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Respiratory Medicine Case Reports

A Haralsingh, R Rawlins
Tuberculosis (TB) is a significant public health problem in many developing countries. In many cases, tuberculosis may present a significant diagnostic challenge. A 32-year-old male Chinese immigrant presented to our institution with a fever and non-productive cough. He was found to have a right pleural effusion, for which a chest drain was inserted. His tuberculin skin test was unreactive (0mm) although he was not immunocompromised (HIV negative). All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for acid-fast bacilli...
2019: Respiratory Medicine Case Reports
Joe Aoun, Khabib Dgayli, Cynthia Abou Zeid, Gordon Wong, Peter LaCamera
The Boston Marathon is the most popular marathon in the New England region and attracts some of the most qualified athletes participating from the United States and abroad. The race occurs in April, a month in the northeast characterized by unpredictable weather. While there are a number of well described weather-related medical complications that occur during exercise, less is known about noncardiogenic pulmonary edema (NCPE) in marathon runners, a condition that most physician are unfamiliar with. This phenomenon has been described in the literature as a complication of severe hyponatremia and cerebral edema...
2019: Respiratory Medicine Case Reports
Nguyen Ho Lam, Tran Van Ngoc, Le Thuong Vu
Dysphagia is the most common symptom in symptomatic patients with aberrant right subclavian artery (ARSA) and also the risk factor of aspiration, especially in elderly patients. We presented an 84 year-old female patient with dysphagia induced by the compression of ARSA to the adjacent structures. Recurrent pneumonia and bibasilar bronchiectasis were recorded in the association with ARSA. We concluded that elderly patient with ARSA should be evaluated the pulmonary complications such as aspiration pneumonia and bronchiectasis...
2019: Respiratory Medicine Case Reports
Adaeze Chikaodinaka Ayuk, Diane Gray, Aneesa Vanker, Marco Zampoli
One third of the world's population is estimated to be infected with Mycobacterium tuberculosis . Tuberculosis (TB) is endemic in many sub-Saharan African counties. The burden is further made worse by the HIV scourge. The number of children with TB and its attendant complications, is equally on the rise. TB can mimic many diseases ranging from infections to malignancies. Among pleuro-pulmonary TB complications, exudative effusion is more common while chylothorax is rare and thus easily missed especially if not the classical milky appearance...
2019: Respiratory Medicine Case Reports
Noni Novisari Soeroso, Endah Galih Harina, Aryati Yosi
Scrofuloderma is a clinical form of secondary cutaneous tuberculosis. It is commonly characterized by bluish-red nodules that cover the lymph nodes, bones or joints, disrupting the affected tissue to be replaced with granulation tissue. We reported a case of 10-year-old boy with ulcers in the cervical and axillary region. The lesion began as papules, which gradually developed into nodules and pustules. Chronic cough was also found, however chest x ray was normal and sputum direct smear for acid fast bacil was negative...
2019: Respiratory Medicine Case Reports
Keigo Okamoto, Keiko Ueda, Masutarou Ichinose
Background: Most rib fractures are treated conservatively, but patients with severe trauma may require surgical treatment. We report a rare case of delayed pericardial injury due to a fractured rib stump. Case presentation: A 61-year-old man fell while riding a bicycle and was transferred to our hospital. A computed tomography (CT) scan showed mild rib fractures on the 4th-6th ribs, and he was hospitalized because of acute pain. A few days later, his respiratory condition had worsened...
2019: Respiratory Medicine Case Reports
Asma Iftikhar, Muhammad A I Cheema, Preethi Ramachandran, Sonu Sahni
Renal cell carcinoma (RCC) is a highly vascular tumor, which may spread to the lungs and other organs. It often presents with localized or systemic manifestation, including paraneoplastic syndromes. Sarcoidosis is a systemic granulomatous inflammatory disease characterized by non-caseating granulomas that typically afflicts the respiratory system. In the absence of any evidence of systemic sarcoidosis they are referred to as sarcoid-like reactions. Non-caseating epithelioid granulomas, also regarded to sarcoid-like granulomas have been described in association with certain malignancies such as carcinomas of the breast, colon, seminoma, and Hodgkin's lymphoma...
