Abstract
We present the case of a 19 year old female presenting to the Emergency Department
with signs of pneumonia and sepsis, with her clinical status deteriorating rapidly
to septic shock and respiratory failure. Her pneumonia was complicated by formation
of an empyema and a bronchopleural fistula.
Bronchopleural fistula (BPF) is a fistula between pleural space and a bronchus. It
is an uncommon complication of lung surgery, endobronchial interventions or chest
trauma. They are sometimes formed secondary to postoperative pneumonia. Management
of BPF requires surgical or bronchoscopic intervention with supportive care. Since
a BPF can cause physiological tension pneumothorax, it can lead to significant worsening
of respiratory status of these patients. Ventilator settings need to be adjusted to
reduce the Positive end expiratory pressure and tidal volume to support these patients.
With this case we highlight the importance of recognizing and diagnosing a BPF and
timely management of a BPF in the emergency setting to help patients get to the definitive
treatment of the fistula.
Keywords
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Article Info
Publication History
Published online: January 26, 2021
Accepted:
January 22,
2021
Received in revised form:
January 14,
2021
Received:
December 23,
2020
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Elsevier Inc. All rights reserved.
