Spontaneous pneumothorax and massive subcutaneous emphysema in a patient with Klebsiella pneumoniae necrotizing pneumonia

Camino Ferró, Helena; Gómez Camino, Sergio; Chicote Álvarez, Enrique

doi:10.1016/j.medine.2024.03.004

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The patient exhibited good initial respiratory progress. However, after 8 days of mechanical ventilation, she developed a spontaneous left pneumothorax, which was drained and the chest drain kept in place. Twenty-four hours later, extubation was attempted, but reintubation was deemed necessary due to weakness and poor secretion management. Following reintubation, the patient exhibited hypotension and acute respiratory failure. A new left pneumothorax was seen, leading to the placement of yet another drainage tube. The thoracic x-ray performed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) revealed the presence of a re-expanded left lung, and a hypodense lesion in the right base and significant subcutaneous emphysema. The CAT scan performed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) with bilateral consolidation confirmed the presence of multiple cavitations consistent with necrotizing pneumonia.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 624 "Ancho" => 755 "Tamanyo" => 57814 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 633 "Ancho" => 755 "Tamanyo" => 123460 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004800000010/v1_202409270531/S2173572724000572/v1_202409270531/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004800000010/v1_202409270531/S2173572724000572/v1_202409270531/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724000572?idApp=WMIE"]

ISSN: 2173-5727

Medicina Intensiva is the journal of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), and has become the reference publication in Spanish in its field. Medicina Intensiva mainly publishes Original Articles, Reviews, Clinical Notes, Images in Intensive Medicine, and Information relevant to the specialty. All works go through a rigorous selection process.

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Vol. 48. Issue 10.

Pages 627 (October 2024)

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