title: Severe Legionella pneumonia successfully treated by independent lung ventilation with intrapulmonary percussive ventilation.
abstract: A case of severe Legionella pneumonia was successfully treated by independent lung ventilation (ILV) with intrapulmonary percussive ventilation (IPV). A 57-year-old man with lobar pneumonia was intubated and mechanically ventilated because of his deteriorating respiratory status. The diagnosis of Legionella pneumonia was made on the fourth day after admission and appropriate antibiotic therapy was commenced. On the fifth hospital day, ILV was commenced because the right unaffected lung was over-distended, his haemodynamic state was unstable and his left lung was producing copious amounts of purulent sputum. His right lung was ventilated and his left lung was treated with IPV owing to the existence of massive atelectasis. After treatment with antibiotics and ILV combined with IPV, his respiratory and haemodynamic status gradually improved. On the tenth day after admission, ILV was changed to conventional bilateral ventilation. The patient was extubated on the sixteenth hospital day and discharged from the intensive care unit 30 days after admission. The combination of ILV and IPV was therapeutically effective during the acute phase of unilateral severe Legionella pneumonia.
authors.affiliation: The Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Yamaguchi, Japan. motoki-ygc@umin.ac.jp
authors.forename: Motoki
authors.initials: M
authors.lastname: Fujita
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tsuruta
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Oda
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kaneda
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Shunji
authors.initials: S
authors.lastname: Kasaoka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maekawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012123:Pulmonary Ventilation / Q000502:physiology; D012121:Respiration, Artificial / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D012122:Ventilators, Mechanical
chemical_list: D000900:Anti-Bacterial Agents