Article / Case Report
Kerameikos Health Center, Greece.
Efstathios Koutsostathis ,
Kerameikos Health Center,
Greece.
6 April 2025 ; 2 May 2025
Aim
Presentation of interesting case involving a woman with morbid obesity who was hospitalized in the ICU due to type 2 acute respiratory failure.
A female patient aged 47 with personal history of morbid obesity, chronic respiratory failure, DVT on the left superficial femoral artery, chronic lymphedema, chronic skin lesions with multiple dermatitis episodes, ex-smoker (around 50 py), menopause 2 years ago, presented to the Emergency Department with reported dyspnea at rest and reduced level of consciousness (GCS<8). The patient was intubated due to type 2 ARF on the grounds of pneumonia. She underwent a bronchoscopy (presence of ample pus in the left bronchial tree). The pleural aspiration of the right hemithorax revealed a transudate. The thigh U/S revealed a large fluid collection (hematoma) in the middle of the right thigh, measuring 12x12 cm. It was fully transfused with PRBCs, FFPs, she received a tranexamic acid IV, and a compression bandage was placed on left thigh at the height of the femoral-inguinal junction.
The patient was placed on empirical antibiotic treatment with piperacillin, tazobactam and linezolid (pneumonia treatment). She became febrile and received empirical antibiotic treatment anew with ciprofloxacin and clindamycin in the context of right lower limb cellulitis. She was extubated and discharged from the ICU following clinical and lab improvement.
Morbid obesity is determined based on the height-weight relationship, which is called Body Mass Index (BMI) and is derived by dividing the weight (in kilos) by the height (in meters, squared).
In this context, a BMI between 18-25 is considered normal, a BMI between 25-30 is considered overweight and a BMI between 30-35 is considered obesity. It is estimated that the number of obese adults globally is 500 million, while the number of overweight people is over 1.4 billion. It is accompanied by significant morbidity and mortality.