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Intersting case reports in pulmonary and critical care

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109 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27863462/liver-abscess-and-bacteremia-caused-by-lactobacillus-role-of-probiotics-case-report-and-review-of-the-literature
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
October 5, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27692838/pulmonary-contusion-and-traumatic-pneumatoceles-in-a-platform-diver-with-hemoptysis
#8
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...
September 28, 2016: 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
#9
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...
October 14, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27759752/pneumomediastinum-as-a-complication-of-mdma-3-4-methylenedioxymetamfetamine-ecstasy-ingestion
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27672457/acute-liver-and-renal-failure-a-rare-adverse-effect-exclusive-to-intravenous-form-of-amiodarone
#13
Robin Paudel, Prerna Dogra, Saurav Suman, Saurav Acharya, Jyoti Matta
Amiodarone is an antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias making it irreplaceable in certain group of patients. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone which resolved after stopping the medication. The mechanism of acute liver and renal toxicity is not clearly known but is believed to be secondary to amiodarone induced (relative) hypotension, idiosyncratic reaction to the drug, and toxicity of the vector that carries the medication, polysorbate-80...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27670679/tuberculous-spondylitis-diagnosed-through-xpert-mtb-rif-assay-in-urine-a-case-report
#14
George Sikalengo, Adria Ramirez, Diana Faini, Kim Mwamelo, Manuel Battegay, Levan Jugheli, Christoph Hatz, Klaus Reither, Emilio Letang
BACKGROUND: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10-35 % of EPTB cases, with vertebral osteomyelitis (Pott's disease) representing 50 % of the cases. We present two cases of suspected Pott's disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital...
September 26, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27656300/pneumothorax-causing-pneumoperitoneum-role-of-surgical-intervention
#15
Fernanda Duarte, Jessica Wentling, Humayun Anjum, Joseph Varon, Salim Surani
The most common cause of a pneumoperitoneum is a perforation of a hollow viscus and the treatment is an exploratory laparotomy; nevertheless, not all pneumoperitoneums are due to a perforation and not all of them need surgical intervention. We hereby present a case of pneumoperitoneum due to a diaphragmatic defect, which allowed air from a pneumothorax to escape through the diaphragmatic hernia into the abdominal cavity.
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27630781/systemic-air-embolism-associated-with-pleural-pigtail-chest-tube-insertion
#16
Emad Alkhankan, Ahmad Nusair, Rida Mazagri, Mohammed Al-Ourani
Pleural pigtail catheter placement is associated with many complications including pneumothorax, hemorrhage, and chest pain. Air embolism is a known but rare complication of pleural pigtail catheter insertion and has a high risk of occurrence with positive pressure ventilation. In this case report, we present a 50-year-old male with bilateral pneumonia who developed a pneumothorax while on mechanical ventilation with continuous positive airway pressure mode. During the placement of the pleural pigtail catheter to correct the pneumothorax, the patient developed a sudden left sided body weakness and became unresponsive...
2016: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/27601482/clot-extraction-with-the-flowtriever-device-in-acute-massive-pulmonary-embolism
#17
Aaron Samuel Weinberg, Suhail Dohad, Danny Ramzy, Hooman Madyoon, Victor F Tapson
Clinical guidelines support the use of systemic thrombolytic therapy for acute massive pulmonary embolism (PE). When anticoagulation and thrombolysis fail or are contraindicated, options become limited. We report an acute PE case in which treatment options were limited, and a novel device, the FlowTriever (Inari Medical, Irvine, California), was successfully used. This is the first case report of the use of this device that we are aware of.
September 6, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27520997/rivaroxaban-in-treatment-refractory-heparin-induced-thrombocytopenia
#18
Joshua Misha Lewis Casan, George Grigoriadis, Noel Chan, Sanjeev Chunilal
Following orthopaedic surgery, a 56-year-old woman developed heparin-induced thrombocytopenia (HIT), complicated by extensive proximal deep vein thrombosis. The patient did not respond to multiple conventional therapies; however, a prompt treatment response occurred after starting rivaroxaban at standard dosing. This case represents the first documentation of efficacy for rivaroxaban in the setting of treatment refractory HIT and strengthens the limited existing evidence for this agent in HIT.
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27478673/primary-pulmonary-amebiasis-complicated-with-multicystic-empyema
#19
Ali Zakaria, Bayan Al-Share, Khaled Al Asad
Amebiasis is a parasitic infection caused by the protozoan Entamoeba histolytica. While most infections are asymptomatic, the disease could manifest clinically as amebic dysentery and/or extraintestinal invasion in the form of amebic liver abscess or other more rare manifestations such as pulmonary, cardiac, or brain involvement. Herein we are reporting a case of a 24-year-old male with history of Down syndrome who presented with severe right side pneumonia complicated with multicystic empyema resistant to regular medical therapy...
2016: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/25034495/marked-serum-procalcitonin-level-in-response-to-isolated-anaphylactic-shock
#20
Jason Mann, Rodrigo Cavallazzi
The objective of this study was to present a case report that highlights the limitation of serum procalcitonin levels greater than 10 ng/mL as being almost exclusively secondary to septic shock. Data source was a medical intensive care unit patient at the University of Louisville. Anaphylactic shock may cause elevations of serum procalcitonin to levels greater than 10 ng/mL.
January 2015: American Journal of Emergency Medicine
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