46 year old male with h/o fever with chills along with progressively worsening sob & cough with expectoration for last 5 days Dengue malaria chkungunia neg P-90/min Bp-126/83 Spo2-69% with 10 LO2 Febrile-101 Avaps applied - spo2 now 96 % with 4 L O2 Tlc 7600 Dd Management?



A case of ARDS precipitated most likely by a viral illness.. Already managed well.. Send sputum or BAL for culture and sensitivity and gram stain smear.. Send nasal secretions for H1N1.. Treat with broad spectrum antibiotics.. Send PROCALCITONIN level to differentiate between a bacterial or viral infection as a precipitating cause...

Diagnosis: Atypical Interstitial pneumonia Adv: Get a CECT Thorax done Send Naso pharyngeal swab for H1N1 Empirical antibiotic therapy to cover atypical organisms: 1. Beta lactams 2. Clarithromycin/Fluoroquinolone/Tetracycline 3.Start Tab Oseltamivir 75 mg BD for 5 days if PCR positive or patient not improving

pt has pneumomediastinum and it pneumothorax also reduce titrate bipap pressure treatment for atypical infections including coxiella or Q fever along with treatment as mentioned by others already

please get an ABG and Echo to assess cardiac status what is the ECG picture

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ARDS Cause may be infective like 1. H1N1 2. atypical organisms like legionella, chlymadia 3. PCP if immunocompramised Non infective like 1. AIP - acute interstitial pneumonia 2. Acute eosinophilia pneumonia 3. Drug induced Manage as per ARDS protocol Broad spectrum antibiotics with atypical cover. Septran with steroids if possibility of retropositivity. HRCT chest, H1N1 PCR and HIV serology needed. Also better to go for intubation and BAL which can give clue to definite answer.

Pneumonia leading to ARDS. Advised sputum for AFB, culture and sensitivity. In the mean time start with heavy I/V antibiotics, nebulisation, oxygen, fluids and other supportive treatment.

bilateral interstitial pneumonitis..requires sputum cultures,pcr evaluation for swine flu,cover him with antibiotics for atypical organisms..high possibility of patient going for ARDS..

Interstitial Pneumonia. Mx- 1. i/v Augmentin + Tab. Azithral 500 mg + Tab. Clindamycin. 2. Nebulisation with Mistair and Chest Physio 3. Sputum AFB, ELISA. Kindly share if there is h/o Asthma/COPD/ contact with TB or any h/o suggestive of HIV infection.

I think it a case of extensive bialat kochs in ccf & may be open case so first sputumAFB / routine & culture & sensitivy & other tests Management AKt O2 Digilatization . Diuretics Steam inhalation & reevluate CXr all blood tests

Ards bilateral pneumonia r/0 sarscovid19

give him antibiotics like amoxclav 625 bd nd expectorant in mean time investigate sputum for afb after results treat according to reports

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