# Community-acquired pneumonia associated with immunosuppression due to follicular thyroid cancer: a case report

## TL;DR

A 38-year-old woman with diabetes and thyroid cancer developed severe pneumonia and multiple complications, highlighting the risks of immunosuppression in cancer patients.

## Contribution

This case report highlights the rare and severe clinical course of community-acquired pneumonia in a patient with immunosuppression due to thyroid cancer.

## Key findings

- The patient developed community-acquired pneumonia complicated by respiratory failure and septic shock.
- Despite interventions, she experienced prolonged ICU stay and multiple complications including bronchopleural fistula and multiorgan dysfunction.
- Metastatic papillary thyroid carcinoma was diagnosed after 62 days, contributing to immunosuppression and poor outcomes.

## Abstract

We present the case of a woman with cancer, which weakened the immune system and increased the risk of infection. Thus, infections are a frequent complication of cancer. The development of community-acquired pneumonia, an acute respiratory infectious disease that damages the lung parenchyma, caused by the invasion of pathogenic microorganisms, can lead to respiratory failure with multiorgan failure due to respiratory sepsis.

Case report of a 38-year-old mixed-race woman with diabetes mellitus and irregular treatment, who was admitted with community-acquired pneumonia complicated by type I respiratory failure requiring mechanical ventilation. During her hospital stay, she developed ventilator-associated pneumonia, recurrent empyema, bronchopleural fistula, refractory septic shock and multiorgan dysfunction despite multiple interventions. The patient required prolonged mechanical ventilation, vasopressor support and antibiotic therapy. After 62 days, metastatic papillary thyroid carcinoma was diagnosed. She presented with hypoparathyroidism and permanent hypocalcemia. She died after multiple complications and a refractory critical condition.

The case exemplifies the potential severity of community-acquired pneumonia in a patient with risk factors such as diabetes and immunosuppression. It highlights the complexity of treating multiple comorbidities and the importance of multidisciplinary management with close surveillance for timely interventions for complications.