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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr0520103000.
Published online Sep 10, 2010. doi:  10.1136/bcr.05.2010.3000
PMCID: PMC3027714
Unusual association of diseases/symptoms
Management of acute-onset and life-threatening respiratory distress of unusual aetiology
Robert M. Radke,1 Torsten Kessler,2 and Pia Lebiedz1
1Department of Cardiology and Angiology, University Hospital of Muenster, Muenster, Germany
2Department of Haematology and Oncology, University Hospital of Muenster, Muenster, Germany
Correspondence to Robert M. Radke, robert.radke/at/ukmuenster.de
Abstract
A 30-year-old female experienced severe acute respiratory distress in her apartment assumed to be due to an allergic asthma. Upon arrival of the emergency physician at the scene the patient was unconscious and cyanotic. Auscultation yielded no respiratory sounds despite visible efforts of the patient. Mask ventilation was virtually impossible. Endotracheal intubation was performed but complicated by a distinct resistance. Ventilation remained difficult, despite antiobstructive medication and deep general anaesthesia. Fiberoptic bronchoscopy in the hospital finally showed a bulk of granulomatous tissue located just above the tracheal bifurcation. Here, the authors report a rare case of acute-onset respiratory distress due to Wegener's granulomatosis.
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