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Respiratory Medicine Case Reports

Rizna Abdul Cader, Kanagerajan Thoriappa, Rozita Mohd, Wei Yen Kong, Ruslinda Mustafar, Lydia Kamaruzaman
A 54 year old lady with underlying chronic lung disease on long term oxygen therapy and end stage renal disease of unknown aetiology on regular haemodialysis for two years started developing progressive shortness of breath during her routine haemodialysis. She was unable to tolerate her haemodialysis sessions which had to be terminated prematurely in view of her symptoms despite adjustment of her dry weight and treatment of anaemia. She was not in chronic fluid overload and her symptoms always worsened after initiation of haemodialysis and improved after termination of haemodialysis...
2019: Respiratory Medicine Case Reports
Kayani Kayani, Ravi Mahadeva, Sîan Stinchcombe, Matthew Rutter, Judith Babar, Jonathan Fuld
We describe two cases of patients with emphysema who, in the lead up to hyperinflation intervention, developed pneumonia with significant physiological, anatomical, functional and quality of life improvement observed following. This directly goes against the natural history of both disease processes, demonstrating the benefit resulting from infective autobullectomy.
2019: Respiratory Medicine Case Reports
Akihiro Shiroshita, Kei Nakashima, Masahiro Aoshima
We report a case of chronic hypersensitivity pneumonitis treated with pirfenidone in a 76-year-old woman who complained of acute-onset abdominal pain and rashes. The patient was diagnosed with disseminated varicella-zoster virus (VZV) infection, and pirfenidone was discontinued. Her condition improved in one month. Pirfenidone may induce disseminated VZV infection.
2018: Respiratory Medicine Case Reports
Nimeh Najjar, Martin Cerda, Jorge Trabanco, Vinoo Ramsaran, James Cury
Asphyxiating thoracic dystrophy (ATD also known as Jeune syndrome) is a very rare disorder with an incidence in the United States of 1 case per 100,000-130,000 live births. Chronic alveolar hypoventilation leading to concurrent hypoxia is the main cause of morbidity and mortality in these patients due to its complications. A 22-year-old male with past medical history of ATD and severe kyphoscoliosis presented with progressively worsening shortness of breath for several days. Past surgical history was significant for multiple reconstructive sternal surgeries, his first surgery was at the age of two...
2018: Respiratory Medicine Case Reports
Valentina Molodtsova, Marina Ryabova, Ivetta Dvorakovskaya, Marya Vasilyeva, Andrey Akopov
Recurrent respiratory papillomatosis (RRP) is a rare disease caused by human papillomavirus. Aggressive forms of RRP require repeated cytoreductive surgery to restore airway patency. Tracheal disease is even less common and lung parenchyma is involved in less than 1% of patients. We present reports of three cases of RRP with progressive lung disease in adult patients.
2018: Respiratory Medicine Case Reports
Lauryn A Benninger, Julia A Ross, Marino E Leon, Raju Reddy
Pleural effusions occur in up to 70% of cases of malignant pleural mesothelioma (MPM). However, MPM rarely presents as a chylous effusion making it a diagnostic challenge. There are only six reported cases to date. Most cases of chylothoraces due to malignancy are due to lymphoma or bronchogenic carcinoma. We report an interesting case of MPM in a 75-year-old man who presented with recurrent chylothorax. He reported a four-month history of dyspnea and chest discomfort. Chest x-ray revealed a pleural effusion...
2018: Respiratory Medicine Case Reports
Kritika Krishnamurthy, Sarah Alghamdi, Jyotsna Kochiyil, George F Bruney, Robert J Poppiti
Osteosarcoma is the most common primary malignant neoplasm of the bone with over 60% of the cases occurring in patients 10-20 years old. Osteosarcoma rarely occurs in patients older than 40 years of age, most commonly in bones affected by preexisting conditions such as Paget's disease, prior irradiated bone or osteogenesis imperfecta. Osteosarcoma presenting with pleural metastases is very rare. Herein we describe a case of metastatic osteosarcoma presenting with pleural effusion due to underlying pleural metastases in a 55 year old woman...
