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Intersting case reports in pulmonary and critical care

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117 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28166920/tuberculosis-the-great-imitator-a-usual-disease-with-unusual-presentations
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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 × 10(9)/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 × 10(9)/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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27776827/intranasal-dexmedetomidine-sedation-as-adjuvant-therapy-in-acute-asthma-exacerbation-with-marked-anxiety-and-agitation
#15
Giorgio Cozzi, Sara Lega, Rita Giorgi, Egidio Barbi
We describe 2 patients with acute asthma exacerbation who were admitted to the emergency department (ED) with severe agitation and restlessness as a prominent finding, for which bedside asthma treatment sedation with intranasal dexmedetomidine was performed. In both cases, dexmedetomidine allowed the patients to rest and improved tolerance to treatment. Dexmedetomidine is a unique sedative with an excellent safety profile and minimal effect on respiratory function. These properties render it particularly promising for the management of severe agitation in children admitted to the ED with acute asthma exacerbation...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27692838/pulmonary-contusion-and-traumatic-pneumatoceles-in-a-platform-diver-with-hemoptysis
#16
Joanna Shi-En Chan, Jeremy C Wee, R Ponampalam, Evelyn Wong
BACKGROUND: Injuries in divers resulting purely from impact with the water are uncommon in the published literature. We present a case report of pulmonary contusion in a young diver. CASE REPORT: A young, healthy competitive platform diver landed flat on his back in the water from a dive of 10 meters. He complained of upper back pain and had an episode of hemoptysis after the dive. He was initially observed for 15 hours postinjury, and was discharged when three chest radiographs (CXRs) taken at 1, 7, and 11 hours postinjury did not show significant abnormalities...
February 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27751704/when-hydromorphone-is-not-working-try-loratadine-an-emergency-department-case-of-loratadine-as-abortive-therapy-for-severe-pegfilgrastim-induced-bone-pain
#17
Katherine Moore, Rachel Haroz
BACKGROUND: Intractable bone pain is a notorious adverse effect of granulocyte-colony stimulating factors (G-CSFs), such as pegfilgrastim and filgrastim, which are given to help prevent neutropenia in patients who are undergoing chemotherapy. G-CSF-induced bone pain is surprisingly common and often refractory to treatment with conventional analgesics. CASE REPORT: This article describes an emergency department case of opiate and nonsteroidal anti-inflammatory drug-resistant pegfilgrastim-induced bone pain that was successfully alleviated with 10 mg of oral loratadine, allowing for discharge home...
February 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27759752/pneumomediastinum-as-a-complication-of-mdma-3-4-methylenedioxymetamfetamine-ecstasy-ingestion
#18
Suleiman Ezoubi, Hassan Kahal, William Stephen Waring
MDMA (3,4-methylenedioxymethamfetamine, Ecstasy) is a widely used recreational drug. We present a case of pneumomediastinum as a complication of MDMA use in a 21-year-old man with no previous history of lung or gastrointestinal pathology. We have performed a literature review, and summarised the symptoms, signs, and prognosis for this under-recognised complication of a commonly used recreational drug. We recommend enquiring about illicit drug use in any patient presenting with spontaneous pneumomediastinum.
2016: Acute Medicine
https://www.readbyqxmd.com/read/27717235/exogenous-lipoid-pneumonia-induced-by-nasal-decongestant
#19
Giorgia A Osman, Alberto Ricci, Fabrizio Terzo, Carlo Falasca, Maria R Giovagnoli, Pierdonato Bruno, Andrea Vecchione, Salvatore Raffa, Sabatino Valente, Maria R Torrisi, Chiara De Dominicis, Simonetta Giovagnoli, Salvatore Mariotta
INTRODUCTION: Lipoid pneumonia is a clinical condition that may be initially asymptomatic or confused with an infectious or malignant lung disease. OBJECTIVES: We report four cases of this pathological condition. METHODS: The first case concerned an 85-year old woman with bilateral confluent pulmonary opacities, ground-glass type. Diagnosis was based on the cytology of the bronchoalveolar lavage (BAL) fluid followed by its ultrastructural examination...
September 22, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27698009/acute-eosinophilic-pneumonia-masquerading-as-multiple-pulmonary-embolisms
#20
Takeshi Saraya, Sunao Mikura, Miku Oda, Hajime Takizawa
A 47-year-old previously healthy man was admitted to the hospital with a 5-day history of fever, dry cough, and dyspnoea. Thoracic radiographs and CT scan showed extensive bilateral consolidation predominantly involving the central portions of the upper lung lobes, along with multiple scattered nodules. On taking a thorough history, it was found that the patient had visited a gritty 100-year-old Japanese folk house 1 week ago. An urgent bronchoscopy was performed, and the results were consistent with the findings of acute eosinophilic pneumonia (AEP)...
October 3, 2016: BMJ Case Reports
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