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Intersting case reports in pulmonary and critical care

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123 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28835429/a-rare-case-of-pulmonary-toxoplasmosis-in-a-patient-with-undifferentiated-inflammatory-arthritis-on-chronic-methotrexate-and-corticosteroid-therapy
#1
Abdullateef Abdulkareem, Ryan Steven D'Souza, Nitin Patel, Anthony A Donato
Pulmonary toxoplasmosis is a serious pulmonary condition caused by the protozoan Toxoplasma gondii It typically affects immunocompromised patients presenting acutely with cough, fever, myalgias, arthralgias and lymphadenopathy, and chronically with persistent cough and dyspnoea. Because of its protean features, it can mimic many more common lung conditions in the immunocompromised patient, including atypical pneumonia, Pneumocystis pneumonia and interstitial lung disease. In this article, we present the case of a 55-year-old woman who presented to our hospital with persistent dyspnoea and cough, initially suspected to have an arthritis-related interstitial lung disease...
August 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28928253/filarial-pleural-effusion-without-peripheral-blood-or-pleural-fluid-eosinophilia
#2
Amitabh Das Shukla, Abhinav Chaudhary, Arvind Kumar Verma, Shreenivasa Anantha
Lymphatic filariasis is a tropical parasitic disease and is endemic in India. It is present in various forms but its manifestation as pleural effusion is rare. Here, we describe a case of 58-year-old male who presented with complaint of left side chest pain and breathlessness. He was investigated and diagnosed as a case of left side pleural effusion due to filariasis, with peripheral blood lymphocytosis but without peripheral blood or pleural fluid eosinophilia. Our case foregrounds that filariasis can present with peripheral blood lymphocytosis and without peripheral blood or pleural fluid eosinophilia...
September 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28931369/acute-hiv-infection-presenting-as-hemophagocytic-lymphohistiocytosis-case-report-and-review-of-the-literature
#3
Farheen Manji, Evan Wilson, Etienne Mahe, John Gill, John Conly
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is an uncommon systemic inflammatory condition that can result from infections, autoimmune diseases and malignancies. It is a rarely reported life threatening complication of an acute HIV infection, with only ten documented case reports per our literature search. We present a case of HLH secondary to acute HIV infection with a negative HIV antibody-based assay and high plasma viral load. CASE PRESENTATION: A 45 year old male with a past medical history of well controlled hypertension presented with fever, dizziness and non-bloody diarrhea...
September 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28831322/intercostal-artery-laceration-rare-complication-of-thoracentesis-and-role-of-ultrasound-in-early-detection
#4
Wissam Mansour, Ghassan Samaha, Sandy El Bitar, Ziad Esper, Rabih Maroun
Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28039947/acute-pulmonary-involvement-by-paracoccidiodomycosis-disease-immediately-after-kidney-transplantation-case-report-and-literature-review
#5
REVIEW
Marcelo V Radisic, Laura Linares, Javier Afeltra, Natalia Pujato, Roxana G Vitale, Martin Bravo, Ana C Dotta, Domingo H Casadei
Paracoccidioides brasiliensis is the cause of paracoccidioidomycosis, one of the most important systemic mycoses in Latin America. Human disease has been observed in a limited geographic and ecological niche, and it is attributed to exposure to the fungus in soil. Most primary infections are subclinical, as the infection is contained by the host mainly through cell-mediated immune response. However, as the fungus has the ability to survive in a dormant state for long periods, an impairment of the immune response may lead to reactivation and clinical disease...
April 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28717524/anasarca-fever-thrombocytopenia-organomegaly-and-multiorgan-failure-in-a-24-year-old-pregnant-woman
#6
Guillaume Morel, Joy Mootien, Philippe Guiot, Khaldoun Kuteifan
TAFRO syndrome is a distinct idiopathic multicentric Castleman disease characterized by the association of thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. We report the first case occurring in a Caucasian pregnant woman. At 34 weeks of gestation, our patient presented with all clinical and biological symptoms compatible with a TAFRO syndrome. Tough quick cesarean section was performed as symptoms got worse with onset of multiorgan failure requiring mechanical ventilation for acute respiratory distress, continuous renal replacement, and vasopressors...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28166920/tuberculosis-the-great-imitator-a-usual-disease-with-unusual-presentations
#7
Sujata Jetley, Zeeba S Jairajpuri, Mukta Pujani, Sabina Khan, Safia Rana
BACKGROUND: A number of infectious diseases have been referred to by the phrase 'The Great Imitator', of which the oldest is syphilis; others include Lyme disease, nocardiosis, etc. Tuberculosis has been described as the second great imitator as it can imitate various other disease processes. An awareness of the atypical clinical manifestations of tuberculosis is important, especially in regions where tuberculosis continues to be a major public health problem, such as India. Extrapulmonary tuberculosis (EPTB) constitutes about 15-20% of all cases of tuberculosis in immunocompetent patients and accounts for more than 50% of the cases in human immunodeficiency virus (HIV)-positive individuals...
