Patient Dong (character name has been changed, 39 years old, Ho Chi Minh City), before being admitted to the hospital, was in a state of exhaustion, thin, pale due to prolonged blood loss and respiratory failure. He had been treated for pulmonary tuberculosis 8 years ago, and in recent months has been continuously coughing up blood, shortness of breath, chest tightness, fatigue and rapid weight loss.
At the hospital, the patient was prescribed a CT scan, and doctors discovered that the fungus entered the pulmonary blood vessels like moss, causing continuous bleeding.
Assoc. Prof. Dr. Vu Huu Vinh, Director of the Thoracic Surgery - Vascular Surgery Center, Tam Anh General Hospital, Ho Chi Minh City, said: "Patient Dong has lung fungal tumor, a sequelae after pulmonary tuberculosis. The fungus invades and completely destroys the left lung, forming a cavity full of pus. The damaged lung has complications that cling tightly to vital organs such as the heart, aorta and thoracic wall.
As soon as the cause was detected, doctors indicated that the patient had a blocked injection, this is a technique to seal blood vessel punctures from the inside, but even if the injection is blocked many times, the blood still flows, overflowing into the trachea leading to coughing up blood, spreading to healthy lungs causing respiratory failure.
Determining that surgery is the only option to save the patient's life, Associate Professor Vinh and the team planned and prepared the plan meticulously. Before surgery, the patient was given protein and continuous blood transfusions to improve physical condition combined with regular respiratory examinations. "Because the damaged lungs are firmly attached to large blood vessels and the heart, even a small mistake during dissection can cause massive bleeding, and the patient may die from blood loss," Associate Professor Vinh said.
The team carefully peeled off each layer of skin, muscles of the chest wall, bones, pleural layers... In addition, the fungus also pierced the diaphragm, the team had to perform the recovery step for the patient. After surgery, the biggest challenge is to maintain stability for the thoracic cavity, because when one lung is lost, sudden changes in pressure can cause the heart and mediastinum to be displaced, twisting blood vessels causing immediate death.
To resolve the space after lung resection, the team injected about 1 liter of solution to replace the lost lungs, keeping the mediastinum and heart from being displaced. This amount of fluid is replaced daily to avoid infection as well as to wash away residual pus.
After 10 days of special care, the patient's health gradually stabilized, the lung fluid was clear, the remaining drainage tube was removed and he was discharged from the hospital. According to Associate Professor Vinh, although only one lung remained, the patient could still live and work normally when he recovered.
Associate Professor Vinh said that lung fungal disease is caused by Mycobacterium tuberculosis bacteria on patients who have had tuberculosis. To prevent tuberculosis and lung fungal tumors, people need to build a healthy lifestyle, not smoke, limit alcohol, maintain a ventilated living environment, wear masks in crowded or polluted places... Patients with a history of tuberculosis, bronchospasm or weakened immune system need to have periodic lung screening to promptly detect and treat early.
