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puzzling case From: JOshea1770@aol.com Fri Feb 14 15:22:44 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: Puzzling case - longish" Previous message: Larry Glazerman: "Re: RU486" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: puzzling case" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: Gail Waldby: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: Gail Waldby: "Re: puzzling case" Subject: Puzzling case - longish ??Drug reaction to Macrobid - frequently pulmonary John O'Shea, MD State College > > 28 year old P0G1 presents for routine screening ultrasound at -22 weeks - > cervical funnelling seen. Treated conservatively - funnelling worsens - > "rescue" cerclage performed(M'Donalds) > A few days later diagnosed with cystitis -placed on Macrobid. About 10 days > after cerclage placement, follow-up sonogram shows worsening of funneling > and dilation, baby in breech presentaion - now 25 weeks.Membranes > intact.Patient admitted for bedrest, steroids, indocin and > trendelenberg.Develops a cough, steadily worsens, dyspnoea, and within 3 > days of hospital admission develops what seems to be ARDS. Is intubated and > on ventilator.WBC 20,000. Highest temp 99.4. Urine cultures,blood, amniotic > fluid(amniocentesis) sputum cultures negative for usual pathogens including > fungi, negative, bronchoscopy negative.HIV negative. HBV positive, normal > liver functions. No ruptured membranes. > Pregnancy terminated by cesarean section at pulmonologists request as ARDS > is worsening - live male infant weighing 900 grams delivered, no evidence > of chorio-amnionitis.One week post cesarean section, now on jet ventilator, > no real improvement, open lung biopsy probably consistent with ARDS - > specimen sent to Mayo Clinic to be reviewed by expert pulmonary > pathologist. No one has a clue as to what is going on. Any thoughts? > Next message: Richard Chudacoff, MD: "Re: Puzzling case - longish" Previous message: Larry Glazerman: "Re: RU486" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: puzzling case" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: Gail Waldby: "Re: puzzling case" Maybe reply: RModugno@aol.com: "Re: puzzling case" Maybe reply: Gail Waldby: "Re: puzzling case"

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