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Case Reports in Pulmonology

Takeo Nakada, Yo Tsukamoto, Mitsuo Yabe, Takeyuki Misawa, Tadashi Akiba, Takashi Ohtsuka
An 84-year-old woman was referred to our institution with suspected right lung cancer. Subsequently, she underwent thoracoscopic right lower lobectomy without mediastinal lymph node dissection. Postoperatively, she complained of dyspnea and developed arterial oxygen desaturation after 12 h and acute respiratory failure (ARF). An emergency chest computed tomography revealed the right upper bronchial stenosis with hilar peribronchovascular soft tissue edema because the middle lung lobe had been pushed upward and forward and the right upper lung lobe had twisted dorsally...
2018: Case Reports in Pulmonology
M Abu Hishmeh, P Srivastava, Q Lougheide, M Srinivasan, S Murthy
Introduction: Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease...
2018: Case Reports in Pulmonology
Sheila A Habib, Robert C Vasko, Jack Badawy, Gregory M Anstead
Plastic bronchitis is the expectoration of bronchial casts in the mold of the tracheobronchial tree. It is a rare occurrence of unknown etiology that has been primarily described in children with congenital heart disease. In this case report, we present the first reported case of plastic bronchitis in a patient with pulmonary Kaposi sarcoma and underlying HIV infection.
2018: Case Reports in Pulmonology
Norikazu Kawai, Takeshi Kawaguchi, Takashi Tojo, Takao Osa, Yoshifumi Yamamoto, Motoaki Yasukawa, Noriyoshi Sawabata, Shigeki Taniguchi
Nontuberculous mycobacterial lung disease sometimes causes pneumothorax and empyema, which are often intractable because of patients' background factors. Biological products used in the treatment of rheumatoid arthritis have caused the problem of an increase in infection rates as a side effect, one of which is nontuberculous mycobacteriosis (NTM). On the basis of past experience, we report the case of a patient who had a history of undergoing treatment with biological products against rheumatoid arthritis. The patient was treated for NTM-induced pyopneumothorax by endoscopic bronchial occlusion therapy using endobronchial Watanabe spigots...
2018: Case Reports in Pulmonology
Adam Dallmann, Richard L Attanoos
Yellow nail syndrome is a rare acquired condition of unknown aetiology associated with distinct nail discolouration/xanthonychia, pulmonary manifestations, and lymphoedema. Pleural plaques and diffuse pleural thickening are typically, although not exclusively, recognised as markers of prior commercial asbestos exposure. The presence of such biomarkers may assist an asbestos personal injury evaluation. A postmortem examination performed on a 72-year-old man with known long-standing yellow nail syndrome identified pleural plaques and diffuse pleural thickening...
2018: Case Reports in Pulmonology
Claudio Galvis, Juan M Galvis, Juan Guardiola, Adrian P Umpierrez De Reguero
An aortic aneurysm is a permanent localized arterial dilation with more than 50% of the artery diameter. Among the complications of an aortic aneurysm, one of the rarest is the aorto-bronchial fistula, which presents with massive hemoptysis; this condition is lethal if not treated surgically. We report a 90-year-old man with no significant medical history who presented to the emergency department with abrupt onset of hemoptysis; his chest X-ray displayed left upper lobe opacity with widened mediastinum. CT chest revealed aneurysmatic dilatation of the aorta, left upper lobe opacity suspicious of pulmonary aortic fistula...
2018: Case Reports in Pulmonology
Muhammad Shabbir Rawala, Muhammad Farhan Khaliq, Muhammad Asif Iqbal, S Tahira Shah Naqvi, Kinaan Farhan, Andrew Myers, Kristen Helmick
Endometriosis is a common condition in which endometrial cells and stroma are deposited in extrauterine sites. Its prevalence has been estimated to be 10% of reproductive age females. It is commonly found in the pelvis; however, it may be found in the abdomen, thorax, brain, or skin. Thoracic involvement is a relatively rare presentation of this common disease. Thoracic endometriosis commonly presents as pneumothorax in 73% of patients. A rarer presentation of thoracic endometriosis is hemothorax (<14%) or hemoptysis (7%)...
