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Respiratory Medicine Case Reports

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https://www.readbyqxmd.com/read/28626634/an-unusual-late-onset-of-pulmonary-alveolar-microlithiasis-a-case-report-and-literature-review
#1
Alexandros Stamatopoulos, Davide Patrini, Sofoklis Mitsos, Reena Khiroya, Elaine Borg, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
Pulmonary alveolar microlithiasis (PAM) is an uncommon genetic disorder associated with alveolar cell injury. This injury is caused in most cases by inactivating mutations in SLC34A2 gene, which is responsible for the production of a sodium-dependent phosphate co-transporter. The dysfunction or deficiency of this transporter leads to the aggregation of local phosphate intra-alveolarly and formation of microliths. Most of the patients are asymptomatic at the time of the diagnosis but as the disease progress it leads to fatal respiratory or cardiac failure...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626633/mediastinal-hemangioendothelioma-case-report-and-review-of-the-literature
#2
Davide Patrini, Laura Scolamiero, Reena Khiroya, David Lawrence, Elaine Borg, Martin Hayward, Nikolaos Panagiotopoulos
BACKGROUND: Epithelioid haemangioendothelioma (EHE) is a rare low-grade vascular neoplasm that can arise in the lung, liver, soft tissues or, less commonly, bone. Due to its low prevalence of less than one in a million and its non-specific clinical features, EHE is often misdiagnosed and managed inappropriately. Here we discuss the case of a 58 year-old gentleman with mediastinal EHE and review existing literature on pulmonary EHE (PEH). CASE HISTORY: A 58 year-old gentleman presented to our outpatient Clinic with chest discomfort and palpitations...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626632/synchronous-mucinous-and-non-mucinous-lung-adenocarcinomas-with-different-epidermal-growth-mutational-status
#3
Rita Linhas, David Tente, Margarida Dias, Ana Barroso
In recent years, the spread of more-sensitive diagnostic methods has resulted in an increase of synchronous multiple primary lung cancer diagnosis. Nevertheless, its occurrence is still rare. Distinction between synchronous lesions from second independent primary tumors is a problem when dealing with multiple lung tumors, particularly if the histological type is the same. We present a case report of a 78-year-old female patient referred to our institution due to pneumonia. A subsequent thoracic computed tomography (CT) was performed showing two suspicious lesions, one in the right upper lobe and the other in the right inferior lobe...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626631/chronic-eosinophilic-pneumonia-adjunctive-therapy-with-inhaled-steroids
#4
Christopher Chan, David DeLapp, Perry Nystrom
Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2-4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the "photographic negative of pulmonary edema", the presence of eosinophils ≥40% on bronchoalveolar lavage or ≥1000/mm(3) eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616380/rare-case-of-pulmonary-histoplasmosis-complicated-with-bronchocentric-granulomatosis-in-a-non-endemic-area
#5
Evanthia Botsa, Ioanna Thanou, Stamatina Kabanarou, Loukas Thanos
BACKGROUND: Pulmonary histoplasmosis is a fungal infection caused by histoplasma capsulatum, rarely diagnosed in non endemic areas and/or immunocompromised patients. Complication of pulmonary histoplasmosis with bronchocentric granulomatosis is extremely rare. CASE REPORT: A 48-year-old man with prolonged fever and nausea was admitted to our hospital. Clinical examination revealed pathological auscultatory sounds to the left lung. Computed tomography was performed and revealed a large solid mass of the left upper lobe, limited pleural and pericardial effusion and calcified lymphadenopathy of mediastinum...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616379/re-biopsy-after-relapse-of-targeted-therapy-t790m-after-epidermal-growth-factor-mutation-where-and-why-based-on-a-case-series
#6
Paul Zarogoulidis, Aggeliki Rapti, Chrysanthi Sardeli, Panagiotis Chinelis, Anastasia Athanasiadou, Katerina Paraskevaidou, Anastasios Kallianos, Lemonia Veletza, Georgia Trakada, Wolfgang Hohenforst-Schmidt, Haidong Huang
Guidelines for the treatment of non-small cell lung cancer adenocarcinoma positive in epidermal growth factor mutations indicate tyrosine kinase inhibitors. There are currently three tyrosine kinase inhibitors that can be used as first line treatment: gefitinib, erlotinib and afatinib. Regarding erlotinib and afatinib dosage can be modified in the case of severe adverse effects. In the case of disease relapse investigation for T790M mutation has to be made either with re-biopsy or liquid biopsy and osimertinib has to be administered when T790M is diagnosed...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616378/primary-ciliary-dyskinesia-presenting-with-spontaneous-pneumothorax-case-report-and-review-of-the-literature
#7
