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Respirology Case Reports

Takunori Hozumi, Koichiro Kajiura, Kei Nakamura, Haruki Taniguchi, Takao Goto, Michitaka Nasu
Aorto-pleural fistula (APF) is a rare, potentially fatal condition that should be immediately treated by an endovascular or surgical approach. In this case, we treated APF using bronchial occlusion with Endobronchial Watanabe Spigots (EWSs) after one-lung ventilation. Notably, EWS is composed of silicon for endobronchial occlusion under bronchoscopy. An 88-year-old man was referred to our hospital for sudden massive hemoptysis. We maintained the airway by emergent intubation into the right main bronchus through guided bronchoscopy...
January 2019: Respirology Case Reports
Yang Song, Lucy Rebecca Keatley, Peter Gordon Middleton
Cystic Fibrosis (CF), the most common lethal inherited disorder in Australia, is associated with increased respiratory tract colonization/infection. Given that many adults with CF work as health-care workers (HCW), which has been associated with an increased risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization/infection, we examined these risks in 252 adults with CF at our centre between 2001-2015. Demographic and clinical characteristics, including pathogens, were compared for HCW and non-HCW groups...
December 2018: Respirology Case Reports
Munechika Hara, Shin-Ichiro Iwakami, Issei Sumiyoshi, Takashi Yoshida, Shinichi Sasaki, Kazuhisa Takahashi
A 69-year-old man was admitted to our hospital with acute dyspnoea, which developed after using a wood-preserving agent in an enclosed space. Burn injuries were evident on his face, neck, chest, and both upper arms. Bronchoalveolar lavage was carried out. The collected fluid resembled wood preservative. Subsequently, it was established that kerosene was a major component of the wood preservative. A diagnosis of hydrocarbon pneumonitis was established. The patient's respiratory and general findings improved with intensive care, which included mechanical ventilation...
December 2018: Respirology Case Reports
Yi Chen Chang, Yu Min Lin
For hepatocellular carcinomas, radiofrequency ablation is extensively used to alleviate primary and metastatic hepatic tumours. Common complications of this procedure include bleeding, infection, and hollow organ perforation. We present the case of a patient with hepatoma who underwent radiofrequency ablation. He had intractable cough with yellowish sputum, particularly while lying down, three weeks after treatment. Chest computed tomography demonstrated a right middle lobe consolidation with pleural effusion and right subphrenic fluid collection...
December 2018: Respirology Case Reports
Antony Divananth Rawindraraj, Christine Yang Zhou, Vikas Pathak
Breast cancer relapse remains a common cause of morbidity and mortality in patients who undergo initial treatment with surgery and with or without concurrent chemotherapy or radiation. Relapse rates remain high within the first decade after initial treatment, after which the risk of relapse decreases. While common within the first year of breast cancer diagnosis, pleural metastasis with malignant pleural effusion (MPE) after 10-12 years of a disease-free period is rare. Here, we present two uncommon cases of delayed breast cancer relapses with pleural metastasis, which caused MPEs...
December 2018: Respirology Case Reports
Maple Huang, Reuben Sum, Sheetal Deshpande, Simon A Joosten
Xanthogranulomatous pyelonephritis (XGP) is a rare chronic granulomatous process that affects the kidneys. It is usually associated with longstanding urinary tract infections and obstruction. Patients suffering from XGP typically present with undifferentiated symptoms, including abdominal pain, weight loss, and intermittent fevers. For this reason, diagnosis is often delayed until patients are acutely unwell with sepsis.
December 2018: Respirology Case Reports
Eun Ho Choe, Luke Sutherland, Christopher Hills, Jai-Deep Sood
A 19-year-old male who regularly smoked tobacco shisha pipes presented with pleuritic chest pain, dyspnoea, and cough. He was found to have multiple bilateral lung nodules on computed tomography. A biopsy of the lung revealed necrotizing granulomatous inflammation but without evidence of infection, foreign body, vasculitis, or malignancy. There was spontaneous and complete clinical and radiographic resolution over the next 12 weeks following cessation of shisha use.
