scholarly journals Pulmonary Involvement in Brucellosis

2012 ◽  
Vol 23 (1) ◽  
pp. e13-e15 ◽  
Author(s):  
Mehmet Uluğ ◽  
Nuray Can-Uluğ
Keyword(s):  
Rare Event ◽  
Lower Lobe ◽  
Pulmonary Involvement ◽  
Reticuloendothelial System ◽  
Residual Effects ◽  
Breath Sounds ◽  
Chest Auscultation ◽  
Night Sweats ◽  
One Year ◽  
The Right

BACKGROUND: Brucellosis is a zoonotic disease caused by a Gram-negative bacillus of theBrucellagenus with multisystem involvement, primarily affecting the reticuloendothelial system, joints, heart and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare.OBJECTIVE: To report a case of brucellosis with pulmonary involvement.CASE PRESENTAION: A previously healthy 36-year-old woman was admitted with complaints of fever, weakness, night sweats, dry cough and bilateral chest pain. She hed been diagnosed with pneumonia 20 days previously and was started on a course of ampicillin for 14 days, with no response. Her chest auscultation revealed diminished breath sounds and scattered crackles and rhonchi over the inferior zone of the right hemithorax. Wright and Coombs testing resulted in titres of 1:1280 and 1:640, respectively. Chest radiography revealed an area of confluent lobar consolidation in the right lower lobe. Treatment was started with a six-week course of oral doxycycline 200 mg/day and rifampicin 600 mg/day. This treatment regimen rapidly improved the patient’s condition. Follow-up after one year showed no residual effects from the infection.CONCLUSION: Pulmonary involvement is a rare event in the course of brucellosis, but the rate could be higher than currently estimated. In endemic regions, brucellosis should be considered as a causative agent in patients with pulmonary symptoms.

scholarly journals DisseminatedMycobacterium interjectumInfection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
David Sotello ◽  
D. Jane Hata ◽  
Mohammed Reza ◽  
Raj Satyanarayana ◽  
Vichaya Arunthari ◽  
...  
Keyword(s):  
Venous Catheter ◽  
Pulmonary Involvement ◽  
Healthy Children ◽  
Central Venous ◽  
Catheter Infection ◽  
First Case ◽  
Night Sweats ◽  
One Year ◽  
Central Venous Catheter Infection

We present a 49-year-old female with one year of intermittent fevers, chills, night sweats, and significant weight loss. Liver and lung biopsy showed evidence of a granulomatous process. Blood and liver biopsy cultures yielded growth of presumedMycobacterium interjectum, thought to be related to a disseminated long-term central venous catheter infection. She successfully received one year of combined antimicrobial therapy after catheter removal without recurrence of disease.M. interjectumhas been previously described as a cause of lymphadenitis in healthy children and associated with pulmonary disease in adults, although other localized infections have been reported. This is the first case described of a disseminatedM. interjectuminfection with bacteremia, hepatic and pulmonary involvement associated with a long-term catheter infection.

scholarly journals Rapidly Progressive Pulmonary Apical Fibrosis and Parenchymal Destruction in a Patient with Ankylosing Spondylitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hasan Ulusoy ◽  
Nazmiye Tibel Tuna ◽  
Aslı Tanrivermis Sayit
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Rare Complication ◽  
Granulomatous Inflammation ◽  
Pulmonary Involvement ◽  
High Resolution Computed Tomography ◽  
Thoracic Computed Tomography ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Pulmonary apical fibrosis is a rare complication of ankylosing spondylitis (AS). The essential characteristics of this lesion are its very slow progression and frequently asymptomatic nature. Herein, we are presenting a patient with AS who rapidly developed pulmonary apical fibrosis in a 3-year period despite decreased musculoskeletal pains. The 60-year-old male applied with complaints of progressively increasing cough in the recent two years, dyspnea, and fatigue. He had no chronic disease except AS. He had no continuous medication except nonsteroid anti-inflammatory drugs for 2-3 days monthly since his musculoskeletal pains decreased in the recent years. His physical examination revealed reduced breath sounds in the upper zones of the right lung. Chest X-ray revealed increased diffuse opacity in the upper zones of the right lung. Thoracic high-resolution computed tomography showed a consolidation accompanied with traction bronchiectases compatible with chronic fibrosis in the upper lobe of the right lung. However, thoracic computed tomography of the patient performed 3 years ago did not reveal pulmonary apical fibrosis and parenchymal destruction. Biopsy revealed no finding of malignancy, granulomatous inflammation, or vasculitis. The results of cultures were negative. So, the patient was diagnosed as pulmonary involvement of AS, which developed in a 3-year period. This case has shown that extra-articular complications may continue to develop in patients with AS even if their musculoskeletal complaints have subsided. So, patients with AS should be followed up regularly with systemic examinations.

scholarly journals Ocular Tuberculosis with Multiple Cerebral Abscesses

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Saidin Nor-Masniwati ◽  
Embong Zunaina ◽  
Yaakub Azhany
Keyword(s):  
Maintenance Phase ◽  
Mantoux Test ◽  
Significant Finding ◽  
Ocular Tuberculosis ◽  
Night Sweats ◽  
Normal Chest ◽  
One Year ◽  
Loss Of Appetite ◽  
The Right ◽  
Choroidal Tuberculoma

A 23-year-old Malay man presented with headache for one-month duration. It was associated with painless blurring of vision of the right eye. He had loss of appetite and reduced weight but no night sweats or hemoptysis. His visual acuity on the right eye was 6/45 and improved to 6/15 with pinhole. Right fundus examination revealed a choroidal tuberculoma located at one disc diameter away from optic disc superiorly with mild vitritis. Systemic examinations revealed no significant finding. Mantoux test reading was 22 mm with erythrocyte sedimentation rate that was 14 mm/h. Other blood investigations were negative with normal chest radiography. The computerized tomography scan of the brain revealed multiple cerebral abscesses. A clinical diagnosis of right ocular tuberculosis with multiple cerebral abscesses was made. He was treated with antituberculosis chemotherapy for one year which divided into intensive phase for three months and maintenance phase for nine months. Cerebral abscesses resolved after three months of antituberculosis drugs and at one-year follow-up, and the choroidal tuberculoma resolved completely with scar formation and significant macular striae.

scholarly journals Tomographic findings in bronchial atresia

2021 ◽  
Vol 54 (1) ◽  
pp. 9-14
Author(s):  
Elazir Barbosa Mota Di Puglia ◽  
Rosana Souza Rodrigues ◽  
Pedro Augusto Daltro ◽  
Arthur Soares Souza Jr. ◽  
Marilene Monteiro Paschoal ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Lung Parenchyma ◽  
Pulmonary Involvement ◽  
Middle Lobe ◽  
Pathological Examination ◽  
Surgical Specimen ◽  
Distal Lung ◽  
The Right ◽  
Ct Finding ◽  
Bronchial Atresia

Abstract Objective: To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. Materials and Methods: The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). Results: The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. Conclusion: The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.

scholarly journals Acute fibrinous organising pneumonia presenting as a cavitary lung lesion and treatment response to azithromycin

2019 ◽  
Vol 12 (8) ◽  
pp. e230868
Author(s):  
Waqas Aslam ◽  
Francisco Perez-Guerra ◽  
Deborah Jebakumar ◽  
Daniel A Culver ◽  
Shekhar Ghamande
Keyword(s):  
Treatment Response ◽  
Diffuse Alveolar Damage ◽  
Lower Lobe ◽  
Lung Lesion ◽  
Pleuritic Chest Pain ◽  
Imaging Studies ◽  
Ct Guided ◽  
Breath Sounds ◽  
Night Sweats ◽  
Subcarinal Lymph Node

Acute fibrinous organising pneumonia is distinct from the classic diffuse alveolar damage, organising pneumonia and eosinophilic pneumonia. A 52-year-old woman presented with fever, productive cough, night sweats and left-sided pleuritic chest pain for a week. Physical examination was significant only for decreased breath sounds in the left infraclavicular area laterally. Imaging studies revealed a peripheral thick-walled left upper lobe cavitary lesion, left lower lobe consolidation and an enlarged subcarinal lymph node. She was treated with doxycycline for 10 days without improvement. Pertinent laboratory tests, microbiologic workup and fibre-optic bronchoscopy were non-diagnostic and a CT-guided left upper lobe lung biopsy revealed acute fibrinous organising pneumonia. She was treated with azithromycin with complete resolution of symptoms. To our knowledge, this is the first reported case of acute fibrinous organising pneumonia presenting as a cavitary lung lesion and the first with treatment response to azithromycin.

A New and Safe Method to Control the Depth of Endotracheal Intubation in Neonates

PEDIATRICS ◽  
1974 ◽  
Vol 54 (4) ◽  
pp. 506-508
Author(s):  
Alexandra Loew ◽  
Donald W. Thibeault
Keyword(s):  
Endotracheal Intubation ◽  
Main Bronchus ◽  
Lower Lobe ◽  
Lung Field ◽  
Safe Method ◽  
Interstitial Emphysema ◽  
Breath Sounds ◽  
Present Technique ◽  
The Right

Endotracheal intubation in neonates is usually performed during emergency resuscitation. The most common and most serious complication of endotracheal intubation is placement of the tube in the right main bronchus followed by overventilation of the right lower lobe which is often associated with underventilation and atelectasis of the remainder of the lungs.1 If the inflation of the right lower lobe is excessive then alveolar rupture and interstitial emphysema may follow.2 The present technique of endotracheal intubation is to insert the tube into the trachea and then auscultate over both lung fields. If breath sounds are decreased over one lung field then the tube is slightly withdrawn.

scholarly journals SUN-129 Hipoinsulinemic Hipoglycemia Caused by Solitary Fibrous Tumor IGF-2 Producer: Case Report

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavia Tedesco Motta ◽  
Thamiris Freitas Maia ◽  
Paulo Enrique Peinado Noriega ◽  
Hially Ribeiro Cabral ◽  
Juliana Farhat ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Oral Prednisone ◽  
Tumor Resection ◽  
Lower Lobe ◽  
Oral Glucose ◽  
Intravenous Glucose ◽  
Breath Sounds ◽  
Mesenchymal Neoplasm ◽  
Fibrous Tumor ◽  
The Right

Abstract BACKGROUND: Solitary Fibrous Tumor is a mesenchymal neoplasm composed of CD34+ fibroblastic cells that can produce spontaneous hypoglycemia by the overproduction of IGF-2. It closely resembles the hypoglycemia characteristic of functioning islet cell tumors. CLINICAL CASE A 77-year-old male was found unconscious and taken to an emergency department with evidence of hypoglycemia and clinical improvement following intravenous glucose administration. He did not have a history of diabetes mellitus and was not taking any glucose lowering medications. He was discharged with nutritional orientation and for control of capillary glycaemia to prevent hypoglycemia. He had 3 episodes of capillary hypoglycemia (50, 45 and 38) at home, that was predominant in the fasting morning and during its occurrence he presented mild sweating, speech difficulty, staring and diplopia, with complete improvement of symptoms after oral glucose replacement. Months earlier, he sought an otolaryngologist for intermittent mild dyspnea; denied cough, hemoptysis, chest pain and unintentional weight loss. He performed chest X-ray with evidence of large right hemithorax mass. Physical examination revealed diminished breath sounds in the right middle and lower lung fields and dullness to percussion. Despite marked hypoglycemia (31 mg/dl), the serum insulin level was less than 0.6  μIU/mL (less than 3 μIU/mL), the C-peptide level was 0.24 nmol/L (less than 0,6 nmol/L), had negative ketonemia and a positive response after glucagon administration (glycaemia increased in 50 mg/dl). Anti-insulin antibodies were negative. Serum cortisol secretion and adrenocorticotropic hormone were normal. The serum level of growth hormone (GH) was 0,03 (less than 0,97ng/ml). The serum IGF-2 level was 227 ng/ml  (267 - 616 ng/ml), the IGF-I level was 72 ng/ml (37,1 - 172 ng/ml) and the IGF2/ IGF1 was 3,15 (equal or greater than 3). Computed tomographic (CT) scan revealed a large heterogeneous mass with dimensions of 17,4 × 15× 12.2 cm. It determines almost total atelectasis of the lower lobe on this side and maintains broad medial contact with the mediastinum, compressing the right atrium and the inferior pulmonary vein on this side. Preoperatively, was administered 40 mg oral prednisone with capillary glucose normalization. The tumor was completely resected and was a grayish-white solid, with dimensions of 17 x 16 x 12 cm. Immunohistochemical stains demonstrated positivity for CD34 and IGF2 expression. Postoperatively, serum glucose and insulin levels returned to normal, and episodes of hypoglycemia are resolved. CONCLUSION This case reinforce the importance of investigate IGF-2 tumor production as a cause of hypoinsulinemic hypoglycemia and reports the complete resolution of hypoglycemia after corticoid administration and/or tumor resection.

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

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