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Respiratory Medicine Case Reports

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https://www.readbyqxmd.com/read/28417065/progressive-dyspnea-due-to-pulmonary-carcinoid-tumorlets
#1
Anastasios Kallianos, Lemonia Velentza, Paul Zarogoulidis, Sofia Baka, Christoforos Kosmidis, Sofia Labaki, George Lazaridis, Haidong Huang, Wolfgang Hohenforst-Schmidt, Georgia Trakada
This is a case description of a female patient, 77 years-old, who presented with progressive dyspnea and cough. She had a mild hypoxemia in the arterial blood gases (PaO2 72 mmHg) and normal spirometry. The chest computer tomography revealed diffuse "ground glass" opacities, segmental alveolitis, bronchiectasis, fibrotic lesions and numerous micronodules. A thoracoscopy was performed and the obtained biopsy showed carcinoid tumorlets, with positive CK8/18, CD56, TTF-1 and synaptophysin immunohistochemical markers...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28417064/adenocarcinoma-of-the-lung-presenting-as-thrombotic-thrombocytopenic-purpura
#2
Ahmed Dirweesh, Waqas Siddiqui, Muhammad Khan, Praneet Iyer, Marc Seelagy
Acquired thrombotic thrombocytopenic purpura (TTP) usually presents as severe microangiopathic hemolytic anemia (MAHA) and thrombocytopenia in a previously healthy individual. It occurs in approximately three in one million adults and 1 in 10 million children annually. The incidence is increased in females and blacks. Diagnosing TTP and initiating therapy with plasma exchange is a must to avoid preventable complications. Acquired thromotic microangiopathy has been linked to collagen vascular diseases, use of certain medications, organ transplants, infections, pregnancy and cancer...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#3
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413774/a-diffuse-lung-emphysema-severe-pulmonary-hypertension-and-lack-of-airflow-limitation
#4
Morgane Faure, Emmanuel Gomez, Peter Dorfmüller, Damien Mandry, Matthieu Canuet, Romain Kessler, François Chabot, Ari Chaouat
Pulmonary veno-occlusive disease is characterized by remodeling of pulmonary arteries, capillaries and venules. We report a case of diffuse lung emphysema and pulmonary veno-occlusive disease with the characteristic of having no airflow limitation. A very low diffusing capacity for carbon monoxide and results of high-resolution computed tomography of the chest suggested pulmonary veno-occlusive disease. The diagnosis was confirmed on histological analysis after lung transplantation. The combination of results of the computed tomography of the chest and the histological analysis suggested a relationship between diffuse lung emphysema and remodeling of pulmonary vessels...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413773/a-m-%C3%A2-avium-complex-spondylodiscitis-in-a-middle-aged-woman-with-diabetes
#5
Irini Gerogianni, Stylianos Boutlas, Theophilos Karachalios, Eythymia Petinaki, Marianna Vlychou, K I Gourgoulianis
Spondylodiscitis, the inflammation of the vertebral bodies and the intervertebral disk space, is the reason for low back pain in a minority of cases. This is caused by various pathogens. Mycobacterium tuberculosis is responsible for 17-39% of all the cases of spondylodiscitis. On the contrast, spondylodiscitis from non tuberculous mycobacteria is extremely rare in literature. We describe a 68 -year old diabetic woman which is the first case of bone marrow involvement by M. intracellulare (member of M avium complex)with spondylodiscitis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28409111/a-rare-case-of-raoultella-planticola-pneumonia-an-emerging-pathogen
#6
Donevan Westerveld, Jonathan Hussain, Almotasembellah Aljaafareh, Ali Ataya
Raoultella planticola (R. planticola), considered an environmental organism, is a gram negative, motile, bacillus with phenotypic similarities to the genus Klebsiella. The organism remains a rare cause of human infection with a few cases reported in the literature. However, since its description in 1981 there have been increasing rates of infections caused by R. planticola with reports of conjunctivitis, liver abscess, cholangitis, pancreatitis, and necrotizing fasciitis. More concerning are reports of carbapenemase-producing isolates which have led to the only 2 mortalities associated with R...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393935/how-are-the-ancient-cystic-fibrosis-patients-cystic-fibrosis-diagnosed-over-60-years-old
#7
C Prados, M Lerín, J J Cabanillas, L Gómez-Carrera, R Álvarez-Sala
BACKGROUND AND AIMS: To specify the prevalence of patients diagnosed with CF at age of ≥60 year-old and to analyze their characteristics. PATIENTS AND METHODS: Observational study of CF patients which were diagnosed at age ≥60 year-old. The analyzed variables were: age, sex, nationality, lung function parameters, conditions present at diagnosis, microbiological characteristics and genetic findings. RESULTS: eight patients were included...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393010/successful-treatment-of-familial-congenital-chylothorax-by-ligation-of-the-thoracic-duct-a-case-report