December 2018: Respirology Case Reports
Mai Ngoc Tran, Lauren Galt, Farzad Bashirzadeh
Recurrent respiratory papillomatosis (RRP) is a rare condition that affects the respiratory system. It is caused by human papilloma virus (HPV) infection. Usually infection and papilloma growth is limited to 6-12 months duration; however, some patients have persistent disease, resulting in long-term symptoms and the need for recurrent intervention. Predominant symptoms include shortness of breath, reduced exercise tolerance and voice deterioration during flares. Current gold-standard management is through resection via microdebrider, CO2 laser, cryotherapy, electrocoagulation, Nd: YAG laser or pulse-dye laser...
November 2018: Respirology Case Reports
Chiara Scelfo, Chiara Longo, Marina Aiello, Giuseppina Bertorelli, Ernesto Crisafulli, Alfredo Chetta
Pulmonary hernia (PH) is an uncommon condition. We report a case of PH secondary to thoracic surgical intervention. In addition to the rarity, the peculiarity of the case is given by the clinical course as it is characterized by a clinical latency before the onset. The patient showed risk factors such as obesity and poliomyelitis infection sequelae. We also reviewed the literature about this topic.
November 2018: Respirology Case Reports
Kyoko Yagyu, Atsushi Miyamoto, Haruhiko Matsushita, Akira Okimora
Most patients with lung tumorlets are usually asymptomatic, and most diagnoses are incidental findings during microscopic lung examinations at autopsy or after excision of a tissue lesion. A 73-year-old woman was admitted to our hospital due to recurrent haemoptysis. Chest computed tomography demonstrated right inferior lobe collapse with bronchiectasis. Bronchoscopic examination revealed the right inferior lobar bronchus to be filled with blood clots. Haemoptysis persisted even after two arterial embolization trials and occlusion with endobronchial Watanabe spigot...
November 2018: Respirology Case Reports
Naoya Nishioka, Yoshiko Kaneko, Tadaaki Yamada, Naoko Okura, Soichi Hirai, Koichi Takayama
Pulmonary pleomorphic carcinoma (PPC) is a rare disease with a poor prognosis. Most patients with PPC are refractory to chemotherapy, whereas good responses to platinum-based chemotherapy in combination with the anti-angiogenesis agent bevacizumab have been reported. An 82-year-old man was diagnosed with PPC with a clinical stage of T3N0M0, coincident with primary lung adenocarcinoma in an early stage. We chose single-agent chemotherapy with docetaxel as an initial treatment, but both the primary adenocarcinoma and two PPC lesions in the right lung were enlarged after one treatment cycle...
November 2018: Respirology Case Reports
Toshihiro Masuda, Toshihiro Shirai, Mika Saigusa, Kazuhiro Asada, Hiroyuki Muro
Classically, metastatic tumours are solid, multiple, well-circumscribed, and rarely cavitary. This rare case of metastatic pulmonary malignant melanoma showed a ring-shaped ground-glass opacity and then the halo sign, depending on the disease progression.
November 2018: Respirology Case Reports
Keitaro Nakamoto, Yuka Sasaki, Hiroyuki Kokuto, Masao Okumura, Takashi Yoshiyama, Hajime Goto
The galaxy sign and cluster sign were first reported in pulmonary sarcoidosis. From those reports, these two signs became known as one of the characteristic computed tomography (CT) findings of sarcoidosis. We report a patient with pulmonary tuberculosis who had these two signs. A 44-year-old man was referred to our hospital for general fatigue, cough, and low-grade fever lasting about two months. Thoracic CT showed a large parenchymal nodule arising from coalescent small nodules (galaxy sign) and clusters composed of numerous small nodules (cluster sign) in the bilateral lungs...
November 2018: Respirology Case Reports
Thomas James Altree, Hubertus Jersmann, Phan Nguyen
A 62-year old man with severe chronic obstructive pulmonary disease developed a persistent air leak from an iatrogenic pneumothorax following Computed Tomography-guided core biopsy of a pulmonary nodule. The pneumothorax was treated with an 8.5F intercostal catheter, which was then replaced by a 28F thoracostomy tube after development of significant subcutaneous emphysema and a tension pneumothorax. The air leak showed no improvement until endobronchial valve (EBV) insertion guided by objective flow data from a digital drainage system (DDS)...