Jia Hou, Yanan Zhang, Ri Gong, Xiwei Zheng, Xia Yang
BACKGROUND: Primary ciliary dyskinesia (PCD) is an autosomal recessive heterogeneous group of conditions with variable clinical findings. CASE PRESENTATION: A 36-year-old nonsmoking Chinese man present to the emergency department of our hospital with acute-onset breathlessness and sudden-onset left-sided chest pain. The patient had 6 years primary infertility and suffered from recurrent episodes of respiratory tract infections since childhood. Chest X-ray was performed, which showed a left-sided pneumothorax with lung collapse...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#8
Taaran Cariappa Ballachanda Subbaiah, Jeremy P Feldman
INTRODUCTION: We present a 51 year old, African American, female who presented with persistent hypoxemia. She had been taking dapsone for many years for prophylaxis against Pneumocystic Jiroveci with no symptoms but eventually developed methemoglobinemia only after a splenectomy. From our literature review there are no documented cases that have demonstrated this relationship between dapsone, splenic function and methemoglobin and we hope to share our perplexing case and shed light on the interaction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28560149/non-invasive-ventilation-in-a-pregnancy-with-severe-pneumonia
#9
Mohd Zulfakar Mazlan, Saedah Ali, Huda Zainal Abidin, Ariffin Marzuki Mokhtar, Laila Ab Mukmin, Zeti Norfidiyati Ayub, Chandran Nadarajan
INTRODUCTION: Non-invasive ventilation (NIV) is not proven to be effective in treating respiratory failure in severe pneumonia. However, some clinicians nevertheless attempt NIV to indirectly deliver adequate oxygenation and avoid unnecessary endotracheal intubation. CASE PRESENTATION: In this article, we report the case of a 24-year-old woman at 32 weeks' gestation who presented with hypoxemic respiratory failure requiring mechanical ventilation. She was successfully managed by NIV...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28560148/mesenchymal-cystic-hamartoma-of-the-lung
#10
Adebayo Ayodeji Fasanya, Yousef Hattab, Ami Patel, Mark Lega
Mesenchymal cystic hamartoma, although first reported as early as 1980s, remains a very rare lung disease. There have been less than 20 cases reported to date. Mesenchymal cystic hamartoma usually has an indolent course, but it could potentially result in morbidity and mortality. Biopsy is needed to confirm the diagnosis because it is essential to rule out other possibilities including malignancy.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28560147/bosutinib-induced-pleural-effusions-case-report-and-review-of-tyrosine-kinase-inhibitors-induced-pulmonary-toxicity
#11
Natalia I Moguillansky, Hafiz Abdul Moiz Fakih, John R Wingard
Tyrosine kinase inhibitors are known to cause pulmonary complications. We report a case of bosutinib related bilateral pleural effusions in a patient with chronic myeloid leukemia. Characteristics of the pleural fluid are presented. We also discuss other tyrosine kinase inhibitors induced pulmonary toxicities, including pulmonary hypertension and interstitial lung disease.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28560146/endobronchial-primary-large-b-cell-non-hodgkin-lymphoma-in-hiv-infected-patient-in-the-highly-active-antiretroviral-therapy-era-description-of-a-case-report
#12
U Caterino, O Tambaro, G Palmiero, F Borrelli, M Cotugno, G Bonadies
We report an unusual case of endobronchial primary large B-cell Non Hodgkin Lymphoma in a HIV-infected patient in the course of effective Highly Active Antiretroviral Therapy (HAART). Diagnosis of large B-cell NHL was obtained by fibreoptic bronchoscopy (FOB) biopsies. Three cycles of R-CHOP chemotherapy (rituximab, vincristine, cyclophosphamide, hydroxydaunorubicin, prednisone) was performed and clinical and radiological remission was obtained after 3 cycles of therapy.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28516032/a-case-of-respiratory-infection-possibly-caused-by-mycobacterium-triviale-current-problems-on-diagnostic-and-therapeutic-strategies
#13
Asako Okabayashi, Mizue Hasegawa, Akitoshi Sato, Hideki Katsura, Toshiko Kamata, Eitetsu Koh, Yasuo Sekine
Mycobacterium triviale is a subspecies of the Mycobacterium terrae complex, which rarely causes disease in humans. We encountered a case of respiratory infection, possibly caused by M. triviale, which was successfully treated by levofloxacin and clarithromycin. Although DNA-DNA hybridization identified M. triviale in one of three samples, clinical validations convinced us that it was the pathogen. 16s ribosomal RNA sequencing would have been reliable and ideal to perform in this case, although it is not covered by the insurance system in Japan...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28507894/re-administration-of-abatacept-for-the-control-of-articular-symptoms-of-rheumatoid-arthritis-during-anti-tuberculous-therapy
#14
Hironori Kawamoto, Jin Takasaki, Satoru Ishii, Manabu Suzuki, Eriko Morino, Go Naka, Motoyasu Iikura, Shinyu Izumi, Yuichiro Takeda, Haruhito Sugiyama
