PMC5061076_01
Chest CT at the diagnosis of SCLC and 3 months later at admission. (A) Chest CT at the diagnosis of SCLC (3 months prior to this admission) in the patient, a 49-year-old Japanese male smoker. The chest CT shows the primary tumor shadow in the left superior lobe and lymph node metastasis in the mediastinum. (B) Chest CT on admission. Reductions of size in both the primary tumor shadow and the lymph node metastasis are observed.
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He had been diagnosed with SCLC 3 months prior to this admission (Fig. 1). Since the chest CT scan on his admission to our institution revealed the reduction of tumor size (reduction rate: 75%, Fig. 1) by chemotherapy, he was admitted for the administration of a third cycle of chemotherapy.
Chest X-ray on transfer to the intensive care unit. Chest X-ray on transfer to the ICU. The chest X-ray shows enlargement of left hilar shadow (arrow) without consolidations.
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A chest X-ray showed no abnormal shadows, such as consolidations, except for shadows of the main tumor and lymph node metastasis (Fig. 2).
Clinical course in the intensive care unit. Changes in the SOFA score, DIC score, CRP level and lactate level. After PMX-DHP treatment and the administration of antibiotics, the SOFA score, DIC score, and CRP level dropped from 11 to 3, from 7 to 1, and from 24.4 mg/dl to 3.3 mg/dl, respectively during the patient's 5-day stay in the ICU.
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After the patient's transfer to the ICU, his antibiotic therapy was changes to tazobactam/piperacillin (TAZ/PIPC) and gentamicin (GM) for a total of 14 days, and he underwent PMX-DHP for 2 consecutive days (Fig. 3).