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28410698/spontaneous-chylothorax-revealing-a-mediastinal-and-abdominal-lymph-node-tuberculosis
#8
Jihen Ben Amar, Haifa Zaibi, Besma Dahri, Hichem Aouina
Chylothorax is a rare manifestation of tuberculosis. We report a case of spontaneous chylothorax due to tuberculosis. A 62-year-old woman was admitted with fever, chest pain and dyspnea. Chest and abdominal computed tomography revealed a fluid collection with necrotic mediastinal and abdominal lymph nodes. Biopsy of lymph nodes by mediastinoscopy. The patient was treated with anti-tuberculosis medication. He is clinically improved and his pleural effusion also completely resolved.
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28454572/invasive-pulmonary-mucormycosis-rare-presentation-with-pulmonary-eosinophilia
#9
Taizou Hirano, Mitsuhiro Yamada, Kei Sato, Koji Murakami, Tokiwa Tamai, Yoshiya Mitsuhashi, Tsutomu Tamada, Hisatoshi Sugiura, Naomi Sato, Ryoko Saito, Junya Tominaga, Akira Watanabe, Masakazu Ichinose
BACKGROUND: Fungi can cause a variety of infectious diseases, including invasive mycosis and non-invasive mycosis, as well as allergic diseases. The different forms of mycosis usually have been described as mutually exclusive, independent entities, with few descriptions of overlapping cases. Here, we describe the first reported case of a patient with the complication of pulmonary eosinophilia in the course of invasive mucormycosis. CASE PRESENTATION: A 74-year-old Japanese man with asthma-COPD overlap underwent emergency surgery for a ruptured abdominal aortic aneurysm...
April 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28458928/iatrogenic-right-sided-pneumothorax-presenting-as-st-segment-elevation-a-rare-case-report-and-review-of-literature
#10
Bashar Alzghoul, Ayoub Innabi, Anusha Shanbhag, Kshitij Chatterjee, Farah Amer, Nikihil Meena
Pneumothorax is a well-recognized complication of central venous line insertion (CVL). Rarely, pneumothorax can lead to electrocardiogram (ECG) findings mimicking ST-segment elevation myocardial infarction. We present a 63-year-old man with iatrogenic right-sided pneumothorax who developed ST-segment elevation on a 12-lead ECG suggestive of myocardial infarction. The ECG findings completely resolved after needle decompression and chest tube placement. This case points up this rare electrocardiographic finding with discussion of possible mechanisms and differential diagnosis...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28473928/dka-induced-takotsubo-cardiomyopathy-in-patient-with-known-hocm
#11
Ayla Gordon, Gina LaCapra, Roberto Roberti
The first published case of Diabetic Ketoacidosis-induced Takotsubo cardiomyopathy was in 2009. Our patient is the 1st reported case of Diabetic Ketoacidosis- (DKA-) induced Takotsubo cardiomyopathy (TC) in a patient with known hypertrophic cardiomyopathy (HOCM) in the United States. In the literature, there are only two examples linking DKA to TC; however, this report focuses on the biochemical and physiological causes of TC in a patient with known HOCM and new-onset DKA. TC in previously diagnosed HOCM poses particular complications...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28183501/an-unusual-cause-of-pulmonary-nodules-after-stem-cell-transplantation
#12
Anna K Brady, Jonathan R Fromm, Siddhartha G Kapnadak
A man in his 20s with a history of classical Hodgkin's lymphoma was admitted with fever. His original lymphoma diagnosis was made 3 years prior, when he had presented with lymphadenopathy and a mediastinal mass. He had relapsed disease despite chemotherapy and radiation. As a result, he underwent autologous peripheral blood stem cell transplant (SCT) 6 months prior to current presentation and subsequently allogeneic SCT 2 months prior for added graft vs tumor effect.
February 2017: Chest
https://www.readbyqxmd.com/read/28183503/a-66-year-old-woman-with-sudden-onset-of-disseminated-intravascular-coagulation-lactic-acidosis-and-hypoglycemia
#13
Benjamin Henkle, Patrick Arndt
A 66-year-old woman presented to an urgent care clinic for 2 to 3 weeks of general malaise, nausea/vomiting, night sweats, and dyspnea. On examination, she was tachycardic, and her laboratory evaluation was normal except for a lactate level of 4.4 mmol/L and platelet count of 118 × 109/L. CT imaging was performed. Two days later in the follow-up clinic, the patient's international normalized ratio (INR) was elevated, and she was hospitalized with initial findings of disseminated intravascular coagulation (DIC) (ie, INR > 10, platelets 97 × 109/L, fibrinogen < 60 mg/dL, positive D-dimer result)...
