Hippokratia 2003, 7(3):138-142
E Mendrinou, P Georgakopoulos, G Liaros, A Notoropoulos, I Ravani, K Dragotis, G Siempos, V Ntontou, A Regli
Microbiology Dpt of “St Andreas” General Hospital of Patras,
Intensive Care Unit, “St Andreas” General Hospita; of Patras
Nuclear Dpt, “AHEPA” University Hospital of Thessaloniki, Thessaloniki, Greece
We present a case of a 41-years old male with severe interstitial pneumonia due to Coxiella Burnetii infection. The infection evolved on ARDS and the patient was supported with mechanical ventilation under sedation in the Critical Care Unit. The diagnosis was based on seropositive tests (an ImmunoFluorescence Assay – IFA). The severe general situation and the insisting respiratory failure with refractory hypoxemia, obliged us to use prone position ventilation twice, for 24h each time, although the patient was non responding. After the 9 th day of hospitalization, the patient was getting better. A difficult weaning started on day 13 but he was tracheostomised on day 15 and was eliberated from ventilator on day 23. We used the antibiotics Erythromycine, Rifampicine and Vancomycin although Tetracycline is reffered as the antibiotic of choice in Coxiella Burnetti Pneumonia. The patient had a good outcome with few sequelae as pulmonary fibrosis in middle lobe and lingula, detected with CT scan, but without functional respiratory disturbances on spirometry.