Ventilator-Associated Pneumonia

A 50-year-old diabetic male patient was admitted to the hospital with ischemic stroke (GCS = E1V1M3). He was put on invasive positive-pressure ventilation support. On the fourth day of ICU stay, he developed fever (38.6 °C), a rise in total leukocyte count (156,000, N 93%), and heterogeneous, ill-defined shadows in the right lower zone in the chest X-ray. Chest auscultation revealed bronchial breathing in the right infra-axillary area, and the nurse reported an increase in amount and purulence of secretions requiring frequent suctioning. The patient needed 5 mcg/min noradrenaline to maintain systolic blood pressure of more than 100 mmHg.