Bleomycin-Induced Pulmonary Fibrosis, Severe Hypoxia and Intracardiac Air Embolism: Case Report

Bleomycin sulphate is a mixture of cytotoxic glycopeptide antibiotics isolated from a strain of Streptomyces verticillus. Use of bleomycin in squamous cell carcinoma, lymphoma, testicular carcinoma and malignant pleural effusion has been associated with the development of pulmonary fibrosis in 1% of cases. Bleomycin-induced pulmonary fibrosis results in severe hypoxemia due to inflammation that develops in the alveolar capillary membrane and this patients are associated with less-than-expected response to medical treatment besides the likelihood of complications related to mechanical ventilation. Herein, we report development of severe hypoxemia and intracardiac air embolism under mechanical ventilation who has no response to medical treatment in a 39-year-old male patient following bleomycin treatment.