Negative pressure pulmonary oedema due to rigors and chills associated with liver abscess.
Publication/Presentation Date
9-1-2021
Abstract
A 61-year-old male presented with progressive generalized weakness, myalgia, diaphoresis, fever, episodic chills and rigors that had started 4 days previously. Chest x-ray (CXR) showed overlying curvilinear radio-opacities. Abdominal computed tomography revealed liver and bilateral adrenal lesions. Empiric 7-day intravenous Piperacillin / Tazobactam (Zosyn) was initiated, and he was admitted for sepsis. After an episode of rigors on Day 2, he developed acute hypoxic respiratory failure with inspiratory stridor. CXR revealed new, bilateral airspace disease. Racemic Epinephrine, Solumedrol, Ketorolac (Toradol) and Diphenhydramine were given, and he was transferred to the intensive care unit with presumptive diagnosis of foreign body aspiration or allergic reaction. With each subsequent episode of rigor and chills, he continued developing hypoxic respiratory failure with stridor and an incremental increase in pulmonary oedema on imaging. Pulmonologist concluded it likely secondary to negative pressure pulmonary oedema caused by transient laryngeal dyskinesia induced by the increased work of breathing associated with rigors. Symptoms resolved after the complete course of antibiotics along with supportive therapy.
Volume
9
Issue
9
First Page
0826
Last Page
0826
ISSN
2051-3380
Published In/Presented At
Chaudhry, H., Nimmala, S., Papudesi, B. N., Sajjad, F., Paul, S., Gohar, Z., Azad, R., Naveen, H., & Demidovich, J. (2021). Negative pressure pulmonary oedema due to rigors and chills associated with liver abscess. Respirology case reports, 9(9), e0826. https://doi.org/10.1002/rcr2.826
Disciplines
Medicine and Health Sciences
PubMedID
34457310
Department(s)
Department of Medicine
Document Type
Article