Adult Respiratory Distress Syndrome Caused by Psittacosis

His family physician prescribed betalactam drugs for a suspected upper respiratory tract infection. He was referred to the Department of Pulmonary Diseases of our hospital because of acute respiratory insufficiency. Their treatment consisted of cefaperazone-sulbactam, flucanozole and ornidazole. But the lung abnormalities progressed. So the patient was transferred to Intensive Care because of the necessity for mechanical ventilation. On examination we saw a temperature 40°C, and rales on auscultation of the lungs. The chest x-ray revealed bilateral infiltrates in all lobes (Figure 1). The arterial blood gases were: PH: 7.21, PCO 2 : 40, PO 2 :46, BE: 11.5, HCO 3 : 15.9, SaO 2 : 67%. 8cmH 2 O PEEP was applied with controlled mechanical ventilation. Lung injury score was “10” (CHEST X-RAY: No infiltrate: 0, one quadrant: 1, two quadrant: 2, three quadrant: 3, four quadrant: 4. HYPOXEMIA: PaO2/FIO2: >300: 0, 225229: 1, 175-224: 2, 100-174: 3, 15: 4. COMPLIANCE: >80: 0, 60-79: 1, 40-59: 2, 20-39: 3, 2.5) (3).