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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Management of acquired bronchopleural fistula due to chemical pneumonia
Reddy Ravikanth1, Sunil Mathew2, Denver Steven Pinto1
1Department of Radiology, St. John's Medical College, Bengaluru, Karnataka, India.
Abstract:
Bronchopleural fistula (BPF) is a sinus tract between the bronchus and the pleural space that may result from a necrotizing pneumonia/empyema (anaerobic, pyogenic, tuberculous, or fungal), lung neoplasms, and blunt and penetrating lung injuries or may occur as a complication of procedures such as lung biopsy, chest tube drainage, thoracocentesis, or radiation therapy. The diagnosis and management of BPF remain a major therapeutic challenge for clinicians, and the lesion is associated with significant morbidity and mortality. Here, we present a 70-year-old male with acquired BPF due to chemical pneumonitis caused by aspiration of kerosene who presented with the symptoms of fever, cough with expectoration, breathlessness and signs of tachycardia, tachypnea, diminished breath sounds, and crepitations. After a 3-week course of culture-sensitive antibiotics with β-lactam and β-lactamase inhibitors, open drainage of the empyema was done following which the patient showed symptomatic improvement and was discharged.
Insights
Bronchopleural fistula (BPF) is a serious airway complication. This case highlights successful management of acquired BPF from kerosene aspiration using antibiotics and open empyema drainage.
Area of Science:
- Pulmonology
- Thoracic Surgery
Background:
- Bronchopleural fistula (BPF) is a challenging clinical condition with significant morbidity and mortality.
- Causes include necrotizing pneumonia, lung neoplasms, trauma, and iatrogenic complications.
Observation:
- A 70-year-old male presented with symptoms of fever, cough, and dyspnea.
- Clinical signs included tachycardia, tachypnea, diminished breath sounds, and crepitations.
- Diagnosis was acquired BPF secondary to chemical pneumonitis from kerosene aspiration.
Findings:
- A 3-week course of culture-sensitive antibiotics (beta-lactam and beta-lactamase inhibitors) was administered.
- Open drainage of the empyema was performed.
- The patient demonstrated symptomatic improvement and was discharged.
Implications:
- This case underscores the importance of prompt diagnosis and multimodal treatment for acquired BPF.
- Effective management involves addressing the underlying cause, controlling infection, and surgical intervention when necessary.
- Successful outcomes are achievable with appropriate therapeutic strategies.
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