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Pulmonary Alveolar Proteinosis Complicated by Invasive Streptococcus pneumoniae Infection Requiring Extracorporeal
Utaho Mizusawa1, Shinichiro Ohshimo1, Kazuya Kikutani1
1Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Background:
There have been no previously reported cases of pulmonary alveolar proteinosis (PAP) complicated by invasive pneumococcal infection requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO).
Case Presentation:
A 44-year-old man was transferred to our hospital under V-V ECMO for severe respiratory failure. Chest computed tomography showed bilateral crazy-paving patterns, and milky bronchoalveolar lavage fluid confirmed PAP. On day 3, he developed septic shock due to Streptococcus pneumoniae. After stabilization, right-sided whole lung lavage was performed on day 7, yielding yellow-brown fluid atypical for PAP. Bilateral segmental lavages on days 12 and 13 improved oxygenation. ECMO was discontinued on day 10, and the patient was extubated on day 14.
Conclusion:
In this rare case of PAP complicated by invasive pneumococcal infection, timely therapeutic interventions were successfully performed under V-V ECMO support.
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