This case report describes the re-administration of abatacept to successfully reduce the articularsymptoms of a patient with rheumatoid arthritisduring the intensive phase of anti-tuberculous therapy. A 75-year-old man developed active pulmonary tuberculosis during the administration of abatacept for rheumatoid arthritis. The patient experienced a paradoxical reaction and exacerbation of rheumatoid arthritis that caused us to discontinue the abatacept. Later re-administration of abatacept along with anti-tuberculosis treatment led to well-controlled rheumatoid arthritis without exacerbation of the tuberculosis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28507893/delayed-diagnosis-of-severe-tuberculous-spondylodiscitis-in-an-asylum-seeker-patient-or-doctors-delay
#15
Kristina Langholz Kristensen, Daria Podlekareva, Pernille Ravn
The still increasing global migration affects the epidemiology of tuberculosis (TB) in European countries. We present the case of an asylum seeker from a TB high-endemic country, who presented with severe TB spondylodiscitis and need for emergency surgery. The patient had a history of recurrent sterile axillary and perianal abscesses for years, but TB was never properly ruled out. The patient underwent surgery, responded well to antibiotics and regained the ability to walk. After 6 month of treatment the patient was lost to follow-up...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#16
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28491491/tuberculous-pleural-effusion-occurring-concurrently-with-asbestos-related-pleural-disease
#17
Massa Zantah, Debapriya Datta
An eighty-four-year-old man presented with progressive exertional dyspnea, productive cough and weight loss for two months. His physical exam was notable for diminished breath sounds at the right base, with dullness to percussion. Chest-x-ray showed moderate right-sided pleural effusion and bilateral calcified pleural plaques as well as diaphragmatic plaques consistent with asbestos-related pleural disease (ARPD). Pleural fluid was exudative with predominantly mononuclear cells, negative acid fast bacilli stain, negative cultures, and negative cytology for malignant cells...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28487824/significance-of-a-clean-tip-catheter-closed-suctioning-system-in-a-high-setting-ventilated-super-morbidly-obese-patient-with-profuse-respiratory-secretions
#18
Mohd Zulfakar Mazlan, Rhendra Hardy Mohd Zaini, Shamsul Kamalrujan Hassan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan
INTRODUCTION: Closed suctioning is commonly used in the context of high-setting mechanical ventilation (MV), given its ability to prevent lung volume loss that otherwise accompanies open suctioning. However, closed suctioning systems (CSS) are not equivalent regarding components and capabilities, and thus this technique may be differentially effective to adequately clear patient secretions from an endotracheal tube (ETT), which is of paramount importance when the tube size makes the ETT particularly vulnerable to block by patient secretions...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28480162/an-unusual-cause-of-orthopnoea-hashimoto-s-thyroiditis-presenting-as-bilateral-diaphragmatic-palsy
#19
N K Thulaseedharan, P Geetha, N Arathi, V K Shameer, N V Jayachandran, Gomathy Subramaniam, Santhosh Narayanan
We report a case of 36 yr old male without any comorbidities, who presented with a history of gradually progressive dyspnoea and orthopnoea for 6 months. Physical examination revealed bradycardia, paradoxical respiration suggestive of bilateral diaphragmatic palsy. Fluoroscopy demonstrated the presence of bilateral diaphragmatic paralysis. Etiological work up showed evidence of autoimmune hypothyroidism due to hashimoto's thyroiditis. Other possibilities were ruled out with appropriate tests. He was started on thyroxine and showed symptomatic improvement...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28480161/multiple-cavities-with-halo-sign-in-a-case-of-invasive-pulmonary-aspergillosis-during-therapy-for-drug-induced-hypersensitivity-syndrome
#20
Tomoo Ikari, Katsura Nagai, Masashi Ohe, Toshiyuki Harada, Yasushi Akiyama
A 67-year-old female with rheumatoid arthritis and asthma-chronic obstructive pulmonary disease overlap syndrome was admitted for drug-induced hypersensitivity syndrome (DIHS) caused by salazosulfapyridine. Human herpes virus 6 (HHV-6) variant B was strongly positive on peripheral blood. Multiple cavities with ground grass opacities rapidly emerged predominantly in the upper and middle lobes. She was diagnosed with invasive pulmonary aspergillosis (IPA), and was treated successfully with antifungal agents. Therapeutic systemic corticosteroids, emphysematous change in the lungs, and the worsening of the patient's general condition due to DIHS were considered major contributing factor leading to IPA...
2017: Respiratory Medicine Case Reports
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