Bronchiectasis with Sepsis and Respiratory Failure

· Critical Care, Lung Infection

Farah Fatmawati1, Menaldi Rasmin2
1Departemen Pulmonologi dan Ilmu Kedokteran Respirasi Fakultas Kedokteran Universitas Airlangga, RSUD dr. Soetomo, Surabaya
2 Departemen Pulmonologi dan Ilmu Kedokteran Respirasi Fakultas Kedokteran Universitas Indonesia, RSUP Persahabatan, Jakarta

Bronchiectasis is diagnosed based on high resolution chest computed tomography (HRCT) image, with specific criteria that the internal diameter of the bronchus is greater than that of the accompanying blood vessel, or the bronchus toward the peripheral of the chest is not tapered. The prevalence of bronchiectasis in the United States increases annually from 2000 to 2007 with 8.74% annual change. Mortality rates range from 10 to 16% caused by primary bronchiectasis or associated with respiratory failure. A 59-year-old woman came to IGD Persahabatan Hospital Jakarta with the chief complaint was unable to urinate since 1 day before entering the hospital. Based on anamnesis, physical examination, investigation, patients was diagnosed with infected bronchiectasis, former tuberculosis (TB) dd TB relapse cases, and anuria. Bronchiectasis should be suspected in patients with chronic cough and sputum production or recurrent respiratory infections. Infected bronchiectasis is characterized by increased sputum (volume, viscosity, and purulence), increased cough, wheezing, shortness of breath, coughing up blood, and decreased lung function. Management of bronchiectasis includes management of infection with adequate antibiotics, and management of sepsis and respiratory failure as a complication. During the course of disease, the patient worsened, experiencing severe sepsis and respiratory and patient was intubated and treated in ICU with ventilator. Patients have several times experienced failure in ventilator wearing due to shortness of breath and tachyarrhythmias, but after the fifth day the patient can succesfully extubated. (J Respir Indo. 2017; 37: 165-76)
Keywords: bronchiectasis, sepsis, respiratory failure

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