2019: Respiratory Medicine Case Reports
M Perruzza, E Fusha, P Cameli, P L Capecchi, E Selvi, F Gentili, M A Mazzei, S Aversa, D Spina, D Di Lucia, P Sestini, L Luzzi, E Bargagli
Pleuroparenchymal fibroelastosis (PPFE) is a rare interstitial lung disease characterized by the fibrotic thickening of subpleural and parenchymal areas of the upper lobes. It may be both idiopathic or secondary to infections, interstitial lung diseases and/or drug exposure. Often PPFE patients report recurrent lower respiratory tract infections, suggesting that repeated inflammatory alterations induced by pulmonary infections may contribute to the development/progression of PPFE. Here, we report for the first time the case of a patient affected by Giant cell Arteritis with histologically proven PPFE...
2019: Respiratory Medicine Case Reports
Takashi Sakai, Kazuyuki Yahagi, Tatsuhiro Hoshino, Toshiya Yokota, Kengo Tanabe, Masaya Mori, Shingo Ikeda
A 74-year-old man with lung adenocarcinoma recurrence was admitted to our hospital because of dyspnea 7 days after receiving initial immunotherapy with nivolumab. Electrocardiography revealed ST-segment elevation in V1-6 and echocardiography showed a markedly reduced left ventricular ejection fraction of 9% and akinesis of the anteroseptal wall and apex. He died from acute heart failure 3 days after admission. Microscopically, multiple small foci of myocardial necrosis with few inflammatory cells were scattered in both ventricles...
2019: Respiratory Medicine Case Reports
S Kepka, L Lemaitre, T Marx, P Bilbault, T Desmettre
Background: Primary Spontaneous Pneumothorax (PSP) is usually considered as a benign pathology occurring in young people. In about half of cases, observation only is purposed. In case of intervention, chest tube drainage remains the preponderant strategy even if no studies conclude about superiority of drainage or aspiration. Re-expansion pulmonary edema (REPE) is a rare but potentially severe complication of chest tube drainage. Risk factors are not well identified, but REPE is more frequent for patients with diabetes, younger than 40 years, with large pneumothorax, lung collapse more than one week and fast re-expansion...
2019: Respiratory Medicine Case Reports
Yasuhiro Kato, Yosuke Tanaka, Mitsunori Hino, Akihiko Gemma
We report a case of non-small-cell lung cancer (NSCLC) to small-cell lung cancer (SCLC) transformation after epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment. The patient was a man who diagnosed with EGFR-mutant advanced NSCLC. After he was introduced afatinib, his tumor had been reduced by the treatment. However, plasma pro-gastrin-releasing peptide (ProGRP) became higher with disease progression, and SCLC was detected at the second biopsy. It is suggested that elevation of plasma ProGRP level before EGFR-TKI therapy is useful for predicting EGFR-mutant NSCLC to SCLC transformation...
2019: Respiratory Medicine Case Reports
Dharti Patel, Arshad Muhammad Iqbal, Ateeq Mubarik, Nirali Vassa, Rania Godil, Mohamad Saad, Salman Muddassir
Septic pulmonary emboli is a rare condition due to the dislodgement of an infected thrombus traveling to the pulmonary vasculature via the venous system. Staphylococcus spp. and Candida spp. are the most common causative agents. The most common risk factor is intravenous drug abuse, but there has been an association with intravenous catheters. Delftia acidovorans (DA) is a rare organism causing catheter-related infection, which has a tendency to embolize and clog up major vessels. It is highly resistant to all available aminoglycoside agents...
2019: Respiratory Medicine Case Reports
H A Abdel Maksoud, Mohamed G Elharrif, M K Mahfouz, M A Omnia, M H Abdullah, M E Eltabey
inhalation of benzene vapours promote various and dangerous health problems. Fuel station workers are most susceptible to benzene inhalation toxicity. Samples were collected twice, at beginning of the study and 6 months later from 40 fuel station workers from different egyptian governorates and 10 control healthy volunteers. Fuel station workers were sub divided into four groups according to years working in the station. All of them are exposed to benzene vapours and exhausts during their duties, their work shifts were 8 hrs...
