[48-Year-Old Triathlete with Severe COVID-19 Pneumonia: Successful and Safe Treatment with Oxygen and CPAP]. / 48-jähriger Triathlet mit schwerer COVID-19-Pneumonie: erfolgreiche und sichere Behandlung mit Sauerstoff und CPAP.

We present the case of a 48-year old man, a triathlet, with severe COVID-19 and extensive bilateral pneumonia. On day 7 since onset of symptoms, the patient had fever, cough, rheumatic pain, dyspnea as well as severe hypoxemic respiratory failure (PaO2 49,9 mmHg, PaCO2 35,7 mmHg, Horovitz-Index 130). CT of the lung showed extensive bilateral ground glass opacities.The patient was treated according to a predefined standard, including oxygen supplementation and, after intermittent worsening, with CPAP-ventilation. The patient improved and could be discharged with normal blood gases at ambient air after 12 days of hospitalization. Six weeks after discharge the patient was fully recovered and lung function as well as CT of the lungs were normal.Our case demonstrates that invasive ventilation can successfully be avoided in patients with severe hypoxemia caused by COVID-19 with bilateral pneumonia.

[Severe disseminated Mycobacterium bovis BCG infection as a consequence of intravesical BCG therapy: diagnostic challenges and therapeutic options]. / Schwere disseminierte Infektion durch Mycobacterium bovis BCG als Folge einer intravesikalen BCG-Therapie: Diagnostische Herausforderungen und therapeutische Optionen.

We present the case of a 65-year-old patient with superficial carcinoma of the bladder who developed systemic inflammatory reaction as a result of a severe disseminated infection with M. bovis BCG after intravesical instillation of BCG. Besides the recommended antituberculosis therapy, considering the resistance of M. bovis to PZA, we discuss here the option of using steroids in the therapeutic management of this patient.