Abstract A 49-year-old male who was admitted to the Veterans Affairs Hospital, medical critical care unit for influenza and found to have MSSA pneumonia and bacteremia. He required intubation and management of ARDS including paralysis and proning. His course was prolonged and he underwent bedside tracheostomy on day 11 of hospitalization. Bronchoscopy identified necrotic tissue with hemorrhagic material and sloughing of the mucosa throughout all visualized areas of the trachea and bilateral bronchi (Figure 1.) Endobronchial biopsy was obtained and microbiology data was consistent with aspergillus. Influenza, staph aureus, and aspergillus have all previously been described causing necrotizing tracheobronchitis but not all have been identified together. Repeat bronchoscopy on Day 21 after treatment for all three pathogens, showed resolution of necrotic tissue (Figure 1C,D.) This abstract is funded by: None
Husak et al. (Fri,) studied this question.