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Respiratory Medicine Case Reports

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https://www.readbyqxmd.com/read/29326867/cavitary-lung-lesion-suspicious-for-malignancy-reveals-mycobacterium-xenopi
#1
Sumit Fogla, Vaishali M Pansare, Luis G Camero, Uzma Syeda, Naveen Patil, Arun Chaudhury
We report the case of a 68-year-old gentleman who presented with musculoskeletal chest pain which appeared suddenly when he bent over with his dog. The chest pain was localized to the left lower chest and increased with movement and deep breathing. The patient did not complain weight loss, night sweat, fever or chill. He complained of mild cough, with expectoration of whitish mucus. Imaging revealed cavitary chest lesion in the right upper lobe, which was initially suspected to be lung cancer. The patient had a 50-year-old history of smoking 2 packs per day...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29321968/achalasia-with-massive-oesophageal-dilation-causing-tracheomalacia-and-asthma-symptoms
#2
Ana Gomez-Larrauri, Simon Galloway, Rob Niven
Achalasia is an uncommon oesophageal motor disorder characterized by failure of relaxation of the lower oesophageal sphincter and muscle hypertrophy, resulting in a loss of peristalsis and a dilated oesophagus. Gastrointestinal symptoms are invariably present in all cases of achalasia observed in adults. We report a case of a 34 year-old female patient with long standing history of asthma-like symptoms, labelled as uncontrolled and steroid resistant asthma with no gastrointestinal manifestations. Thoracic CT scan revealed a massive oesophagus due to achalasia, which caused severe tracheomalacia as a result of tracheal compression...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29321967/teratoma-as-unusual-cause-of-chest-pain-hemoptysis-and-dyspnea-in-a-young-patient
#3
Irena Hammen, Achhe Lal Yadav
A 16-year-old girl presented with intermittent left chest pain and breathlessness on exertion for last 4 months with one episode of haemoptysis. There has been loss of appetite and weight loss of 4 kg over a period of 1 month. A chest radiograph revealed a large mass like opacity with pleural effusion in the left lung field. Computerized Tomography scanning (CT scanning) and Positron Emission Tomography/Computerized Tomography scanning (PET/CT scanning) demonstrated a 7 cm round, cystic lesion in the anterior mediastinum...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29276676/hamman-s-syndrome-spontaneous-pneumomediastinum-presenting-as-subcutaneous-emphysema-a-rare-case-of-the-emergency-department-and-review-of-the-literature
#4
Konstantinos Grapatsas, Zoi Tsilogianni, Vasileios Leivaditis, Sotirios Kotoulas, Christoforos Kotoulas, Efstratios Koletsis, Ilias Stylianos Iliadis, Manfred Dahm, Georgia Trakada, Lemonia Veletza, Anastasios Kallianos, Haidong Huang, Christoforos Kosmidis, Michael Karanikas, Vasilis Thomaidis, Konstantinos Porpodis, Paul Zarogoulidis
Pneumomediastinum is a rare clinical entity that concerns the clinicians in the emergency department. We present a case of a patient with spontaneous pneumomediastinum (Hamman's syndrome) that presented to our hospital's emergency department with cervical subcutaneous emphysema. A conservative treatment with observation was performed. The patient after 24 hours of observation was discharged with a suggested follow-up.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29276675/an-onion-farmer-with-a-case-of-hypersensitivity-pneumonitis-caused-by-aspergillus-niger
#5
Tomohiro Sakamoto, Akira Yamasaki, Yoshihiro Funaki, Tomoya Harada, Ryota Okazaki, Yasuyuki Hasegawa, Yuriko Sueda, Takehito Fukushima, Masahito Morita, Akihiro Yamamoto, Masahiro Kodani, Eiji Shimizu
A 62-year old man was admitted to our hospital with a 2-week complaint of a dry cough, general fatigue, and dyspnea on effort. He has been an onion farmer for several years and developed these symptoms after cleaning up onion peels with air compressors. A chest roentgenogram and computed tomography showed a ground glass shadow in the bilateral upper lung field. Cellular analysis of the bronchoalveolar lavage fluid showed elevated total cell numbers and lymphocytes. Transbronchial lung biopsies revealed a non-caseating granuloma with both epithelioid cells and Langhans giant cells...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29276674/upfront-triple-combination-therapy-induced-pulmonary-edema-in-a-case-of-pulmonary-arterial-hypertension-associated-with-sjogren-s-syndrome
#6
Kimikazu Takeuchi, Kazuhiko Nakayama, Mitsumasa Okano, Naoki Tamada, Hideya Suehiro, Yuto Shinkura, Kenichi Yanaka, Hiroyuki Onishi, Hidekazu Tanaka, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata
Clinical efficacy of combination therapy using vasodilators for pulmonary arterial hypertension (PAH) is well established. However, information on its safety are limited. We experienced a case of primary Sjogren's syndrome associated with PAH where the patient developed pulmonary edema immediately after the introduction of upfront triple combination therapy. Although the combination therapy successfully stabilized her pre-shock state, multiple ground glass opacities (GGO) emerged. We aborted the dose escalation of epoprostenol and initiated continuous furosemide infusion and noninvasive positive pressure ventilation (NPPV), but this did not prevent an exacerbation of pulmonary edema...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29276673/clear-cell-sugar-tumor-of-the-lung-diagnostic-features-of-a-rare-pulmonary-tumor
#7
Diamantis I Tsilimigras, Anargyros Bakopoulos, Ioannis Ntanasis-Stathopoulos, Maria Gavriatopoulou, Demetrios Moris, Georgios Karaolanis, Eleftherios Spartalis, Stylianos Vagios, Maria Kalfa, Charitini Salla, Dimitrios V Avgerinos
Clear cell tumor of the lung (CCTL) is an extremely rare neoplasm with about 50 cases reported in the literature so far. CCTL belongs to a family arising from putative perivascular epithelioid cells and is otherwise named as "sugar tumor" due to its high cellular glycogen concentration. Due to its rarity, diagnostic features of this entity are not widely known and this usually leads to misdiagnosis. Herein, we report a case of benign CCTL, which was primarily evaluated intraoperatively by FNA cytology and then by a pathological examination of the resected tumor...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29276672/combined-pleuroscopy-and-endobronchial-ultrasound-for-diagnosis-and-staging-of-suspected-lung-cancer
#8
Macarena R Vial, George A Eapen, Roberto F Casal, Mona G Sarkiss, David E Ost, Erik Vakil, Horiana B Grosu
The standard approach to staging of lung cancer in patients with pleural effusion (clinical M1a) is thoracentesis followed by pleural biopsies if the cytologic analysis is negative. If pleural biopsy findings are negative, endobronchial ultrasound-guided transbronchial needle aspiration is used to complete the staging process and, in some cases, obtain diagnosis. In this case series we report 7 patients in which a combined procedure was performed for staging of known or suspected lung cancer. We found that the combined approach was both feasible and safe in this case series...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29255670/pulmonary-venous-thrombosis-secondary-to-radiofrequency-ablation-of-the-pulmonary-veins
#9
Raquel López-Reyes, Alberto García-Ortega, Ana Torrents, Laura Feced, Pilar Calvillo, Eugenia Alejandra Libreros-Niño, Juan Escrivá-Peiró, Dolores Nauffal
Background: Pulmonary Vein Thrombosis (PVT) is a rare and underdiagnosed entity produced by local mechanical nature mechanisms, vascular torsion or direct injury to the vein. PVT has been described in clinical cases or small multicenter series mainly in relation to pulmonary vein stenosis, metastatic carcinoma, fibrosing mediastinitis, as an early surgical complication of lung transplantation lobectomy and radiofrequency ablation performed in patients with atrial fibrillation, although in some cases the cause is not known...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29234594/successful-use-of-linezolid-for-refractory-mycobacterium-abcessus-infection-a-case-report
#10
Teppei Inoue, Akihito Tsunoda, Eriko Nishimoto, Kohei Nishida, Yuka Komatsubara, Rintaro Onoe, Junko Saji, Masamichi Mineshita
A 51-year-old male patient was receiving treatment for Mycobacterium abscessus infection for approximately 10 years. However, as his condition gradually progressed to type II respiratory insufficiency, he was referred to our hospital, which was near his home. Computed tomography on his first visit revealed an abscess in the right lower lobe. Because respiratory insufficiency was evident, he was admitted the same day. We began treatment with meropenem, amikacin, and clarithromycin, but his symptoms did not improve...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29234593/a-new-mode-of-ventilation-for-interventional-pulmonology-a-case-with-ebus-tbna-and-debulking
#11
Paul Zarogoulidis, Haidong Huang, Chong Bai, Christoforos Kosmidis, Konstantinos Porpodis, Anastasios Kallianos, Lemonia Veletza, Georgia Trakada, Naim Benhassen, Wolfgang Hohenforst-Schmidt
Lung cancer is still underdiagnosed mainly due to lack of symptoms. Most patients are diagnosed in a late stage where unfortunately only systematic therapy can be applied. Fortunately in the last five years several novel therapies and combinations have emerged. However; in certain situations local therapeutics modalities have to be applied in order to solve emergency problems as in the case that we will present. Convex-EBUS probe was used along with a novel method of ventilation which keeps PCO2 concentration satisfyingly low...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29204340/evaluation-of-coexistence-of-cancer-and-active-tuberculosis-16-case-series
#12
Beyhan Çakar, Aydın Çiledağ
