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Case reported by Pornsuriyasak P, Suwatanapongched T, Klaewsongkram J, Buranapraditkun S, and Rotjanapan P |
Case reported by Kikuchi R, Iwai Y, Watanabe Y, Nakamura H, and Aoshiba K |
Case reported by Miqdadi A and Herrag M |
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Vaccine |
Influenza vaccine (Vaxigrip*) |
Pneumococcal vaccine (polyvalent pneumococcal vaccine, Pneumovax 23*) |
Anti-COVID-19 vaccine (AZD1222*) |
| |
Year |
2014 |
2019 |
2021 |
| Age |
86 |
68 |
66 |
| History |
Hypertensive arrhythmia and chronic obstructive pulmonary disease |
Dialyzed following chronic glomerulonephritis |
Allergic rhinoconjunctivitis |
| Appearance of signs |
Seven days |
Two days |
Five hours |
| Clinical |
General examination |
Temperature, 38.7°C; respiratory rate, 26 breaths/minute; heart rate, 90 beats/minute; blood pressure, 130/80 mmHg; oxygen saturation on room air, 95%; and pO2, 48 mmHg |
Temperature, 38°C; respiratory rate, 24 breaths/minute; heart rate, 102 beats/minute; and oxygen saturation on room air, 88% |
Temperature, 39°C; respiratory rate, 27 breaths/minute; heart rate, 115 beats/minute; blood pressure, 104/58 mmHg; oxygen saturation on room air, 84%; and pO2, 53 mmHg |
| Symptoms |
Breathlessness, fever, malaise, myalgia, and a cough with scant sputum |
Fever and dyspnea |
Chest tightness with wheezing, polypnea, 39°C fever, asthenia, and muscle weakness |
| Clinical examination |
Coarse crackles and wheezes in the bilateral lower lungs |
Coarse crackles in the lung regions bilaterally |
Restless, cyanotic, and sweating, with intercostal indrawing and jerky words, with bilateral sibilant rales and crackles |
| Biological |
Leukocytes in blood |
15.52 x 109/L |
8,800/μL |
19,300/mm3
|
| Eosinophils in blood |
1% |
11% |
20% |
| Leukocytes in BAL fluid |
445 x 106/L |
9.05 x 105/mL |
- |
| Eosinophils in BAL fluid |
15% |
51% |
- |
| Radiological |
Multiple patchy and/or peribronchial opacities in both lungs, notably in the right upper lobe |
Diffuse infiltrative and ground glass opacities in both lung fields |
Foci of parenchymal condensation of the partially ventilated alveolar type at the expense of the upper lobe and the left Fowler with ground glass foci and a small left pleural effusion slide, and diffuse ground glass areas in the right lung |
| Treatment |
Ceftriaxone + azithromycin, 15 mg dexamethasone/eight hours, and then 60 mg prednisolone/day, and noninvasive ventilation and then mechanical ventilation |
Bolus of methylprednisolone for three days and then 40 mg/day with a decrease over eight weeks |
Third-generation cephalosporin and quinolone, oxygen therapy and nebulization with salbutamol and ipratropium, methylprednisolone 80 mg/eight hours, and then 40 mg/day with a decrease over 12 weeks |
