October 2024 Critical Care Case of the Month: Respiratory Failure in a Patient with Ulcerative Colitis

No abstract available. Manuscript truncated after 150 words. History of Present Illness The patient is a 57-year-old woman with a history of ulcerative colitis (UC) complicated by toxic megacolon with subsequent colectomy. She presented to the emergency department with cough, shortness of breath and hypoxemia (87% on RA). PMH, SH • UC with history of toxic megacolon (4 years prior) with a total colectomy • History of a prior episode of respiratory failure a year earlier thought possibly medication induced (ustekinumab, Stelara®) which she was taking for her UC. She was treated with steroids at that time with good response. • Pyoderma gangrenosum of both ankles (attributed to UC). • Anemia of chronic disease. • She is a lifelong non-smoker. • No exposures to toxic dusts, birds, down, humidifiers, mold or other antigens associated with hypersensitivity pneumonitis. Physical Exam • Afebrile, Oxygen saturation 94% on 2 lpm supplemental oxygen. • Chest: crackles noted at left base. • CV regular rhythm, no murmur. Ext: scarring and erythema on …