Matthew E. Smith, Stephen W. Clin Pract Cases Emerg Med Case Report Early antibiotic administration is critical in cases of sepsis and severe community-acquired pneumonia, which is frequently due to Streptococcus pneumoniae, Staphylococcus aureus, Legionella species, or influenza. We describe the case of a 29-year-old previously healthy man who presented to an urban emergency department (ED) in the North Central U.S. with fever, hip pain, severe hypoxemia, and diffuse pulmonary infiltrates. He was intubated and received piperacillin/tazobactam, levofloxacin, vancomycin, and oseltamivir; given his fulminant presentation and predicted high mortality, doxycycline, methylprednisolone, and amphotericin B were also administered empirically in the ED. A respiratory culture eventually grew Blastomyces dermatitidis, and the patient survived. Severe acute respiratory distress syndrome due to fulminant pneumonitis carries a high mortality. Faced with this scenario and no room for error, it is important that the emergency physician cover for all possible pathogens, including zoonotic bacteria and endemic fungi. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2017-03-13 /pmc/articles/PMC5965415/ /pubmed/29849375 http://dx.doi.org/10.5811/cpcem.2017.1.33213 Text en © 2017 Prekker et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Case Report Prekker, Matthew E. Smith, Stephen W. No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title | No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title_full | No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title_fullStr | No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title_full_unstemmed | No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title_short | No Room for Error: Empiric Treatment for Fulminant Pneumonia |
title_sort | no room for error: empiric treatment for fulminant pneumonia |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965415/ https://www.ncbi.nlm.nih.gov/pubmed/29849375 http://dx.doi.org/10.5811/cpcem.2017.1.33213 |
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