title: Case Report Serious pulmonary infection in a splenectomized patient with adult type 1 Gaucher disease.
abstract: A 49-year-old man with a history of Gaucher disease type 1, resulting in serious splenomegaly and eating disorder, was referred to our department and underwent a splenectomy under general anesthesia. Gaucher disease is very rare, and its first signs are unexplained splenomegaly and hypersplenism. On preoperative examination, the patient's platelet count was slightly low, and his other test results were normal. Surprisingly, on the first postoperative day, the patient developed a lung infection. This gradually progressed to acute respiratory distress syndrome with respiratory failure, requiring intubation and mechanical ventilation. The patient eventually recovered, and he was discharged after receiving antibiotics and other treatments to enhance immunity. However, his postoperative lung infection led to a significantly prolonged and expensive hospital stay. This case suggests that we must pay close attention to the immune dysfunction of patients with Gaucher disease type 1. Anesthesia and surgery with accompanying post-traumatic stress can weaken patients' immunity and cause susceptibility to severe lung infections. Pulmonary signs and functions should be monitored closely during the perioperative period, and, if necessary, gamma globulin and thymosin should be administered early in the preoperative or postoperative period to enhance immunity.
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Y F
authors.initials: YF
authors.lastname: Mao
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China dujmin@126.com.
authors.forename: J M
authors.initials: JM
authors.lastname: Du
mesh_terms: D000151:Acinetobacter Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D040981:Acinetobacter baumannii; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005776:Gaucher Disease / Q000000981:diagnostic imaging* / Q000276:immunology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D013156:Splenectomy; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents