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Case Reports in Pulmonology

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https://www.readbyqxmd.com/read/29225987/daptomycin-induced-acute-eosinophilic-pneumonia-late-onset-and-quick-recovery
#1
Mohamad Rachid, Khansa Ahmad, Meghan Saunders-Kurban, Aelia Fatima, Aditya Shah, Anas Nahhas
Background: Daptomycin is a cyclic lipopeptide antibiotic that provides great coverage for gram positive cocci. From the early years of daptomycin use, concerns were raised regarding the pulmonary side effects of daptomycin and potential development of acute eosinophilic pneumonia (AEP) secondary to daptomycin therapy. Discussion: AEP could be idiopathic or induced by drugs or toxins. It is a distinct entity from atopic diseases and autoimmune, parasitic, or fungal infections that can also cause pulmonary eosinophilia...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29201483/purulent-appearing-material-in-an-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-of-mediastinal-lymph-node-a-diagnostic-challenge
#2
Damaris Pena, Gilda Diaz-Fuentes, Sindhaghatta Venkatram
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29163998/multifocal-pulmonary-granular-cell-tumor-presenting-with-postobstructive-pneumonia
#3
Samid M Farooqui, Muhammad S Khan, Laura Adhikari, Viral Doshi
Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29158938/orthodeoxia-without-platypnea-in-hereditary-hemorrhagic-telangiectasia-in-the-presence-of-a-cerebral-abscess-and-multiple-pulmonary-arteriovenous-malformations-unusual-complications-and-transcatheter-endovascular-treatment
#4
Carlos Salazar, Jacky Bruce Blank, Veronica Palmero
Hereditary hemorrhagic telangiectasia is a rare autosomal-dominant condition affecting visceral blood vessel development. Cerebral and most commonly pulmonary arteriovenous malformations are found in the majority of symptomatic patients. The most common complications include embolic strokes and cerebral abscesses, which have been attributed to abnormal vessel communications. Platypnea orthodeoxia is a rare condition that presents dyspnea and oxygen desaturation when adopting an upright position and is relieved on decubitus...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29123934/symptomatic-patent-foramen-ovale-with-hemidiaphragm-paralysis
#5
Hussain Ibrahim, Adnan Khan, Shawn P Nishi, Ken Fujise, Syed Gilani
Dyspnea accounts for more than one-fourth of the hospital admissions from Emergency Department. Chronic conditions such as Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Asthma are being common etiologies. Less common etiologies include conditions such as valvular heart disease, pulmonary embolism, and right-to-left shunt (RLS) from patent foramen ovale (PFO). PFO is present in estimated 20-30% of the population, mostly a benign condition. RLS via PFO usually occurs when right atrium pressure exceeds left atrium pressure...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29123933/hemoptysis-following-talc-pleurodesis-in-a-pneumothorax-patient
#6
Yusuke Kakiuchi, Fumihiro Yamaguchi, Makoto Hayashi, Yusuke Shikama
The purpose of this article is to report a case of hemoptysis occurring in combination with secondary spontaneous pneumothorax following chemical pleurodesis by talc. A Japanese male with cancer of renal pelvis was found with the left pneumothorax and multiple lung metastases. A computed-tomography scan revealed severe emphysema throughout the lungs. Talc pleurodesis was employed to arrest air leakage. The patient developed hemoptysis 45 minutes after talc injection into the thorax. This is the first report of hemoptysis following talc pleurodesis...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29109889/a-case-report-on-vt-from-tv-dvt-and-pe-from-prolonged-television-watching
#7
Alan Lucerna, James Espinosa, Lindsey Ackley, Philip Carhart, Douglas Stranges, Risha Hertz
Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29098106/a-rare-case-of-idiopathic-plastic-bronchitis
#8
Mohammed Raoufi, Leila Achachi, Fatima Zahra Mrabet, Laila Herrak, Mustapha El Ftouh, Najoua Bourhroum, Nezha Ouazzani Taibi
Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29057135/rare-congenital-aberrant-left-superior-pulmonary-vein-discovered-with-central-line-placement-in-a-patient-with-critical-cardiorespiratory-collapse
#9
Spencer Knox, Mario Madruga, S J Carlan
BACKGROUND: Partial anomalous pulmonary venous connection is a rare congenital vascular disorder that may be asymptomatic. Left-sided connections with the innominate vein are discovered infrequently and those without an atrial septal defect are extremely rare. CASE: A 66-year-old male was found to have an anomalous left pulmonary vein when a central venous catheter was inserted for management of hypoxemia. In addition to the connection with the left innominate vein an echocardiogram revealed no atrial septal defect...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28932614/acute-low-dose-hydralazine-induced-lupus-pneumonitis
#10
Sarah K Holman, Donique Parris, Sarah Meyers, Jason Ramirez
A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28932613/primary-pulmonary-lymphoma-presenting-with-superior-vena-cava-syndrome-in-a-young-female
#11
Divya Salhan, Prakash Verma, Tun Win Naing, Ebad Ur Rehman, Saroj Kandel, Danillo Enriquez, Joseph Quist, Frances Schmidt
