scholarly journals Ventilator Management of Bronchopleural Fistula Secondary to Methicillin-Resistant Staphylococcus aureus Necrotizing Pneumonia in a Pregnant Patient with Systemic Lupus Erythematosus

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed F. Alohali ◽  
Saleh Abu-Daff ◽  
Kamardeen Alao ◽  
Mohammed Almaani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Staphylococcus Aureus ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Lupus Erythematosus ◽  
Distress Syndrome ◽  
Bronchopleural Fistula ◽  
Pregnant Patient ◽  
Necrotizing Pneumonia ◽  
Systemic Lupus

Managing mechanical ventilation in patient with bronchopleural fistula with coexisting acute respiratory distress syndrome is a challenging situation for the intensivist. We are reporting a case of a pregnant patient with systemic lupus erythematosus on immunosuppressive medications who developed methicillin-resistant Staphylococcus aureus necrotizing pneumonia complicated by bronchopleural fistula and acute respiratory distress syndrome.

scholarly journals Acute respiratory distress syndrome and COVID-19 in a child with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332198979
Author(s):  
Simone Sukhdeo ◽  
Emily Negroponte ◽  
Hariprem Rajasekhar ◽  
Sunanda Gaur ◽  
Daniel B Horton ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lupus Erythematosus ◽  
Distress Syndrome ◽  
Work Of Breathing ◽  
Low Oxygen ◽  
Systemic Lupus ◽  
Markers Of Inflammation

We report a case of COVID-19 in a pediatric patient with systemic lupus erythematosus (SLE), who presented with respiratory distress marked by increased work of breathing and low oxygen saturation. Lab tests confirmed COVID-19, and showed lymphocytopenia and elevated markers of inflammation and coagulopathy. Chest X-ray showed bilateral mid-lung opacities, and the patient required intubation early in his disease course. Imaging and clinical findings were consistent with acute respiratory distress syndrome (ARDS) with inflammation. The patient was treated with different combinations of antivirals (hydroxychloroquine and remdesivir), cytokine inhibitors (anakinra and tocilizumab), glucocorticoids (hydrocortisone and methylprednisolone), and an anticoagulant (enoxaparin). Inflammatory markers decreased before clinical improvement in lung aeration. This case highlights the potential for pediatric patients with SLE to present with COVID-19 similar to the clinical presentation described in adults.

Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: a case report

Lupus ◽  
2018 ◽  
Vol 27 (10) ◽  
pp. 1729-1731 ◽  
Author(s):  
C H Lo ◽  
J C C Wei ◽  
C F Tsai ◽  
L C Li ◽  
S W Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Pregnant Patient ◽  
Polymorphic Ventricular Tachycardia ◽  
Av Block ◽  
Systemic Lupus ◽  
Complete Av Block

Systemic lupus erythematosus (SLE) can affect all heart structures including the conduction system, with either reversible or permanent derangement. However, only a few cases of adult SLE and complete atrioventricular (AV) block have been reported. We describe a young pregnant woman who initially presented with complete AV block on electrocardiography before the diagnosis of SLE. Syncope subsequently developed during the postpartum period due to frequent nonsustained polymorphic ventricular tachycardia, suggesting lupus myocarditis. The ventricular arrhythmia was successfully treated by intravenous corticosteroids, lidocaine and implantation of a permanent pacemaker. This may represent the first report of complete AV block with polymorphic ventricular tachycardia, which was identified before the other clinical features of SLE fully manifested. SLE should be considered if a patient presents with complete AV block without other clinical features. It may warn for early diagnosis and appropriate treatment of SLE including lupus-related heart disease.

Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome

2021 ◽  
Vol 14 (4) ◽  
pp. e242870
Author(s):  
Meenupriya Arasu ◽  
Nagalakshmi Swaminathan ◽  
Anusha Cherian ◽  
Magesh Parthiban
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Pregnant Patient ◽  
Lung Compliance ◽  
Pcr Assay ◽  
Oxygenation Indices

A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.

Rheumatology

2020 ◽  
pp. 263-306
Author(s):  
Charlotte Frise ◽  
Sally Collins
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Systemic Sclerosis ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Lupus Erythematosus ◽  
Pregnant Patient ◽  
Systemic Lupus ◽  
Musculoskeletal Problems ◽  
In Pregnancy

This chapter covers rheumatic diseases in the pregnant patient. It gives background, clinical features, and management in the pregnant patient for rheumatoid arthritis, Sjögren’s syndrome, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid syndrome, and ankylosing spondylitis among others. It also covers systemic sclerosis, osteoporosis, and other musculoskeletal problems. Medications and the use of biologics in pregnancy are also discussed, with reference to breastfeeding.

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