scholarly journals Recurrent Wheezing and Cough Caused by Double Aortic Arch, Not Asthma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Qiao Zhang ◽  
Zhou Fu ◽  
Jihong Dai ◽  
Gang Geng ◽  
Wenlong Fu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Lung Function Test ◽  
Double Aortic Arch ◽  
Past Medical History ◽  
Recurrent Wheezing ◽  
Vascular Abnormality ◽  
Case Presentation ◽  
Function Test ◽  
History Of ◽  
Computed Tomography Angiogram

Introduction. Double aortic arch is a congenital vascular abnormality in which the connected segments and their branches course between and compress the trachea and esophagus, often resulting in invariable airway compression. Case Presentation. A 4-year-old boy with a history of recurrent wheezing was admitted to our hospital for evaluation of asthma based on his past medical history, persistent cough, wheezing, and airway hyperresponsiveness by lung function test. Double aortic arch was diagnosed with computed tomography angiogram. After surgery, the respiratory infection improved strikingly. Early diagnosis and treatment may prevent chronic, irreversible complications. Conclusion. We present a case of double aortic arch masquerading as asthma.

scholarly journals Asthma-like symptoms: is it always a pulmonary issue?

2018 ◽  
Vol 13 ◽  
Author(s):  
Davide Piloni ◽  
Claudio Tirelli ◽  
Rita Di Domenica ◽  
Valentina Conio ◽  
Amelia Grosso ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Aortic Arch ◽  
Pulmonary Function Tests ◽  
Vascular Ring ◽  
Final Diagnosis ◽  
Double Aortic Arch ◽  
Case Presentation ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
History Of

Background: Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts. Case presentation: A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood. Since the beginning, an intrathoracic obstruction was suspected at pulmonary function tests. After 1 month of complete asthma treatment, the cough was unchanged and the spirometry confirmed the presence of an intrathoracic obstruction. Then, she underwent a chest CT with contrast medium, a contrast transthoracic echocardiography, a fiberbronchoscopy and an esophageal radiography with contrast medium. The final diagnosis was made and a double aortic arch was found. Conclusion: A careful observation of the flow/volume curve should always be guaranteed and the presence of congenital vascular anomalies should be suspected in case of difficult-to-treat asthma.

DOUBLE AORTIC ARCH

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 751-768
Author(s):  
HERBERT E. GRISWOLD ◽  
MAURICE D. YOUNG
Keyword(s):  
Aortic Arch ◽  
Double Aortic Arch ◽  
Rare Type ◽  
Radiographic Findings ◽  
Descending Aorta ◽  
Vascular Abnormalities ◽  
History Of ◽  
The Right ◽  
The Given ◽  
Right Descending Aorta

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed. Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch. Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that: 1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic. 2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms. 3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component. 4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta. 5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare. The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.

scholarly journals Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related hypersensitivity pneumonitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michiru Sawahata ◽  
Noritaka Sakamoto ◽  
Hideaki Yamasawa ◽  
Yuki Iijima ◽  
Hirotoshi Kawata ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Propionibacterium Acnes ◽  
Lipoteichoic Acid ◽  
Specific Monoclonal Antibody ◽  
Past Medical History ◽  
Case Presentation ◽  
Different Types ◽  
History Of ◽  
First Time

Abstract Background The number of reports on sarcoidosis complicated by hypersensitivity pneumonitis (HP) is limited, and most describe cases complicated by chronic bird-related HP. Here, we present for the first time a case with Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related HP. Case presentation A 62-year-old man with a past medical history of sarcoidosis was admitted to our department, and chest computed tomography showed diffuse ground-glass opacities, which appeared as he rapidly increased the number of pigeons he kept for a competition. Random transbronchial lung biopsy revealed well-formed non-caseating epithelioid granulomas, which contained positively stained substances on immunohistochemistry using the PAB antibody, a specific monoclonal antibody against P. acnes lipoteichoic acid. Poorly formed non-caseating granulomas without positively stained substances were also detected. Conclusion We describe the successful identification of this exceptionally rare case of sarcoidosis complicated by acute bird-related HP in which two morphologically and immunohistologically different types of granulomas were present in the same lung.

