Pleural effusion with compression atelectasis is quite often in critically ill patients. If fever and increased levels of inflammatory markers appear a suspicion of nosocomial infection raises. The most common nosocomial infection is pneumonia. It may be difficult to distinguish between compression (non-infected) atelectasis and the infected one (i.e. pneumonic consolidation), especially if another inflammatory focus is not found.
Following cases show patients who underwent laparoscopic cholecystectomy for cholecystitis. The first patient is an 89-year-old, and the other one is a 92-year-old one. Both patients were hospitalised at ICU for sepsis due to worsening of their health condition, tachypnea and elevation of inflammatory markers. Do they suffer from nosocomial pneumonia or other complication?
Patient number 1: