Author: Schmalzle, Sarah A; Tabatabai, Ali; Mazzeffi, Michael; Matta, Ann; Hollis, Allison; Zubrow, Marc; Rajagopal, Keshava; Thom, Kerri; Scalea, Thomas
Title: Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii Document date: 2019_3_23
ID: 6gm763j5_4
Snippet: Within 12 h of intubation, the patient had decompensated further and had evidence of acute respiratory distress syndrome (ARDS) with P a 0 2 /F i 0 2 of 62, bilateral infiltrates on chest x-ray, and no evidence of left atrial hypertension. The patient was transported by helicopter to a tertiary hospital critical care resuscitation unit, and immediately initiated on veno-venous ECMO and ventilated with a protective lung strategy. Bronchoscopy reve.....
Document: Within 12 h of intubation, the patient had decompensated further and had evidence of acute respiratory distress syndrome (ARDS) with P a 0 2 /F i 0 2 of 62, bilateral infiltrates on chest x-ray, and no evidence of left atrial hypertension. The patient was transported by helicopter to a tertiary hospital critical care resuscitation unit, and immediately initiated on veno-venous ECMO and ventilated with a protective lung strategy. Bronchoscopy revealed severe erythema and inflammation of mucosa with increasing blood secretions returned with each bronchoalveolar lavage. Additionally he required vasopressors for severe acidosis and hypotension, and was initiated on continuous renal replacement therapy for oliguric renal failure. Twelve units of packed-red blood cells were infused in the first 24 h to maintain hemoglobin levels above 7.0 g/ dL.
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