scholarly journals Personalized Risk Assessment in Never, Light, and Heavy Smokers in a prospective cohort in Taiwan

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Xifeng Wu ◽  
Chi Pang Wen ◽  
Yuanqing Ye ◽  
MinKwang Tsai ◽  
Christopher Wen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Family History ◽  
Lung Function ◽  
Risk Prediction ◽  
Prospective Cohort ◽  
Lung Function Test ◽  
Function Test ◽  
History Of ◽  
Never Smokers ◽  
Heavy Smokers

Abstract The objective of this study was to develop markedly improved risk prediction models for lung cancer using a prospective cohort of 395,875 participants in Taiwan. Discriminatory accuracy was measured by generation of receiver operator curves and estimation of area under the curve (AUC). In multivariate Cox regression analysis, age, gender, smoking pack-years, family history of lung cancer, personal cancer history, BMI, lung function test, and serum biomarkers such as carcinoembryonic antigen (CEA), bilirubin, alpha fetoprotein (AFP), and c-reactive protein (CRP) were identified and included in an integrative risk prediction model. The AUC in overall population was 0.851 (95% CI = 0.840–0.862), with never smokers 0.806 (95% CI = 0.790–0.819), light smokers 0.847 (95% CI = 0.824–0.871), and heavy smokers 0.732 (95% CI = 0.708–0.752). By integrating risk factors such as family history of lung cancer, CEA and AFP for light smokers, and lung function test (Maximum Mid-Expiratory Flow, MMEF25–75%), AFP and CEA for never smokers, light and never smokers with cancer risks as high as those within heavy smokers could be identified. The risk model for heavy smokers can allow us to stratify heavy smokers into subgroups with distinct risks, which, if applied to low-dose computed tomography (LDCT) screening, may greatly reduce false positives.

Double aortic arch presenting with a foreign object in the oesophagus: a case report and imaging diagnosis

2017 ◽  
Vol 27 (8) ◽  
pp. 1651-1653
Author(s):  
Xiuzhen Yang ◽  
Jingjing Ye ◽  
Zhan Gao
Keyword(s):  
Aortic Arch ◽  
Ct Angiography ◽  
Subclavian Artery ◽  
Three Dimensional ◽  
Double Aortic Arch ◽  
Foreign Object ◽  
Right Loop ◽  
Dimensional Reconstruction ◽  
History Of ◽  
The Right

AbstractIn this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.

CEFEPIME-INDUCED COTARD SYNDROME: A CASE REPORT

2021 ◽  
Author(s):  
Molly Howland ◽  
Chelsea Markle ◽  
Jennifer Erickson ◽  
Thomas Soeprono
Keyword(s):  
Low Dose ◽  
Solid Organ Transplantation ◽  
Severe Depression ◽  
Solid Organ ◽  
Visual Hallucinations ◽  
Past Medical History ◽  
Case Presentation ◽  
Mri Brain ◽  
History Of ◽  
Acute Changes

Background: Cotard syndrome features nihilistic delusions about one’s body or existence and is typically related to severe depression though is rarely associated with medical or neurological insults. Case presentation: The patient was a 62-year-old male with no past psychiatric history and a past medical history of congestive heart failure and consequent renal failure who presented for scheduled heart and kidney transplantation. He was started on routine post-transplant ganciclovir and steroids. Due to postoperative hypotension, empiric cefepime was initiated to cover for septic shock. One week postoperatively, the patient stated “I am dead.” He elaborated that “an intern overdilated me” during transplantation and declined tacrolimus. The patient also reported visual hallucinations of green algae and bubbles. He denied depression and was attentive and oriented. He had a Bush-Francis score of 9. MRI brain revealed no acute changes. Low-dose haloperidol was initiated for psychosis. Cefepime was discontinued, but ganciclovir and steroids were continued. Two days later, the symptoms fully resolved. Discussion: This is the first reported case of Cotard syndrome as an acute transplant complication. Though corticosteroid-induced psychosis was initially suspected, cefepime neurotoxicity is the more likely explanation given the correlation between the antibiotic and symptom courses. Older age and renal dysfunction were risk factors. Conclusions: Cotard Syndrome can be an acute complication of solid organ transplantation, where renal impairment and polypharmacy are common. Transplantation teams and consult-liaison psychiatrists should work together to manage this syndrome.