2018: Case Reports in Pulmonology
Gustavo Adolfo Gómez Correa, Jovani Osorno Serna, Manuel Felipe Cáceres Acosta, Juan David Cáceres González, Jaime Andrés Calle Ramirez, Juan Paulo Sandoval Mesa, Miguel Ignacio Roldán Pérez
Case Description: A 72-year-old woman with primary Sjögren Syndrome (SS) was diagnosed during an inpatient hospital stay with dry symptoms. The patient had respiratory and constitutional symptoms, requiring a pulmonary imaging evaluation by high-resolution computed tomography (HRCT) of the thorax. Clinical Findings: Multiple cavitary pulmonary nodules, halo sign, and focal areas of ground-glass opacity with predominance in both bases were found in the images. Complementary studies were done where a neoplastic focus was ruled out...
2018: Case Reports in Pulmonology
Daniel C Sacher, Erika J Yoo
Acute pulmonary edema following significant injury to the central nervous system is known as neurogenic pulmonary edema (NPE). Commonly seen after significant neurological trauma, NPE has also been described after seizure. While many pathogenic theories have been proposed, the exact mechanism remains unclear. We present a 31-year-old man who developed recurrent acute NPE on two consecutive admissions after experiencing witnessed generalized tonic-clonic (GTC) seizures. Chest radiographs obtained after seizure during both admissions showed bilateral infiltrates which rapidly resolved within 24 hours...
2018: Case Reports in Pulmonology
Amjad Kanj, Hussam Tabaja, Ayman O Soubani, Nadim Kanj
Traumatic pulmonary pseudocyst (TPP) is a rare entity that occurs following a trauma to the chest. It usually presents as multiple cystic lesions on thoracic imaging. It is treated conservatively and tends to completely resolve after few months. In the absence of striking signs of trauma such as rib fractures, TPP can be mistaken for other cystic lung diseases. We present a case of TPP in a 17-year-old male who was seen for mild hemoptysis after falling off a cliff. The extent of his right lower lobe cystic lesions along with the lack of major signs of trauma led to an incorrect diagnosis of congenital pulmonary airway malformation...
2018: Case Reports in Pulmonology
Maria Mavromati, Annick Gerber, Gregor John
Pulmonary vein thrombosis (PVT) mainly occurs following lung transplantation but cases associated with thoracic malignancy have also been described. We describe here the first case of PVT in an asymptomatic patient with metastatic follicular thyroid carcinoma.
2018: Case Reports in Pulmonology
Waiel Abusnina, Hazim Bukamur, Zeynep Koc, Fauzi Najar, Nancy Munn, Fuad Zeid
Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy...
2018: Case Reports in Pulmonology
Tyler Pickell, Jamie Donnelly, Francois Abi Fadel
Desquamative interstitial pneumonia (DIP) is a rare interstitial pneumonia often caused by smoking. DIP is typically regarded as a chronic disease, but acute DIP exacerbations can occur, and some have resulted in death. Factors that can provoke a DIP exacerbation are not well described in the literature. We present a case of a 58-year-old male with DIP, who after being treated successfully with smoking cessation and steroids for 7 months, required hospitalization for acute hypoxemic respiratory failure. This acute episode was very likely an exacerbation of his DIP after a smoking relapse period of 6 weeks prior to this acute presentation...
2018: Case Reports in Pulmonology
Douglas Bretzing, Tasnim Lat, Andrew Shakespeare, Mary Lee, Salim Surani, Shekhar Ghamande
Patients with human immunodeficiency virus (HIV) have an increased risk of inoculation with nontyphoid Salmonella compared to the general population. While nontyphoid Salmonella commonly manifests as gastroenteritis, Salmonella bacteremia can be seen in patients with HIV. We present a case of disseminated Salmonellosis in a patient with HIV complicated by bronchopleural fistula and secondary empyema. Case Presentation. A 40-year-old African American male with HIV noncompliant with HAART therapy presented with complaints of generalized weakness, weight loss, cough, night sweats, and nonbloody, watery diarrhea of four weeks' duration...