2018: Respiratory Medicine Case Reports
Saad Habib, Nicholas Fuca, Mohammed Azam, Abdul Hasan Siddiqui, Kartikeya Rajdev, Michel Chalhoub
Achromobacter xylosoxidans , a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans /denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR Escherichia coli and Streptococcus anginosus . A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. He was found to have pleural empyema secondary to MDR E...
2018: Respiratory Medicine Case Reports
Ankit Gupta, Atul Palkar, Priya Narwal, Ashish Kataria
Primary Synovial sarcoma of the lung is an extremely rare entity. Our patient was healthy prior to presentation and came in with a short course of dyspnea and was found to have a large synovial sarcoma on the lung.
2018: Respiratory Medicine Case Reports
Terufumi Kubo, Yoshihiko Hirohashi, Hiromi Fujita, Shintaro Sugita, Yasuhiro Kikuchi, Tomoyo Shinkawa, Munehide Nakatsugawa, Mitsuhiro Tsujiwaki, Yuta Sudo, Yuichiro Asai, Yasuaki Umeda, Hiroki Takahashi, Tadashi Hasegawa, Toshihiko Torigoe
We present a case of ovarian clear-cell carcinoma that was initially diagnosed as adenocarcinoma of lung origin. This is an instructive diagnostic pitfall for clinicians and pathologists because of the unusual clinical course, small biopsy material, and noteworthy immunophenotype of the carcinoma. Imaging analysis identified only lung and liver lesions. In addition, the biopsy specimen from the lung was TTF-1 negative and napsin A positive, which is still possible for cancer of lung origin. Postmortem examination found that the cancer should be classified as ovarian clear-cell carcinoma distinguished by positive staining for napsin A and paired-box gene 8 (PAX8)...
2018: Respiratory Medicine Case Reports
Alexander Dalphy, Andrew Burkett
Cerebrospinal fluid (CSF) shunting into the pleural space can cause complications such as long-standing pleural effusions and trapped lung. These complications can be difficult to manage due to the propensity of effusions to recur, and the irreversible nature of trapped lung. This report describes the case of a woman with a pleural CSF shunt who developed chronic pleural effusions and trapped lung over two years, following a 24-year period without any respiratory shunt complications. Management options for this patient included thoracentesis, lung decortication, insertion of an indwelling pleural catheter, and shunt revision...
2018: Respiratory Medicine Case Reports
Saad Habib, Lazer Ezriel Leifer, Mohammed Azam, Abdul Hasan Siddiqui, Kartikeya Rajdev, Michel Chalhoub
Giant Cell Carcinoma of the lung, a subtype of Sarcomatoid lung cancer is a poorly differentiated Non-Small-Cell Lung Cancer. GCCL has exceptionally aggressive characteristics, and its prognosis is much poorer than any other NSCLCs. Herein, we present a rare case of Giant Cell Carcinoma of lung treated successfully with surgical resection and adjuvant vinorelbine and cisplatin. A 48-year-old African American man with a history of smoking and chronic obstructive pulmonary disease was admitted to the hospital for chief complaints of shortness of breath...
2018: Respiratory Medicine Case Reports
Mahé Berland, Marjolaine Oger, Emi Cauchois, Karine Retornaz, Valérie Arnoux, Jean-Christophe Dubus
Thoracic trauma is a major source of morbi-mortality in injured children. Their pliable chest wall makes pulmonary contusion the most common chest injury. It is most often secondary to blunt trauma caused by traffic accidents. We report a case of severe chest trauma caused by a bumper car collision in an 8-years old girl. She sustained right lung contusion that led to complete atelectasis. After a week of supportive therapy, bronchoscopy removed a mucous plug from the main bronchus, resulting in significant clinical improvement...
2018: Respiratory Medicine Case Reports
Amos Lal, Jamal Akhtar, Sangeetha Isaac, Ajay Kumar Mishra, Mohammad Saud Khan, Mohsen Noreldin, George M Abraham
Chest pain is a common symptom culminating in hospital admissions and specialist referrals. Although cardiac work up is pursued in most of the cases, cardiac etiology is found to be the culprit in minority of the cases. Acute chest pain is a clinical syndrome that may be caused by almost any condition affecting the thorax, abdomen, or internal organs. On occasions this extensive and expensive diagnostic work up can be avoided with awareness of commoner and non-lethal reasons. We report a case of a woman with Bornholm disease secondary to Coxsackievirus B5 (CB5) infection and supplementary review of literature till date...
