Hi doctor, My uncle had a high fever for a week, along with a cough, which gradually increased. After no improvements even after taking medicines, we admitted him to a hospital near our place, where they took a chest x-ray and did blood tests. They confirmed it as pneumonia, and he was put on oxygen support. He was also suspected for swine flu, so we were waiting for the reports. But gradually his lung functioning started to diminish. He showed PaO2 levels of 60 mmHg in ABG at that time. But then we had a CT scan of lungs, which showed bilateral infection. But the doctor treating him took it lightly, and he was waiting for the swine flu report. H1N1 came back negative, yet his breathing became a major problem. All this happened within two days. He does not smoke or drink. He had a problem in breathing when he visited a hill station. On the second night, he was almost closing his eyes with a fever of 101 degree and PaO2 level of 54 mmHg. He was shifted to an ICU and was put on NIV. The next morning he did not improve, and his PaO2 level was 45 mmHg. So, we shifted him to a better hospital, who again put him in an isolated ward, as they also suspected H1N1. But, they diagnosed it as atypical pneumonia, as other parameters were normal. He was put on a ventilator, but here also his H1N1 report was negative, but the pulmonologist said that the pictures depict swine flu. The team stated that he his struggling in ventilator too, but since all other vitals are stable they promised us that he would recover slowly. He was on a ventilator for seven days, on the eighth day, he was extubated and put on NIV fearing for VAP. He sustained for 24 hours in NIV with great difficulty with diminishing PaO2 levels, and the respiratory element in monitor rose to 40. During this 24 hours, he was extremely drowsy, and he did not respond to us. He was restless and breathed with so much difficulty. The neurologist said that he is psychologically dull, as all his levels of electrolytes were normal. After this, tracheostomy was done, and he was intubated again. Now it is the third day he is on the stoma. He is in full artificial support now and not breathing naturally. A CT scan was taken yesterday. As he is not improving, the doctors are again suspecting swine flu, although the reports are negative. He is on antibiotics, so the infection did not spread, but the lungs are full of scars. Now, he does not have a fever. The hospital team is not able to give us answers as to why my uncle's health is deteriorating. He is conscious, and other vitals are stable, but his breathing is null without artificial support. We need a second opinion. I am attaching the CT scan report taken 14 days back and also the one taken yesterday. And also attaching few ABG reports, taken two weeks back. Please give us an opinion on his health condition and what are the other steps we can take?
Hi. I have gone through the reports (attachment removed to protect patient identity) and the details that you have given. For further queries consult a pulmonologist online -->