Critical Care
The Southwest Journal of Pulmonary and Critical Care publishes articles directed to those who treat patients in the ICU, CCU and SICU including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals. Manuscripts may be either basic or clinical original investigations or review articles. Potential authors of review articles are encouraged to contact the editors before submission, however, unsolicited review articles will be considered.
Ultrasound For Critical Care Physicians: Neutropenic Patient With Fever and Shortness of Breath
Erik Kraai MD
Michel Boivin MD
Division of Pulmonary / Critical Care and Sleep
University of New Mexico
Albuquerque, NM
A 63 year old female with a history of acute myelogenous leukemia presents with shortness of breath, fever and hypotension to the ICU. She is in septic shock on norepinephrine, and has been treated on the oncology unit with vancomycin, cefepime, acyclovir and voriconazole. She has been neutropenic for 1 month. The patient develops a progressive right lower chest opacity. This opacity has progressed in spite of antibiotics and antifungals. The portable AP chest radiograph is presented below (Figure 1).
Figure 1. Portable AP of chest.
An ultrasound of the right chest was performed for further evaluation of the opacity (figure 2).
Figure 2. Ultrasound of right hemithorax.
Question: What pathology does the ultrasound reveal in the right hemithorax? (Click on the correct answer to proceed to the next panel)
- Air filled cavity
- Chest wall abscess
- Fractured ribs
- Pleural effusion and suspected empyema
- Simple consolidation
Refernece as: Kraai E, Boivin M. Ultrasound for critical care physicians: neutropenic patient with fever snd shortness of breath. Southwest J Pulm Crit Care. 2014;8(6):330-3. doi: http://dx.doi.org/10.13175/swjpcc073-14 PDF