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Refractory ARDS with diffuse centrilobular nodules: did the patient smoke a tree?
  1. Thibaud Soumagne1,
  2. Estelle Dossot1,
  3. Hadrien Winiszewski1,
  4. Gael Piton1,2
  1. 1Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
  2. 2Research Unit EA 3920 and SFR FED 4234, University of Bourgogne - Franche-Comté, Besancon, France
  1. Correspondence to Dr Thibaud Soumagne, Medical Intensive Care Unit, University Hospital of Besançon, 25000 Besançon, France; thibaud_soumagne{at}live.fr

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A 22-year-old man with no relevant medical history except hashish use (10 joints a day) was admitted to the intensive care unit in December 2018 for refractory acute respiratory distress syndrome (ARDS). He presented dry cough and dyspnoea for 1 week. After intubation, veno-venous extracorporeal membrane oxygenation (VV-ECMO) was required because of severe hypoxemia and very low respiratory compliance (15 mL/cmH2O). Given the possibility of severe community-acquired pneumonia and influenza, urgent antibiotic therapy associating cephalosporin plus macrolid and …

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Footnotes

  • Contributors TS wrote the manuscript. TS, ED, HW and GP were in charge of the patient and have reviewed the manuscript and consistently improved its content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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