#8
Leopoldini Dori, Eleftherios Smaropoulos, Georgios Tagarakis, Christophoros N Foroulis, Paul Zarogoulidis, Haidong Huang, Bai Chong, Wolfgang Hohenforst-Schmidt, George Tsikopoulos
A full term boy was admitted with respiratory distress in the fourth week of his life due to spontaneous chylothorax in his right hemithorax. Spontaneous chylothorax occurred previously in a first cousin of the neonate establishing that way the final diagnosis of familial idiopathic congenital pneumothorax. Failure of the conservative treatment consisting of chest tube drainage, discontinuation of oral diet and administration of total parenteral nutrition in combination with octreotide for one month was followed by the successful ligation of the thoracic duct through a right thoracotomy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393009/a-case-of-anti-aminoacyl-trna-synthetase-ars-antibody-positive-polymyositis-pm-dermatomyositis-dm-associated-interstitial-pneumonia-ip-successfully-controlled-with-bosentan-therapy
#9
Tomoyuki Naito, Yosuke Tanaka, Mitsunori Hino, Akihiko Gemma
A 72-year-old woman was admitted to our hospital and was diagnosed with interstitial pneumonia (IP) associated with amyopathic dermatomyositis (ADM). The patient experienced three acute IP exacerbations in the 7 years that followed, which were each treated and resolved with steroid pulse therapy. The patient was closely examined for respiratory failure with right heart catheterization (RHC), which demonstrated that she had a mean pulmonary artery pressure (mPAP) of 34 mmHg. The patient was thus diagnosed as having pulmonary hypertension (PH) associated with anti-synthetase syndrome (ASS) and was started on bosentan therapy, which led to improvements in mPAP as well as in subjective symptoms over time...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393008/an-unusual-cause-of-ventilatory-failure-in-motor-neurone-disease
#10
Epaminondas Markos Valsamis, Ian Smith, Adri De Sousa
A patient previously diagnosed with motor neurone disease (MND) and gastrostomy-fed was under surveillance for ventilatory decline via our respiratory centre. At a planned review she was found to be hypercapnic, which would usually prompt an offer of non-invasive ventilation for home use. However, she was alkalotic and not acidotic as we might expect. Her serum potassium was checked urgently and confirmed as low. It was established that the community team had prescribed a feeding regime with insufficient potassium...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393007/interstitial-lung-disease-pattern-turned-out-to-be-a-predominantly-lepidic-lung-adenocarcinoma
#11
Irena Hammen
We report a case of a 46-year-old woman without any medical history who presented to our Respiratory Department with exertional dyspnoea for the last 6 weeks associated with non-productive cough. Chest radiography showed bilateral diffuse interstitial opacity. Bronchoalveolar lavage and transbronchial biopsies performed during flexible bronchoscopy as a step in the diagnostic workup of idiopathic interstitial pneumonia showed cells of pulmonary adenocarcinoma.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393006/small-cell-lung-cancer-transformation-during-immunotherapy-with-nivolumab-a-case-report
#12
Takuma Imakita, Kohei Fujita, Osamu Kanai, Tsuyoshi Terashima, Tadashi Mio
We report a rare case of transformation of non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), without epidermal growth factor receptor (EGFR) gene mutation, during immunotherapy treatment with nivolumab. A 75-year-old man was referred to our hospital following the observation of a 64 mm mass in a chest computed tomography (CT) scan. A transbronchial biopsy of the mass identified the pathological presence of poorly differentiated NSCLC, with no histological signs of SCLC. No mutations were identified in the EGFR gene...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393005/a-case-of-chronic-cough-in-a-winemaker
#13
Ernesto Viteri, Nathalie Foray, Mingchen Song, Danxuan Long
BACKGROUND: Fungi have been known to cause a variety of respiratory conditions, ranging from mold- associated asthma to allergic bronchopulmonary mycosis and invasive disease. More recently some fungal species have been implicated in a non-asthmatic chronic cough syndrome. CASE PRESENTATION: A 59-year-old male presented to the pulmonary clinic with chronic nonproductive cough. Workup included pulmonary function tests with methacholine challenge, sputum cultures, CT scans of the chest and therapeutic trial with proton pump inhibitors...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28393004/pseudomembranous-tracheitis-caused-by-aspergillus-fumigatus-in-the-setting-of-high-grade-t-cell-lymphoma
