Clinical and Medical Case Reports

A Case Report of A 51-Year-Old Male with Past Medical History of Adrenomyeloneuropathy Requiring a Video-Assisted Thoracic Surgery for a Left Parapneumonic Empyema

Abstract

Cassandra Wasson* and Albert Kelly

51-year-old male with adrenomyeloneuropathy required a video-assisted thorascopic surgery (VATS) for left parapneumonic empyema, likely from recurrent micro-aspirations. General anesthesia and surgery were uneventful. The patient met extubation criteria and was transferred to the intensive care unit (ICU). He required re-intubation post-operatively for hypoxemia and was started on total parenteral nutrition (TPN) and a propofol infusion. He continued to weaken post-operatively, received a percutaneous gastrostomy tube and a tracheostomy, and was transferred to a long-term acute care facility. A poor understanding of the pharmakokinetics of propofol and TPN on adrenomyeloneuropathy may have caused the rapid progression of this rare disease.