A 36-year-old woman was admitted to the hospital in respiratory failure. An impaired cough due to the muscle weakness of multiple sclerosis (MS) resulted in retained secretions, atelectasis, and pneumonia. The atelectasis and pneumonia initially involved the left lung. A right mainstem bronchus intubation complicated the left lung atelectasis, which resolved after retraction of the tube, fiberoptic bronchoscopy, and mechanical ventilation. After several days of continuous ventilation the patient was weaned from the ventilator and extubated. Following extubation, atelectasis involving the right lung occurred. The atelectasis on the right resolved with vigorous respiratory therapy, including mechanical ventilation, chest physiotherapy, and aerosol inhalations. The patient's respiratory status gradually improved until she was discharged to an extended care facility. Respiratory failure can be a complication of MS, and aggressive respiratory therapy including removal of secretions and mechanical ventilation may be lifesaving in its treatment.
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