#14
Prashant Malhotra, Karan Singh, Paul Gill, Sonu Sahni, Mina Makaryus, Arunabh Talwar
Pseudomembranous tracheitis (PMT) is a rare condition most commonly caused by fungal or bacterial infection that is characterized by a pseudomembrane that partially or completely covers the tracheobronchial tree. PMT is most commonly found in immunocompromised patient populations, such as post-chemotherapy, AIDS, post-transplant and hematological malignancies. Due to its rarity, PMT is often not included in the differential diagnosis. This case describes a 65 year old male with persistent fever and refractory cough despite high dose empiric antibiotics...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28377880/paradoxical-bronchospasm-from-benzalkonium-chloride-bac-preservative-in-albuterol-nebulizer-solution-in-a-patient-with-acute-severe-asthma-a-case-report-and-literature-review-of-airway-effects-of-bac
#15
Mathew George, Saumya Vinod Joshi, Emily Concepcion, Haesoon Lee
Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative, prolonged, and correlates directly with basal airway responsiveness. The multi-dose dropper bottle of albuterol sulfate solution contains 50 μg BAC per/2.5 mg of albuterol, which may be below or at the lower limit of the threshold dose for bronchoconstriction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28377879/membranous-tracheal-stenosis-in-a-patient-with-anorexia-nervosa-and-self-induced-vomiting-challenges-in-securing-the-airway
#16
Motohiro Nakamura, Masaki Hisamura, Masayuki Hashimoto, Makoto Sawano, Midori Joshita, Takahiro Toi, Yoshitaka Asano, Hideyo Matsueda, Fumihito Arima, Hidenori Oi, Takehiro Kitawaki, Yoji Ando, Kenji Koshimizu
We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28377878/miliary-tuberculosis-in-a-patient-with-tuberculous-mycotic-aneurysm-of-the-abdominal-aorta-case-report-and-review-of-the-literature
#17
Katerina Manika, Christoforos Efthymiou, Georgios Damianidis, Elisavet Zioga, Eleni Papadaki, Kalliopi Lagoudi, Ioannis Kioumis
The combination of miliary tuberculosis and tuberculous mycotic aneurysm has been described in the literature. We present the case of an 84-year-old man who was diagnosed with a mycotic aneurysm of the abdominal aorta and an adjacent soft tissue mass, after a 3- month history of fever. The patient underwent endovascular restoration of the aneurysm and was treated with broad-spectrum antibiotics. One and a half months later the fever relapsed and the chest CT scan revealed findings consistent with miliary tuberculosis and opacities of both upper lobes not present before, while the abdominal CT scan revealed an increase in the size of the para-aortic mass...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28377877/invasive-aspergillosis-related-to-ibrutinib-therapy-for-chronic-lymphocytic-leukemia
#18
Benjamin Arthurs, Kathy Wunderle, Maylee Hsu, Suil Kim
We report a case of invasive pulmonary aspergillosis in a patient taking ibrutinib, a Bruton's tyrosine kinase inhibitor used to treat refractory chronic lymphocytic leukemia. We hypothesize that ibrutinib promoted this infection by suppressing innate immune responses against Aspergillus. Clinicians should be aware of potential Aspergillus infections in patients treated with this drug.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28348951/spontaneous-pneumomediastinum-a-rare-complication-of-methamphetamine-use
#19
Jessica Albanese, Cole Gross, Mohamed Azab, Sinziana Mahalean, Ranjit Makar
OBJECTIVE: To present an unusual case of spontaneous pneumomediastinum subsequent to recreational amphetamine use. CASE REPORT: A young African American adult male was admitted to internal medicine service for treatment of rhabdomyolysis secondary to methamphetamine use. On admission, he was complaining of chest pain in addition to nausea and generalized muscle aches. By his second hospital day, chest pain had resolved yet physical exam demonstrated crepitation of the anterior chest and left axilla...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28348950/a-case-of-sulfhemoglobinemia-in-a-child-with-chronic-constipation
#20
Ashish George, Danielle Goetz
Sulfhemoglobinemia is a rare condition in which a sulfur atom oxidizes the heme moiety in hemoglobin, making the hemoglobin incapable of carrying oxygen and leading to hypoxia and cyanosis. This condition has been described in patients taking sulfur medications or who have cultured hydrogen sulfide producing intestinal bacteria such as Morganella morganii. This case describes a pediatric patient who was found to have cyanosis on two occasions of urinary tract infection in the setting of chronic constipation, with confirmed sulfhemoglobinemia during the second admission...
2017: Respiratory Medicine Case Reports
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