2019: Respiratory Medicine Case Reports
Camille R Petri, Rushad Patell, Felipe Batalini, Deepa Rangachari, Robert W Hallowell
Immune checkpoint inhibitors are known to cause a variety of immune-related adverse events, including pneumonitis. When symptomatic, treatment typically consists of temporary or permanent cessation of the checkpoint inhibitor and several weeks of corticosteroid therapy. However, a subset of patients may suffer from severe pneumonitis, and the optimal treatment for this group is not known. Here we describe the case of a patient receiving pembrolizumab for non-small cell lung cancer who developed severe checkpoint inhibitor pneumonitis...
2019: Respiratory Medicine Case Reports
Karim El-Kersh, Elie Homsy, Curt J Daniels, J Shaun Smith
Partial anomalous pulmonary venous return (PAPVR) is a rare congenital anomaly that results in a left-to-right shunt. Based on the shunt fraction, PAPVR has a wide spectrum of presentations. If a significant left-to-right shunt is left unrepaired, pulmonary vascular remodeling can occur resulting in the development of pulmonary arterial hypertension (PAH). Furthermore, if the condition is associated with an atrial septal defect (ASD), the patient can develop shunt reversal and Eisenmenger's syndrome in setting of severe PAH...
2019: Respiratory Medicine Case Reports
Melanie Rojas, Ateeq Mubarik, Elizabeth Ann Henderson, Fatima Agha, Lakshpaul Chauhan, Arshad Muhammad Iqbal, Ali Vaziri, Salman Muddassir
Neurofibromatosis Type 1 ( NF1 ) is an autosomal dominant genetic disorder with an incidence of approximately 1 in 4,000 live births [1] . Pulmonary arterial hypertension (PAH) is a rare but extremely life-threatening complication associated with NF1 . Timely recognition of this unusual and severe association between NF1 and PAH is imperative in prolonging the survival in this specific patient population. We present the clinical outcomes of a 47-year old female previously diagnosed with NF1 , who presented with progressively worsening dyspnea...
2019: Respiratory Medicine Case Reports
Kenneth Ofori, Helen Fernandes, Matthew Cummings, Thomas Colby, Anjali Saqi
Benign metastasizing leiomyoma (BML) is a rare benign smooth muscle neoplasm that originates in the uterus and metastasizes to distant sites-most commonly the lungs. BMLs are often found incidentally in patients with a history of uterine leiomyoma(s) and tend to be indolent. Occasionally they may be symptomatic and rarely follow an aggressive clinical course. We report an unusual case of BML presenting in a 46-year-old woman as a miliary nodular pattern bilaterally in the lungs and progressive respiratory failure...
2019: Respiratory Medicine Case Reports
Saad Ullah, Mirza Ali, Phyo Kyaw, Faraaz Nayeemuddin, Rajagopal Sreedhar, John Gao
Vasculitis refers to inflammation of the systemic vessels. Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis characterized by hypereosinophilia, pulmonary infiltrates, difficult to treat asthma and polyneuropathies. Diagnosis can often be challenging. In this article, we present a case of a young lady who was diagnosed ANCA negative EGPA.
2019: Respiratory Medicine Case Reports
Ajaypal Gill, Israel Ugalde, Christopher A Febres-Aldana, Claudio Tuda
Despite the advancements made in medicine and treatment of tuberculosis over the last century, it remains a significant healthcare challenge. It remains the leading cause of death from a single infectious agent and the ninth leading cause of death worldwide. A 23-year-old male with a history of tuberculosis treated in Nepal seven years prior, presented to the emergency department with one week of hemoptysis, fever, chills, night sweats and weight loss. A CT scan of the chest showed multiple cavitary lesions at the superior segment of the left lower lobe...
2019: Respiratory Medicine Case Reports
Matthew Rendo, Tyson J Sjulin, Michael J Morris, Sergio Burguete
There are multiple causes of dyspnea upon exertion in young, healthy patients to primarily include asthma and exercise-induced bronchospasm. Excessive dynamic airway collapse (EDAC) describes focal collapse of the trachea or main bronchi with maintained structural integrity of the cartilaginous rings. It is commonly associated with pulmonary disorders like bronchiectasis, chronic obstructive pulmonary disease and asthma. It is believed to result secondary to airway obstruction in these conditions. While uncommon in young, healthy adults, it has recently been found as a cause of dyspnea in this population...
2019: Respiratory Medicine Case Reports
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