November 2018: Respirology Case Reports
Masatoshi Yamazoe, Hiromi Tomioka, Shuji Yamashita, Kazusa Egami, Kouji Oh
Mycoplasma hominis as a cause of empyema is rare. We report a case of empyema caused by M. hominis following a caesarean section. A 28-year-old woman at 39 weeks and one day of pregnancy was admitted to our hospital and underwent an emergency caesarean section because of premature rupture of membranes. On postoperative day 2, she developed a fever, and flomoxef was administered. A pleural effusion developed on the right side. A diagnosis of empyema was made, and sulbactam/ampicillin was administered. However, the patient's clinical condition did not improve...
November 2018: Respirology Case Reports
Justine Gibson, Ellen Donnan, Geoffrey Eather
Rifampicin mono-resistant tuberculosis (RMR-TB) is rare worldwide; however, it is associated with poor treatment outcomes. Evidence to guide the treatment of RMR-TB is lacking. International guidelines have recently changed and now recommend that RMR-TB should be managed with multi-drug-resistant tuberculosis (MDR-TB) regimens. This report is a retrospective review of all cases of RMR-TB in Queensland, Australia, from 2000 to 2016 to assess treatment outcomes and regimens used. Twelve cases of RMR-TB were diagnosed, with seven patients completing treatment in Queensland...
November 2018: Respirology Case Reports
Lokesh Yagnik, Ranjan Shrestha
Indwelling pleural catheters (IPCs) are increasingly used for the management of symptomatic malignant pleural effusion worldwide. IPCs have been documented to reduce the number of hospital bed days in patients with malignant pleural effusion and thus are often used as the preferred mode of management in fit healthy patients with good performance status. Complications related to IPCs, mainly in the form of pleural infection and needle tract metastasis, are well reported in the literature. Similarly, fracture of IPCs is a recognized complication during the process of IPC removal...
November 2018: Respirology Case Reports
Hiroyuki Kagawa, Keisuke Miki, Mari Miki, Koji Urasaki, Seigo Kitada
Congenital cystic adenomatoid malformation (CCAM) is a benign congenital tumour in which a part of the lung becomes polycystic. Case 1 was a 64-year-old male who was diagnosed with pneumonia, with multiple cysts in the right lower lung lobe, using chest computed tomography (CT). After treatment of the pneumonia, including Mycobacterium abscessus , a right lower lobectomy was performed. Case 2 was a 41-year-old male who had suffered from pneumonia many times since his youth. Polycystic and infiltrative shadows were observed on chest CT...
November 2018: Respirology Case Reports
Kentaro Fukunaga, Shinya Yokoe, Satoru Kawashima, Yasuki Uchida, Hiroaki Nakagawa, Yasutaka Nakano
A 76-year-old man with a past history of acute exacerbation (AE) and idiopathic pulmonary fibrosis (IPF) was treated with nintedanib because of decline in his forced vital capacity over time. A new small nodular lesion was visible on a computed tomography scan of the chest before initiation of nintedanib. Disease progression in IPF and change in size of the nodular lesion were not detected during administration of nintedanib. Nine months after starting nintedanib, the patient was diagnosed with acute gangrenous appendicitis, and nintedanib treatment was discontinued...
November 2018: Respirology Case Reports
Atsushi Sano
We report a case of squamous cell carcinoma antigen (SCCA) elevation due to influenza B infection. A 78-year-old male had undergone right middle lobectomy and lymphadenectomy for lung squamous cell carcinoma two years and four months previously. His SCCA level ranged from 0.8 ng/mL to 1.9 ng/mL after the surgery. He underwent blood testing, including SCCA, as part of a regular check-up three days after the diagnosis of the influenza B infection. His SCCA level was 17.1 ng/mL; no recurrences were found on computed tomography...
November 2018: Respirology Case Reports
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