Acute Respiratoty Failure On The Grounds Of Lower Respiratory Tract Infection in Female Patient Aged 47 with Right-Sided Heart Failure and Morbid Obesity

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.