[Postoperative pneumonia: nosocomial, predictable, iatrogenic, preventable or not?].
We report the case of a 52-year-old man, ASA 3-4, malnourished, heavy smoker and drinker at the stage of chronic obstructive pulmonary disease and cirrhosis. The postoperative course of a cervical cancer surgery was complicated by a pneumonia with fatal outcome in the intensive care unit. Taking into account the patient's history and surgical requirements, this nosocomial infection did not appear easily preventable. The multiple risk factors and the few preventive measures usable were analyzed. In this context, the media and legal trend to make the doctors responsible for the nosocomial infections should be revised.
Dareau
S
S
Département d'anesthésie-réanimation, clinique mutualiste Beausoleil, 119, avenue de Lodève, 34000 Montpellier, France. s.dareau@languedoc-mutualite.fr
Eledjam
J-J
JJ
Gros
T
T
Delire
V
V
Causse
L
L
Javitary
W
W
Bassoul
B
B
D000437:Alcoholism / Q000150:complications; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D002939:Ciprofloxacin / Q000627:therapeutic use; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D004198:Disease Susceptibility; D017809:Fatal Outcome; D006801:Humans; D007049:Iatrogenic Disease; D016867:Immunocompromised Host; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000150:complications; D008318:Malpractice / Q000331:legislation & jurisprudence; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010100:Oxygen / Q000627:therapeutic use; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011014:Pneumonia / Q000209:etiology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014062:Tongue Neoplasms / Q000532:radiotherapy / Q000601:surgery
D000077725:Piperacillin, Tazobactam Drug Combination; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D010397:Penicillanic Acid; D010100:Oxygen; D010878:Piperacillin