Bronchopleural fistula complicating group A beta-haemolytic streptococcal pneumonia. Use of a Fogarty embolectomy catheter for selective bronchial blockade.
A 36-year-old woman developed severe group A Streptococcal pneumonia, complicated by a bronchopleural fistula, ARDS and multi-organ failure. We describe the use of selective middle lobe bronchus blockade, with a Fogarty embolectomy catheter, to localise and control the air leak. This allowed effective mechanical ventilation and oxygenation on intensive care and during right middle lobectomy. The patient made a prolonged, but full recovery.
Intensive Care Unit, Royal Devon and Exeter Hospital, Exeter, UK.
B A
BA
McCormick
I H
IH
Wilson
R G
RG
Berrisford
D000328:Adult; D001983:Bronchial Fistula / Q000382:microbiology / Q000628:therapy*; D002404:Catheterization; D005260:Female; D005402:Fistula / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D010995:Pleural Diseases / Q000382:microbiology / Q000628:therapy*; D018410:Pneumonia, Bacterial / Q000150:complications*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes