A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy

A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy

A 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure t...

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Main Authors: Noor H Bouwmeester, Hans Kieft, Ghada MM Shahin, Arno P Nierich
Format: Article
Language:English
Published: SAGE Publishing 2020-05-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X20918989
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spelling doaj-589e5e912f7c4c69a677168b5fe28fc82020-11-25T03:04:41ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2020-05-01810.1177/2050313X20918989A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapyNoor H Bouwmeester0Hans Kieft1Ghada MM Shahin2Arno P Nierich3Department of Intensive Care, Isala, Zwolle, The NetherlandsDepartment of Intensive Care, Isala, Zwolle, The NetherlandsDepartment of Cardiothoracic Surgery, Isala, Zwolle, The NetherlandsDepartment of Cardiothoracic Anesthesiology, Isala, Zwolle, The NetherlandsA 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure therapy were used to resolve the emphysema. The subcutaneous emphysema decreased significantly, and after 1 week the vacuum-assisted closure therapy was ended successfully. This technique has previously been described in several case reports, where it is a promising treatment in severe subcutaneous emphysema, but it is not yet widely used. This case report supports the further use of vacuum-assisted closure therapy in subcutaneous emphysema. Successful treatment of severe mediastinal and subcutaneous emphysema in Pneumocystis jirovecii pneumonia can be achieved by vacuum-assisted closure therapy on infraclavicular skin incisions.https://doi.org/10.1177/2050313X20918989
collection DOAJ
language English
format Article
sources DOAJ
author Noor H Bouwmeester
Hans Kieft
Ghada MM Shahin
Arno P Nierich
spellingShingle Noor H Bouwmeester
Hans Kieft
Ghada MM Shahin
Arno P Nierich
A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
SAGE Open Medical Case Reports
author_facet Noor H Bouwmeester
Hans Kieft
Ghada MM Shahin
Arno P Nierich
author_sort Noor H Bouwmeester
title A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
title_short A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
title_full A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
title_fullStr A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
title_full_unstemmed A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
title_sort novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy
publisher SAGE Publishing
series SAGE Open Medical Case Reports
issn 2050-313X
publishDate 2020-05-01
description A 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure therapy were used to resolve the emphysema. The subcutaneous emphysema decreased significantly, and after 1 week the vacuum-assisted closure therapy was ended successfully. This technique has previously been described in several case reports, where it is a promising treatment in severe subcutaneous emphysema, but it is not yet widely used. This case report supports the further use of vacuum-assisted closure therapy in subcutaneous emphysema. Successful treatment of severe mediastinal and subcutaneous emphysema in Pneumocystis jirovecii pneumonia can be achieved by vacuum-assisted closure therapy on infraclavicular skin incisions.
url https://doi.org/10.1177/2050313X20918989
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