pus in lungs

[int. corr]

my friend recently visited nigeria..... he came back with fever, noone could diagnose the real problem they passed it of as viral fever but apparently it was malaria which led to jaundice and later pneumonia......now he is in hospital..... doctors say he has fluid(pus) in his lungs which they cleared out but it has reoccured, he's been on a respirator for almost a month...... he got extremely breathless a few days back and the doctors here said that he might not survive because his lungs have become stiff because of pneumonia and are not functioning on their own........ i am not exactly savvy with the medical terms but i am sure the lung doctors on this forum will understand what i am trying to convey........ any doctor on this forum who can help or knows someone who can do so please respond immediately........ please it is desperate plea for help....... i dont want to lose my friend............. please reply and when u do so, i will promptly send u his medical reports and maybe put you in touch with the doctors who are operating on him.......... money is no concern........ please do whatever you can to help me, my friend and his family

[National Jewish]

You are right.  This is a very serious situation.  The best thing you can do for your friend is to make sure that he is getting the best possible care, available anywhere.  He should be under the care of a pulmonologist and an infectious disease specialist, preferably one with special knowledge of tropical diseases.  In most cases this would be available at the closest university medical center.  You might start by calling this medical center and asking to speak to someone in the Infectious Disease division.

You should talk with your friend’s doctors about this to get their recommendations.  Ask his doctors to contact the Center for Disease Control at http://www.cdc.gov/ to see if they have someone with special knowledge about the variety of malaria found in Nigeria.  They may also provide physician consultation for complicated malaria.  Another suggestion is to contact the American Society of Tropical Medicine and Hygiene at http://www.astmh.org/ to find a tropical medicine specialist locally.

The National Institutes of Health (NIH) is actively engaged in research on malaria.  View their Malaria Brochure at http://www.niaid.nih.gov/publications/malaria/ for further information.

[bactitech]

Apparently someone took a good history and decided to start looking for parasites (the malaria parasite invades red blood cells). There are four different types of malaria. Have they said which one he has? Falciparum is the worst.

I assume he is still in a hospital. The best thing to do would be to get a good infectious disease doc on his case, together with a pulmonologist. This probably has already been done, as a finding of malaria sounds as if ID has already been called in. It sounds as if he has some thinking doctors already around him, which is good.

I hope your friend comes out of this. Good luck to him.

[LLRT]

With the lungs being affected from the pneumonia which is caused by your friend being immobile and the secretions settling in the lungs. You can not breathe for him with a ventilator because the secretions are making his lungs stiff. This causes your friend to not get the oxygen that he needs. Your respiratory therapists and nurses should be suctioning him frequently, but sometimes it gets to be too thick and sticky. Patients that I work with end up having oxygenation issues so bad that they end up dying from the pneumonia. If your friend can not be oxygenated, then request that he be "proned," this is the fancy word for flipping him over on to his stomache. This really works. It takes all the vascular congestion and moves it from his back to the front of his lungs to open up airways to improve his oxygen saturation immediately. If your hospital is very advanced with the latest in technology, then they would have access to rent a "Rotoprone" bed. This is a sci fi looking bed that your friend would get strapped into and then gets turned onto his stomach, but also gets rotated left and right while being upside down. The bed is better because you usually have to be on your stomache for 3 hours and "supine" or on your back for one hour and continue this until he gets better. It's hard and takes a lot of nurses and therapists to rotate the dead weight of a sick patient so frequently. It sounds like it's going to be the pneumonia that is going to kill him and this will help. The rotoprone is new and there is not a lot of data to support when the bed should be discontinued and the pt be placed back on a regular bed, but get them to try it. Our hospital is a research facility that is using it and getting data at this time for it. You can go to this website to find more information about this bed. It's a KCI brand bed.

http://www.kci1.com/products/pulmonary/rotoprone/index.asp

Hope this helps. Keep us updated.

~L (Registered Respiratory Therapist)

[bactitech]

Wow - what a good thing to know about. What I know about respiratory therapy can be put on the head of a pin. There are many "teams" that work on patients in hospitals. This is a good thing to know about ahead of time in case anyone I know would end up hospitalized with pneumonia. I have no idea whether our place (a level 1 trauma center affiliated with two medical schools) is using this or not.

I do have a respiratory contact and I will email her to see if this is being done in our area. She works at our competitor hospital in the area but has been in respiratory for over 25 years.

Thanks so much for this information.

[LLRT]

We are also a level one trauma center, so I hope you will have access to it. It is truly an amazing bed. You see a difference almost immediately when proned. Their PO2 usually increases from the 40-50's to 70's or a little higher, and you can begin to wean their FiO2. It is my hope that every pt has the option to use this bed when they have exhuasted all other avenues when battling ARDS, or at least be transferred to a level one trauma center that does it. If you need more references, let me know. I will monitor this thread for a few days. We only began using the "Rotoprone" bed at our hospital within the last 8 months. We are collecting data for this clinical trial and so far it has been good. Pt's now have a chance when before they didn't. Tell your respiratory contact not to be discouraged because it took us a long time to open this trial at our facility, but it works!

~L  RRT

[int. corr]

Thank you all very much for your time....... my friend did not survive. The doctors here did flip him over on to his stomach several times. The malaria led to infection in his blood which caused ARDS....... there was fluid(pus) in his lungs which was filling up faster than they could clear it. The pneumonia along with being on the respirator made his lungs stiff and unable to produce oxygen. The fluid in turn did not let enough oxygenated blood reach his heart which thereby led to a cardiac arrest..... they revived him twice but the third cardiac arrest took him away. If i have any further queries i will write in. Thank you very much

[bactitech]

I am very very sorry for your loss. Pneumonia such as your friend had is very difficult to recover from. My sincere condolences to you and your friend's family.