2018: Case Reports in Pulmonology
Elpis Hatziagorou, Eleana Kouroukli, Vasiliki Georgopoulou, John Tsanakas
Novel targeted treatments for Cystic Fibrosis give rise to new hope for an ever-growing number of CF patients with various mutations. However, very little evidence and guidelines exist to steer clinical decisions regarding patients whose illness takes an unexpected course. In such cases, the benefits and risks of discontinuing these treatments must be carefully and individually weighed, since their long-term effects remain mainly uncharted territory. In this report we document the case of a homozygous F508del CF patient with severe lung disease who presented with a pulmonary exacerbation shortly after the beginning of treatment with lumacaftor/ivacaftor and the complicated initial phase of therapy, which was followed by significant improvements...
2018: Case Reports in Pulmonology
Michael Agustin, Michele Yamamoto, Felix Cabrera, Ricardo Eusebio
There has been a significant increase in electronic cigarette (e-cigarette) use since its introduction in 2007. Ironically, there remains very few published literature on the respiratory complications of e-cigarettes. The use of personalized vaporizers or commonly known as "vaping" has started to overtake standard e-cigarette. Its dynamic vaporizer customization makes it challenging to assess long-term health effects. Case reports on the pulmonary complications of e-cigarettes are limited to bronchiectasis, eosinophilic pneumonia, pleural effusion, and suspected hypersensitivity pneumonitis...
2018: Case Reports in Pulmonology
Sreeja Biswas Roy, Mitchell D Ross, Nikhil Madan, Hesham Abdelrazek, Rebekah Edwards, Earle S Collum, Ross M Bremner, Vipul J Patel, Tanmay S Panchabhai
Foreign body aspiration is relatively rare in adults compared to children. In adults with delayed presentation, a history of choking is often absent, resulting in delayed diagnosis and significant morbidity. Common presenting features in adults include nonresolving cough with or without fever, hemoptysis, or wheezing and may mimic infectious, inflammatory, or neoplastic disorders. We present a case of a 64-year-old man with 80-pack-year smoking history who had a nonresolving left lower lobe infiltrate on chest radiograph after treatment for community-acquired pneumonia...
2018: Case Reports in Pulmonology
Radhika Z Reddy, Yvonne M Carter, David W Hsia
Chronic retention of aspirated foreign bodies is rare but can result in indolent systemic and respiratory symptoms. Bronchoscopy may show features of tissue reaction to the foreign body, including granulation tissue, endobronchial stenosis, strictures, edema, and airway distortion. The diagnosis of foreign body aspiration is often difficult to establish since some patients may not give a clear history of aspiration or may present late. In addition, patients may be misdiagnosed with chronic pneumonia, bronchitis, asthma, or malignancy...
2018: Case Reports in Pulmonology
Zied Mezgar, Mariem Khrouf, Houda Ben Soltane, Mohamed Mahjoub, Sihem Ben Fredj, Amel Amara, Maher Jedidi, Samar Hajer Sandid, Sarra Zaouali, Ines Waz, Asma Saada, Mehdi Methamem
Hydatid pulmonary embolism rarely occurs. It arises from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst into the venous circulation. We report a case with pulmonary hydatidosis resulting in a massive bilateral pulmonary embolism in a 56-year-old woman with history of hepatic echinococcosis. A brief overview of clinical features and radiologic findings is presented.
2018: Case Reports in Pulmonology
Jasleen Kaur, Philip J McDonald, Ravinder D Bhanot, Reda A Awali, Sorabh Dhar, James Rowley
Bronchogenic cysts are rare congenital malformations which arise from abnormal budding of the primitive tracheobronchial tube and can localize to either the mediastinum or lung parenchyma. They remain clinically silent in most adults unless they become infected or are large enough to compress adjacent structures. Infections involving bronchogenic cysts are often polymicrobial. Gram-positive, Gram-negative, and mycobacterial infections have been reported, though frequently a pathogen is not identified. We present the case of a 46-year-old female with known history of bronchogenic cyst who presented with suspected postobstructive pneumonia...
2018: Case Reports in Pulmonology
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