Haemoptysis aand aan aabnormal X X-ray after pprolonged ttreatment iin tthe IICU

Case report A 67 year old man, with a history of insulin-dependent diabetes, hypertension and pulmonary tuberculosis, was admitted to the Medical ICU because of respiratory failure and shock. Three days earlier, a partial resection of the left maxilla had been performed because of a T2N0M0 squamous cell carcinoma. His only complaint before admission to the ICU had been general malaise and shortness of breath. On initial physical examination, the patient had a respiratory rate of 40 breaths·min -1 , cyanosis, a heart rate of 140 beats·min -1 and a blood pressure of 70/40 mmHg. Rales were heard over both lower lung fields. Laboratory evaluation revealed leucocytosis, hypoxaemia (arterial oxygen tension (PaO2) 6 kPa (45 mmHg) and an increased creatine phosphokinase level in the blood. An electrocardiogram (ECG) was compatible with acute anterior myocardial infarction. A chest radiograph demonstrated pulmonary oedema. Staphylococcus aureus was cultured both from the operation wound and from the blood. Staphylococcal sepsis, myocardial infarction and adult