The role of gallium-67 scintigraphy in diagnosing sources of fever in ventilated patients.

Objective: To evaluate the diagnostic value of gallium-67 scintigraphy in febrile ventilated patients by correlating the findings of 67Ga scintigraphy to sources of fever and pulmonary density, as determined by a comprehensive protocolized diagnostic evaluation.

Design: Prospective observational study.

Patients: Thirty-two intubated patients on mechanical ventilation for > or = 3 days with fever (> or = 38.

Case report: acute postoperative respiratory failure caused by Chlamydia pneumoniae and diagnosed by bronchoalveolar lavage.

Most Chlamydia pneumoniae infections are mild, but 10% develop into pneumonia. C. pneumoniae has been observed in hospital in intubated patients undergoing major surgery or admitted with severe trauma.

Fibroproliferative phase of ARDS. Clinical findings and effects of corticosteroids.

Most patients with adult respiratory distress syndrome (ARDS) survive the initial insult which caused respiratory failure only to succumb later to sepsis caused by nosocomial pneumonia or to pulmonary fibrosis. Clinical criteria and analysis of the tracheal aspirate are notoriously inadequate for establishing a diagnosis of ventilator-associated pneumonia. We implemented a comprehensive diagnostic protocol to determine the cause of sepsis in ARDS patients who had been ventilated for more than three days and who had no bronchoscopic evidence of pneumonia.