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Unusual association of diseases/symptoms
CASE REPORT
Septic pulmonary embolism caused by Pseudomonas aeruginosa after a CO2 laser surgery for rhinitis
  1. Toshinori Nishizawa1,
  2. Hiroaki Kanemura2,
  3. Torahiko Jinta2 and
  4. Tomohide Tamura2
  1. 1 Internal Medicine, St Luke’s International University, Chuo-ku, Tokyo, Japan
  2. 2 Division of Pulmonary Medicine, Thoracic Center, St Luke’s International University, Chuo-ku, Tokyo, Japan
  1. Correspondence to Dr Hiroaki Kanemura, whitetigerblink{at}gmail.com

Abstract

A 26-year-old healthy patient had a fever and chest pain three days after nasal carbon dioxide (CO2) laser surgery for chronic and allergic rhinitis. In the emergency room, he was diagnosed as a right pneumothorax and managed as outpatients with oral antibiotic therapy and close follow-up. Six days later, in follow-up clinic, his presenting signs and symptoms included right chest pain, tachypnoea and elevated levels of white blood cell count and C reactive protein. He was diagnosed as septic pulmonary embolism (SPE) by the detection of multiple nodules with cavitation on chest CT. Culture of pleural fluids showed Pseudomonas aeruginosa. Intravenous antibiotic treatment and drainage of the pleural effusion improved his condition. Since SPE occurred after nasal CO2 laser surgery in this case, careful attention should be paid to infectious complications of nasal CO2 laser surgery.

  • infectious diseases
  • respiratory medicine
  • ear, nose and throat/otolaryngology

https://doi.org/10.1136/bcr-2018-228420

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    Footnotes

    • Contributors TN, HK, TJ and TT meet all four ICMJE criteria and certify that they have participated sufficiently in the work to take public responsibility for the content. All authors managed the patient. TN wrote the manuscript and HK and TJ edited and revised it critically with support from TT. TT finally approved the final version of the manuscript to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.