February 2017: Chest
https://www.readbyqxmd.com/read/27938776/a-man-in-his-20s-with-diffuse-lung-opacities-and-acute-respiratory-failure-after-hookah-smoking
#14
Mohleen Kang, Vishal Raj, Andrew R Berman
A man in his 20s with no medical history presented with 2 days of progressively worsening shortness of breath accompanied by subjective fevers, chills, body aches, decreased appetite, night sweats, and cough producing nonbloody sputum. He denied childhood lung diseases, allergies, or a family history of lung disease. He did not smoke cigarettes but had smoked hookah in Saudi Arabia before moving to the United States 1 month before presentation and had restarted 2 days before the start of symptoms. He denied travel outside of the northeastern United States...
December 2016: Chest
https://www.readbyqxmd.com/read/27863462/liver-abscess-and-bacteremia-caused-by-lactobacillus-role-of-probiotics-case-report-and-review-of-the-literature
#15
REVIEW
Muhammed Sherid, Salih Samo, Samian Sulaiman, Husein Husein, Humberto Sifuentes, Subbaramiah Sridhar
BACKGROUND: Lactobacilli are non-spore forming, lactic acid producing, gram-positive rods. They are a part of the normal gastrointestinal and genitourinary microbiota and have rarely been reported to be the cause of infections. Lactobacilli species are considered non-pathogenic organisms and have been used as probiotics to prevent antibiotic associated diarrhea. There are sporadic reported cases of infections related to lactobacilli containing probiotics. CASE PRESENTATION: In this paper we discuss a case of an 82 year old female with liver abscess and bacteremia from lactobacillus after using probiotics containing lactobacilli in the course of her treatment of Clostridium difficile colitis...
November 18, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27835947/successful-treatment-of-severe-pneumocystis-pneumonia-in-an-immunosuppressed-patient-using-caspofungin-combined-with-clindamycin-a-case-report-and-literature-review
#16
REVIEW
Hongjuan Li, Haoming Huang, Hangyong He
BACKGROUND: Pneumocystis jirovecii is responsible for Pneumocystis pneumonia (PCP), which occurs almost exclusively in immunocompromised individuals. Trimethoprim-sulfamethoxazole (TMP-SMZ) is regarded as the first-line treatment and prophylaxis for P. jirovecii infection, but the frequency of adverse reactions and newly emerged antibiotic resistance limit its use. CASE PRESENTATION: Ulcerations and hemorrhages involving the tongue were noted secondary to TMP-SMZ desensitization against PCP in a 46-year-old male who had previously been diagnosed with IgA nephropathy and sustained prolonged corticosteroid therapy...
November 11, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27821499/endobronchial-hamartoma-a-rare-disease-with-more-common-presentation
#17
Mohannad Abu Omar, Mouhanna Abu Ghanimeh, Emily Tylski, Timothy Saettele
Hamartomas are the most common benign tumours of the lung with an overall incidence of 0.025-0.32%. They are known to be amalgamation of various tissue types, originating from the embryonic mesoderm. Lung hamartomas typically involve lung parenchyma and only infrequently grows as endobronchial tumours. We present a case of an 80-year-old man who presented to the pulmonary clinic for consultation for breathlessness, recurrent pneumonias and an abnormal radiograph finding. CT scan of the chest showed scattered infiltrates and atelectasis in the left upper lobe...
November 7, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27790284/pulmonary-strongyloidiasis-masquerading-as-exacerbation-of-chronic-obstructive-pulmonary-disease
#18
Gourahari Pradhan, Priyadarshini Behera, Manoj Kumar Panigrahi, Sourin Bhuniya, Prasanta Raghab Mohapatra, Jyotirmayee Turuk, Srujana Mohanty
Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27758997/spontaneous-resolution-of-a-tumor-like-pulmonary-sarcoidosis
#19
Zied Moatemri, Ghassen Soussi, Salsabil Dabboussi, Samira Mhamdi, Chiraz Aichaouia, Mohsen Khadraoui, Rezaik Cheikh
We report a case of thoracic sarcoidosis in a 72-year-old female, snuff taker, who presented with multinodular pulmonary lesions on chest x-ray. Clinical and biological findings were poor. Thoracic imaging showed soft tissue density nodules with irregular borders. The diagnosis of 'cannon ball' metastases was suspected. A thorough investigation strategy could not prove malignancy. A complete radiologic clearing was obtained spontaneously within three months. A rereading of pathology slides performed afterwards showed multinucleated giant cells on hemorrhagic background with a lymphocytic alveolitis...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27760430/can-large-hydatid-cysts-resolve-with-medical-treatment-alone
#20
Donald Simon, Coenraad F N Koegelenberg, Soumitra Sinha Roy, Brian W Allwood, Elvis M Irusen
A 66-year-old female from a rural area in South Africa presented with non-life-threatening haemoptysis. Radiologic and serological investigations attributed her symptoms to bilateral, large echinococcal cysts. She declined surgery despite her lung physiologic parameters, which deemed her eligible. Medical therapy with oral albendazole was initiated with excellent clinical and radiologic response during a follow-up period of 18 months. To our knowledge, this is one of the first reported cases in the literature that shows complete resolution of bilateral large echinococcal cysts with medical treatment alone in an adult patient...
2016: Respiration; International Review of Thoracic Diseases
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