Primary Pulmonary Diffuse Large B Cell Lymphoma (PPDLBCL) is an extremely rare entity, which exhibits an aggressive behavior by compressing local blood vessels. It represents only 0.04% of all lymphoma cases and is extremely rare in young age. We present a case of a primary pulmonary lymphoma with superior vena cava syndrome (SVCS) in a young female. 27-year-old African American female presented with fever, cough, and facial puffiness for 2 weeks and unintentional weight loss. Chest examination showed decreased breath sounds and dullness on percussion on right side...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28845317/arterial-thoracic-outlet-syndrome-treated-successfully-with-totally-endoscopic-first-rib-resection
#12
Sofoklis Mitsos, Davide Patrini, Sara Velo, Achilleas Antonopoulos, Martin Hayward, Robert S George, David Lawrence, Nikolaos Panagiotopoulos
Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28831322/intercostal-artery-laceration-rare-complication-of-thoracentesis-and-role-of-ultrasound-in-early-detection
#13
Wissam Mansour, Ghassan Samaha, Sandy El Bitar, Ziad Esper, Rabih Maroun
Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28761772/a-rare-case-of-aortoatrial-fistula-from-streptococcal-endocarditis
#14
Hammad Arshad, Meilin Young, Parth Rali
We represent an unfortunate case of postinfluenza streptococcal endocarditis in a 34-year-old healthy male. He presented with hypoxic respiratory failure and was found to have mitral and aortic valve vegetation. Hospital course was complicated by the presence of an aortoatrial fistula from an aortic root abscess, persistent septic shock, and multiorgan failure.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28523200/an-unusual-presentation-of-congenital-lobar-emphysema
#15
Daniel Arnaud, Joseph Varon, Salim Surani
Congenital lobar emphysema is an uncommon bronchopulmonary malformation characterized by lobar overinflation and accompanying alveolar septum damage that leads to compression atelectasis of the lung parenchyma and displacement of mediastinal structures, with the resultant ventilation-perfusion mismatch. We present a case of a 33-year-old lady with progressive exertional dyspnea. Chest radiograph findings lead to the suspicion of congenital lobar emphysema, which was then confirmed by a computed tomography (CT) scan...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28386504/bronchus-associated-lymphoid-tissue-lymphoma-presenting-with-immunodeficiency-and-multiple-pulmonary-nodules
#16
Sermin Borekci, Murat Ozbalak, Ezel Ersen, Hilal Akı, Muhlis Cem Ar, Sema Umut
Bronchus Associated Lymphoid Tissue Lymphoma (BALTOMA) is a rare subgroup of pulmonary non-Hodgkin's lymphomas (NHLs) comprising less than 1% of all cases. It constitutes 3.6% of all extranodal lymphomas and only 0.5-1% of primary pulmonary malignancies. They are usually low grade B-cell lymphomas and are considered to originate from the mucosa associated lymphoid tissue (MALT) of the bronchi. Here, we represent a rare case of BALTOMA presenting with immunodeficiency and multiple pulmonary nodules.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28373921/successful-extubation-using-heliox-bipap-in-two-patients-with-postextubation-stridor
#17
Pragya Punj, Premkumar Nattanmai, Pravin George, Christopher R Newey
Postextubation stridor is associated with significant morbidity. It commonly results in extubation failure after established medical treatment fails, such as nebulized epinephrine and/or intravenous steroids. The role of heliox (i.e., combination of helium and oxygen) in managing patients with postextubation stridor has not been fully established. We report two cases of postextubation stridor successfully treated with heliox delivered with bilevel positive airway pressure (BiPAP) after failure of standard medical therapy...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28348912/nocardia-brasiliensis-infection-complicating-cryptogenic-organizing-pneumonia
#18
Alison M Fernandes, Jason C Sluzevich, Isabel Mira-Avendano
Pulmonary nocardiosis is a severe and uncommon opportunistic infection caused by Nocardia species. We present a patient with cryptogenic organizing pneumonia who was receiving long-term immunosuppressive therapy, whose treatment course was complicated by cutaneous and pulmonary nocardiosis. Tissue cultures confirmed Nocardia brasiliensis. Nocardiosis should be a diagnostic consideration for patients treated with long-term immunosuppression who have worsening pulmonary symptoms and relapsing pustular skin lesions...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28321355/a-rare-presentation-of-sarcoidosis-as-a-pancreatic-head-mass
#19
Shruti Mony, Pradnya D Patil, Rebekah English, Ananya Das, Daniel A Culver, Tanmay S Panchabhai
Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28270942/solitary-endobronchial-papilloma-with-malignant-transformation-and-concomitant-tb-infection-case-report-and-literature-review
#20
Mohammed Al Ghobain
We are reporting a case of solitary endobronchial papilloma located in posterior segment of the left upper lobe of the lung with malignant transformation and negative human papilloma virus (HPV) strains in a 40-year-old Saudi nonsmoker man. The patient had a concomitant tuberculosis (TB) infection. The patient received appropriate treatment in the form of anti-TB medication and surgical resection of the squamous cell carcinoma followed by chemotherapy. There was no evidence of tumor recurrence, resulting in a complete cure...
2017: Case Reports in Pulmonology
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