Fatal Bleomycin-Induced Pulmonary Fibrosis in Case of Seminoma

An interim disease evaluation was suggestive for a complete clinical, metabolic and radiologic response. Three weeks after the completion of the 4th cycle of chemotherapy, he presented a rapid progression of dyspnea and severe hypoxemia with dry cough. The CT scan showed diffuse interstitial and alveolar in iltrates associated with a pneumomediastinum. Because of acute respiratory failure, he required hospitalization in an ICU and intubation 24 hours after admission. He was treated with empiric antibiotics and corticoids in pulse therapy, IV cyclophosphamide and inally veno-venous extracorporeal membrane oxygenation (VV-ECMO) as a bridge to recovery. He inally died, due to chemotherapy acute lung injury.