A Case of ARDS Due to ESBL–Producing Escherichea Coli Infection After Total Gastrectomy

Abstract

We report a case of a man in his 60s with primary gastric cancer and total gastrectomy suffering sudden acute respiratory distress syndrome (ARDS) onset after extended–spectrum beta–lactamase (ESBL) producing Escherichea coli infection. Three days after total gastrectomy, he suddenly reported dyspnea and abdominal fullness from ileus, developing ARDS the next day. We suspected intestinal infection and started empirical meropenem. Three days after ARDS onset, we identified ESBL–producing Escherichea coli from small intestine juice, sputum, and pleural effusion cultures. ESBL occurrence is widespread, particularly in the hospital environment. Carbapenems are the therapeutic choice. We continued meropenem, ameliorating ARDS. The man was discharged on postoperative day 57 days.