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Intersting case reports in pulmonary and critical care

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Z Htet
Non-traumatic rhabdomyolysis induced by alcohol appears to cause serious clinical implications and could result in catastrophic consequences. We describe a patient who developed rhabdomyolysis following acute alcohol intoxication which led to severe kidney injury requiring dialysis therapy. This case also illuminates the fact that deranged liver function can result from a significant skeletal muscle injury in the absence of a concomitant liver pathology.
2018: Acute Medicine
Kristin D'Silva, Sarah Brown, Gary M Hunninghake, Marina Vivero, Joseph Loscalzo
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information by sharing relevant background and reasoning with the reader (regular type). The authors’ commentary follows. Stage. A 42-year-old man..
March 7, 2019: New England Journal of Medicine
James T Rosenbaum, Lana M Rifkin, Karen A Buch, Miriam B Barshak, Mai P Hoang
New England Journal of Medicine, Volume 380, Issue 11, Page 1062-1071, March 2019.
March 14, 2019: New England Journal of Medicine
Colin Casault, Juan G Posadas-Calleja
Background: We describe a case of secondary Hemophagocytic Lymphohistiocytosis (HLH) from autoimmune hepatitis mimicking severe sepsis in a man admitted to the intensive care unit. Case Presentation: A 34-year-old Pakistani male with a prior history of biopsy-proven autoimmune hepatitis presented to a regional hospital with severe fever, cytopenias, hyperferritinemia, hypertriglyceridemia, splenomegaly, and a bone marrow biopsy showing hemophagocytosis. After ruling out mimicking conditions, a diagnosis of HLH was made using the HLH-2004 diagnostic criteria...
2019: Case Reports in Critical Care
Gulhan Ertan, Sila Ulus, Rukiye Kilicarslan, Mesut Yilmaz, Yahya Paksoy, Cengiz Erol
Hydatid cyst disease is a zoonosis caused by the parasite Echinococcus. It may infest any organ of the body, but it most frequently involves the liver, lungs, and nervous system. Portal vein involvement by hydatid cyst disease is extremely rare with only five cases published in the English literature to our knowledge. We present the ultrasonography (US) and computed tomography (CT) findings of a 77-year-old male with hydatid disease of the liver with portal vein invasion mimicking portal vein thrombosis. Colour Doppler US confirmed the lack of blood flow within the portal vein and stigmata of cavernomatosis...
March 7, 2019: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Niclas Lundström, Gert Henriksson, Ola Börjesson, Malin Jonsson Fagerlund, Johan Petersson
We present a case of repeated cardiac arrests derived from dynamic hyperinflation in a patient with severe tracheobronchomalacia. Mechanical ventilation led to auto-PEEP with hemodynamic impairment and pulseless electric activity. Adjusted ventilation settings, deep sedation, and muscle paralysis followed by acute stenting of the affected collapsing airways restored ventilation and prevented recurrent circulatory collapse. We briefly review the pathophysiology and treatment options in patients with dynamic hyperinflation...
2019: Case Reports in Critical Care
C Laivier, M-O Bleuze, P Hantson, J Devos
A 53-year-old man developed a Legionella pneumophila pneumonia complicated by rhabdomyolysis, acute kidney injury, and protracted ileus. Risk factors were smoking and chronic alcoholism, but the patient had no history of previous abdominal surgery. Hemodialysis was required for a period of 5 weeks with a full renal recovery. Pneumonia required respiratory support but for a limited period of 6 days. The protracted course of the ileus led to explorative laparotomy despite negative computed tomography findings...
2019: Case Reports in Critical Care
C A Sykes, J Shepherd, C McGoldrick, N Kennedy, A Raafat
We present a case of pulmonary tuberculosis treated with a rifampicin (RMP) containing regimen, which led to marked haemolysis and acute kidney injury. The patient was shown to have RMP-induced haemolysis on detailed immunological testing. RMP is described as a rare cause of drug-induced haemolysis in the literature. However, it is a widely used drug and this complication may be severe. RMP-induced haemolysis precludes further treatment with the drug. Clinicians should consider this possibility and seek advice if patients on RMP develop haemolysis...
February 1, 2019: International Journal of Tuberculosis and Lung Disease
Jakrin Kewcharoen, Paul Morris, Chanavuth Kanitsoraphan, Hanh La, Narin Sriratanaviriyakul
Background: Simultaneous bilateral primary spontaneous pneumothorax (SBPSP) is an extremely rare and potentially fatal condition. Patients usually have no relevant medical conditions. Some cases, however, may have certain risk factors such as smoking, being young, and male gender. We reported a case of a healthy young male who presented with BPSP. Case Presentation: A 21-year-old man with a past medical history of well-controlled intermittent asthma presented with acute worsening shortness of breath overnight...
2019: Case Reports in Pulmonology
Won Gu Lee
Carbon monoxide (CO) poisoning is one of the most serious medical emergencies causing life-threatening conditions, including cardiovascular and neurological sequelae. Acute CO poisoning can lead to myocardial ischemia, ventricular arrhythmia, syncope, seizures, and coma. Seizures and other neurological complications in the early stages of presentation are related to severe intoxication in CO poisoning. In such situations, aggressive hyperbaric oxygen therapy is recommended. In CO poisoning, non-convulsive status epilepticus has rarely been observed following hyperbaric oxygen therapy (HBO2 )...
December 2018: Journal of Epilepsy Research
Sophia Vu, Ashley Iams, Andra Blomkalns
BACKGROUND: Methemoglobinemia is a rare dyshemoglobinemia that can be difficult to diagnose due to its nonspecific symptomatology and infrequent occurrence. A number of commonly used medications have been known to contribute to this disease process that results in acute hypoxemia. CASE REPORT: A 60-year-old man with history of acquired immunodeficiency syndrome presented to the Emergency Department (ED) with asymptomatic hypoxia. Supplemental oxygen proves to be ineffective in treating his low oxygen saturation...