Introduction: Tuberculosis is an important risk factor for cancer. Pulmonary TB and lung cancer(LC) may mimic each other especially in the aspect of the clinical and radiological features. The aim of the study was to evaluate the features and risk factors of cases with coexistence cancer and active TB. Methodology: We retrospectively reviewed the medical records of patients with coexisting TB and cancer a period from 2009 to 2014. We evaluated demographic data, the ways diagnosis of TB cases, the location of TB and cancer, TB treatment results of the cases...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29204339/chest-pain-in-a-young-immunocompetent-male-a-rare-case-scenario
#13
M D Badusha, Ramanjula Reddy, Konathala Phani Kumar, Satyasri
Musculoskeletal tuberculosis is the commonest form of extrapulmonary tuberculosis however Rib lesion is uncommon and occurs in zero to five percent of bone and joint tuberculosis. In our case report both chest X ray and CT were useful in demonstrating the skeletal lesion and also in the assessment of response to treatment, as follow up chest X ray and CT scan at 4 months and after 12 months of anti tubercular drugs showed remarkable new bone formation and clearing of pleura parenchymal lesions.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29204338/giant-left-atrium-encountered-during-right-sided-thoracentesis
#14
Rashmi Advani, Benjamin T Galen
Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29201637/two-patients-with-daptomycin-induced-eosinophilic-pneumonia-with-different-presentations-and-treatment
#15
Yonas Raru, Fuad Zeid, Shannon Browning, Elizabeth Saunders
We present two cases of daptomycin-induced eosinophilic pneumonia with characteristic chest x ray, CT scan and bronchoalveolar lavage (BAL) findings. It is not a commonly seen complication of Daptomycin but when it happens, it could cause a diagnostic and treatment dilemma. Patients could present acutely with hypoxic respiratory failure or a less dramatic chronic presentation is also possible. Our two patients presented with acute hypoxic respiratory failure and presentation resembles that of an infectious etiology...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29201636/laryngotracheoesophageal-cleft-type-3-and-severe-laryngotracheomalacia-delayed-surgical-repair-a-treatment-challenge-with-an-excellent-outcome
#16
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29167754/a-mass-that-has-no-ebus-echo
#17
Matthew K Rosenblum, Sue X Wang, Eric J Seeley
We report findings for a patient that underwent endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) for diagnostic purposes after an abnormal chest CT. The patient initially presented with cough and shortness of breath. Chest CT revealed a 6 cm soft tissue mass with mildly enlarged right hilar lymph nodes (LNs) and a small right sided pleural effusion. Based on these radiologic findings, the patient underwent an EBUS guided FNA of the mass. To our surprise, the mass was hypoechoic by EBUS and on aspiration, the syringe filled with yellow fluid...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29159034/hamman-rich-syndrome
#18
Arshiya Mastan, Nilaani Murugesu, Adil Hasnain, Terry O'Shaughnessy, Vladimir Macavei
INTRODUCTION: Acute interstitial pneumonia is a rare but important diagnosis, associated with a high mortality rate and important to identify early. CASE PRESENTATION: A 76 year-old individual presented to hospital with a two-week history of shortness of breath, fevers and a non-productive cough. Treatment initially was for lower respiratory tract infection but returned to hospital three days later as her shortness of breath and peripheral oedema was worsening despite diuretic treatment...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29159033/interstitial-pneumonia-caused-by-dabigatran
#19
Toyoshi Yanagihara, Norio Yamamoto, Yasuaki Kotetsu, Naoki Hamada, Eiji Harada, Kunihiro Suzuki, Kayo Ijichi, Yoshinao Oda, Yoichi Nakanishi
We describe the case of a 73-year-old man who experienced dry cough and exertional dyspnea after dabigatran administration. Chest radiographs revealed the development of bilateral consolidative and ground glass opacity, and transbronchial lung biopsy showed organized materials in the alveolar spaces with moderate inflammatory infiltrate and focal fibrosis. Lung opacity gradually disappeared after discontinuing dabigatran. To date, there has been only one report regarding dabigatran-induced lung injury, except for alveolar hemorrhage and eosinophilic pneumonia...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29159032/use-of-ceftolozane-tazobactam-in-a-cystic-fibrosis-patient-with-multidrug-resistant-pseudomonas-infection-and-renal-insufficiency
#20
Katie Stokem, Jonathan B Zuckerman, David P Nicolau, Minkey Wungwattana, Edmund H Sears
We report the successful use of ceftolozane/tazobactam (C/T) to treat a pulmonary exacerbation in a 35 year old female, post lung transplant, with cystic fibrosis (CF), malnutrition, chronic kidney disease, and multi-drug resistant Pseudomonas aeruginosa infection (MDR PSA). Given the complexity of the clinical profile, we measured drug levels of C/T during treatment of her current exacerbation to determine pharmacokinetics. The patient achieved an estimated ceftolozane peak of 174.1 μg/mL and trough of 9...
2018: Respiratory Medicine Case Reports
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