Tracheal Stenosis and Failure to Wean from Mechanical Ventilation due to Herpetic Tracheitis

摘要: A 64-year-old man with chronic obstructive pulmonary disease presented pneumococcal pneumonia that progressed to respiratory failure within one week, requiring mechanical ventilation. Despite a low minute ventilation and clear chest roentgenogram, multiple weaning attempts failed. Bronchoscopy revealed significant narrowing of the distal trachea erythema, edema, ulceration mucosa. Cytology tracheal washings was consistent herpes simplex virus, patient successfully extubated following treatment intravenous acyclovir. acyclovir therapy demonstrated resolution inflammation narrowing. Herpetic tracheitis is rarely recognized reversible cause stenosis, especially in nonimmunocompromised patient. It should be suspected patients without an obvious wean from ventilation, can treated