February 22, 2019: Journal of Emergency Medicine
Shahab Rezvani, Marie Tominna, Sayf Al-Katib, Marc D Smith, Craig Cousineau, Ayad Al-Katib
Lymphomatoid granulomatosis (LG) is an EBV-associated angiodestructive lymphoproliferative disease with multiorgan involvement that predominantly affects the lungs. We present a case of a 72-year-old man with a history of chronic lymphocytic leukemia who presented with upper respiratory symptoms and multiple erythematous skin papules. Chest CT showed ill-defined, irregular solid pulmonary nodules with peripheral ground-glass opacities in a peribronchovascular distribution. The differential for this pattern of lung disease is vast which includes but is not limited to infection, vasculitis, sarcoidosis, lymphoma, and Kaposi sarcoma...
2019: Case Reports in Pulmonology
Yusuke Fujioka, Naohiro Oda, Reo Mitani, Tsuyoshi Hyodo, Ichiro Takata
Sarcoidosis is a multisystem noncaseating granulomatous disorder of unknown etiology that can be found in almost any organ, but symptomatic respiratory muscle involvement is rare. We herein report the case of a 77-year-old woman with diaphragm sarcoidosis diagnosed by a computed tomography (CT)-guided needle biopsy that was successfully treated with a corticosteroid. The patient presented with dyspnea that lasted for two weeks and respiratory failure. CT revealed diffuse diaphragm thickening with contrast enhancement, which might be a characteristic imaging finding for diaphragm myopathy/myositis, including sarcoidosis...
February 25, 2019: Internal Medicine
Sarah Birkhoelzer, Alexandra Belcher, Helen Peet
A diagnostic dilemma occurred when thrombotic microangiopathy developed during pregnancy. The diagnostic criteria of thrombotic microangiopathy include thrombocytopenia (platelets <100) and microangiopathic haemolytic anaemia (including thrombotic thrombocytopenic purpura and haemolytic-uraemic syndrome). An urgent interdisciplinary approach is required to treat thrombotic microangiopathy in pregnancy to differentiate between thrombotic microangiopathy and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)...
November 2017: Journal of the Intensive Care Society
Andrew Ratcliffe, Andrew Baker, Daniel Smith
Acetic acid is an organic acid available in concentrations from 2 to 80%. Whilst lower concentrations of 2-6% are more commonly used as the table top condiment, vinegar, much stronger solutions are regularly used in Eastern Europe as food preservatives and cleaning solutions. Oral ingestion of greater than 12% has been reported to cause haemolysis, renal failure, shock and death. Most reported cases of deliberate or accidental poisoning are from Russia and Eastern Europe in the 1980s, with very little currently in western publications...
February 2018: Journal of the Intensive Care Society
C Kaye, I MacLeod, M Dhillon
A patient suffered significant bleeding during an attempt at percutaneous dilatational tracheostomy due to an aberrant anterior jugular vein. Bleeding was controlled with pressure temporarily, but quickly returned necessitating conversion to an open technique. We present an algorithm for the management of significant peri-procedural bleeding during this procedure.
February 2018: Journal of the Intensive Care Society
Athanasios K Konstantinidis, Vlasios V Vitsas, Konstantinos Tatsis, Thomas Vadivoulis, Apostolos Kittas, Christos Chronis, Vanesa Bellou, Ioannis N Vamvakaris, Rodoula Tringidou, Grigoris K Stratakos
BACKGROUND: Postpneumonectomy-like syndrome is a rare condition resulting from unilateral lung disease with severe lung volume loss leading to excessive mediastinal shift and herniation of the healthy lung into the contralateral hemithorax, mimicking the mediastinal shift observed in postpneumonectomy syndrome after pneumonectomy. We report a unique case of postpneumonectomy-like syndrome caused by an atypical bronchial carcinoid completely occluding the left main bronchus. CASE PRESENTATION: A 25-year-old woman presented with symptoms of chronic exertional dyspnea and productive cough...
February 18, 2019: BMC Pulmonary Medicine
Mahmood Dhahir Al-Mendalawi
No abstract text is available yet for this article.
January 2019: Annals of Thoracic Medicine
G Mascia, D Argiolas, E Carta, M B Michittu, G B Piredda
BACKGROUND: Persistent hyperparathyroidism is one of the main causes of hypercalcemia following kidney transplantation; differential diagnosis is required. CASE PRESENTATION: We report the case of a 61-year-old kidney transplant recipient who underwent transplant in September 2016. She was admitted in March 2017 presenting with a 3-week history of asthenia, hypotension, and cough. Laboratory analysis showed acute kidney injury with hypercalcemia and elevation of inflammatory markers...
January 2019: Transplantation Proceedings
Junping Fan, Ruie Feng, Xiaomeng Hou, Ji Li, Xuefeng Sun, Jinglan Wang, Juhong Shi, Mengzhao Wang, Yan Xu
BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) encompasses a group of immune-mediated disorders that are gaining increasing recognition. Pulmonary presentations are common, with four types of patterns been described on radiography, including solid nodular, bronchovascular, ground glass opacities, and alveolar interstitial. Pleural thickening and pleural effusion have also been reported. However, there have been no reports of IgG4-RD that presents as spontaneous hemothorax. CASE PRESENTATION: A 61-year-old Chinese woman experienced recurrent right-sided chest pain and transient syncope...
February 1, 2019: BMC Pulmonary Medicine
2019-02-04 11:49:51
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