2018: Respiratory Medicine Case Reports
G Dilorenzo, E Salinaro, V Favia, S Pavone, P Drimaco, N Laforgia, G Angelelli, A A Stabile Ianora
Congenital pulmonary airway malformations (CPAMs) are a heterogeneous group of hamartomatous cystic and noncystic lung lesions that result from early airway maldevelopment. Usually they are distinguished according to Stocker's classification in type 0, 1, 2, 3 and 4. We present the case of a 2 weeks old baby who was admitted to hospital with RDS symptoms and left pleural effusion: X rays and CT were suggestive for a pulmonary cystic lesion with pleural complications. Because of the persistence of pleural empyema and the development of a pneumothorax the baby underwent surgery...
2018: Respiratory Medicine Case Reports
Atsuki Fukada, Hideki Yasui, Tomoaki Uto, Shioto Suzuki, Jun Sato, Shiro Imokawa, Takafumi Suda
An 85-year-old man who did not have any hematological or respiratory disorders was transferred to our hospital because of progressive dyspnea. Computed tomography (CT) findings showed ground-glass opacities with a centrilobular distribution and centrilobular micronodules with a "tree-in-bud" pattern. A biopsy of the lungs showed lymphocytic infiltrations in the parenchyma and these were positive for B cell markers. A diagnosis of chronic lymphocytic leukemia (CLL) was made and direct pulmonary involvement of CLL was confirmed simultaneously...
2018: Respiratory Medicine Case Reports
Jeremy A Smith, Matthew T Koroscil, Jackie A Hayes
Congenital Pulmonary Airway Malformation (CPAM) is a rare developmental abnormality of the lower respiratory tract, primarily diagnosed in the neonatal period. The most concerning sequelae for patients with CPAM are recurrent respiratory infections and malignancy. Rarely discovered in asymptomatic adults, CPAM presents challenging questions for management. We describe such a case and discuss the risks and benefits of resection.
2018: Respiratory Medicine Case Reports
Mari Tone, Nobuyasu Awano, Minoru Inomata, Naoyuki Kuse, Tatsunori Jo, Hanako Yoshimura, Yoshiaki Furuhata, Tamiko Takemura, Toshio Kumasaka, Takehiro Izumo
Correct staging of lung cancer is important for the selection of the best therapy, but discriminating between lymphadenopathy from lung cancer and from sarcoidosis by imaging examinations is difficult. Additionally, distinguishing lymphadenopathy of sarcoidosis from sarcoid reactions which are sometimes caused by lung cancer is difficult on imaging and pathological findings. A 73-year-old woman was diagnosed as lung cancer clinical T1bN3M0 stage ШB based on false-positive 18 F-fluoro-2-deoxyglucose positron emission tomography uptake...
2018: Respiratory Medicine Case Reports
Majid Dudha, Zakir Shaikh, Mohammed Bhaiyat, Ishaq J Wadiwala, Zainab-Tasneem Bhaiyat
Echinococcosis, also known as Hydatid disease, is caused by the larvae of the tapeworm Echinococcus. It is globally prevalent and is a major clinical health concern. It is endemic in most underdeveloped regions including Asia, the Mediterranean, South America and Africa. There are four species within the genus Echinococcus, with E. granulosus and E. multilocularis being the most common, causing Cystic Echinococcosis (CE) and Alveolar Echinococcosis (AE). The clinical presentation of the disease is non-specific...
2018: Respiratory Medicine Case Reports
M F Cheng, C F Choy
A 83 years old man was admitted to acute medical unit for mild asthma exacerbation. He also had atrial fibrillation and was on dabigatran. A mass on left upper chest wall was incidentally found. There were bruises over left posterolateral aspect of chest wall. Chest X-ray showed left pleural effusion. Diagnostic tap yielded blood-stained fluid. Computer tomography showed left lung herniation. Cardiothoracic surgery team unit was consulted. Reduction of lung herniation and patch repair of chest wall defect was done...
2018: Respiratory Medicine Case Reports
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