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May 2013 critical care case of the month: not an air-filled sac

Keywords: pneumocystis , Pneumocystis jiroveci , upper gastrointestinal bleeding , trimethoprim/sulfamethoxasole , non-AIDS

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Abstract:

No abstract available. Article truncated after 150 words. History of Present Illness A 66 year old woman presented to outside hospital with hematemesis and hematochezia. She was intubated for airway control and received 4 units of packed red blood cells. She was transferred to the Mayo Clinic Arizona due to an inability to control her upper gastrointestinal bleeding. During her transfer she required vasopressors. PMH She has a history of hepatitis C with cirrhosis and esophageal varices. In addition, she was diagnosed with a B-cell lymphoma 3 months prior to admission and had received 3 cycles of rituximab, cyclophosphamide, hydroxydaunorubicin (doxorubicin), Oncovin (vincristine) and prednisone (R-CHOP). Physical Examination She was intubated and receiving oxygen at a FiO2 of 0.4. Vital signs: P 100 beats/min; B/P 113/78 mm Hg; Afebrile; R 20 breaths/min; SpO2 99%Chest: clear to auscultation. Laboratory Her hemoglobin was 9.3 g/dL and her hematocrit was 29%. Radiology Her admission chest x-ray is shown in Figure …

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