scholarly journals Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation

2020 ◽  
Vol 4 (4) ◽  
pp. 634-635
Author(s):  
Taofiq Oyedokun ◽  
Kevin Durr
Keyword(s):  
Upper Airway ◽  
Mass Effect ◽  
Endoscopic Examination ◽  
Past Medical History ◽  
Fatal Complication ◽  
Case Presentation ◽  
History Of ◽  
Retropharyngeal Hematoma ◽  
Significant Mass Effect ◽  
Significant Mass

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.

scholarly journals A Case Report of Subacute Thyroiditis following mRNA COVID-19 Vaccine

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Leidy Plaza-Enriquez ◽  
P. Khatiwada ◽  
M. Sanchez-Valenzuela ◽  
A. Sikha
Keyword(s):  
Right Hemicolectomy ◽  
Subacute Thyroiditis ◽  
Deficiency Anemia ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Lumbar Radiculopathy ◽  
Past Medical History ◽  
Anterior Neck ◽  
Case Presentation ◽  
Pain Medications ◽  
History Of

Background. Subacute thyroiditis has been reported after administration of influenza vaccine. We describe a case of a patient who developed subacute thyroiditis after administration of. Moderna mRNA COVID-19 vaccine. Case Presentation. A 42-year-old female, with a past medical history of stage IIIB pT3N1aM0 right adenocarcinoma of colon status, after right hemicolectomy on 01/2020, followed by adjuvant chemotherapy, paroxysmal supraventricular tachycardia, iron deficiency anemia, chemotherapy-induced neuropathy, and lumbar radiculopathy, presented to our clinic with anterior neck pain that started 6 days after the second dose of Moderna mRNA COVID-19 vaccine. She was diagnosed with subacute thyroiditis and treated conservatively with pain medications. Conclusion. Subacute thyroiditis could represent one of the side effects of Moderna mRNA COVID-19 vaccine. Further reports are lacking.

scholarly journals Crazy-Paving: A Computed Tomographic Finding of Coronavirus Disease 2019

2020 ◽  
Vol 4 (3) ◽  
pp. 461-463
Author(s):  
Megan Gillespie ◽  
Patrick Flannery ◽  
Jessica Schumann ◽  
Nathan Dincher ◽  
Rebecca Mills ◽  
...  
Keyword(s):  
Imaging Finding ◽  
Radiographic Finding ◽  
Ground Glass ◽  
Past Medical History ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Global Pandemic ◽  
Imaging Characteristics ◽  
History Of

Introduction: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2.1 COVID-19 first occurred in Wuhan, China, in December 2019, and by March 2020 COVID-19 was declared a global pandemic.1 Case Presentation: We describe a case of a 52-year-old female with past medical history of asthma, type 2 diabetes, and previous tobacco use who presented to the emergency department with dyspnea and was found to be positive for COVID-19. We discuss the computed tomographic finding of “crazy-paving” pattern in the patient’s lungs and the significance of this finding in COVID-19 patients. Discussion: Emergency providers need to be aware of the different imaging characteristics of various stages of COVID-19 to appropriately treat, isolate, and determine disposition of COVID-19 infected patients. Ground-glass opacities are the earliest and most common imaging finding for COVID-19.2-4 Crazy-paving pattern is defined as thickened interlobular septa and intralobular lines superimposed on diffuse ground-glass opacities and should be recognized by emergency providers as a radiographic finding of progressive COVID-19.2-4

Colon Tumor Tattooing-Derived Ink-Laden Macrophages in Peritoneal Ascitic Fluid

2019 ◽  
Vol 64 (3) ◽  
pp. 270-273
Author(s):  
Álvaro López-Janeiro ◽  
Luis Blasco ◽  
Ana Margarita Rodriguez ◽  
Pilar Lopez Ferrer ◽  
Blanca Vicandi
Keyword(s):  
Medical History ◽  
Ascitic Fluid ◽  
Peritoneal Fluid ◽  
Anatomical Location ◽  
Colon Tumor ◽  
Past Medical History ◽  
Case Presentation ◽  
History Of ◽  
Exogenous Source

Introduction: Macrophages containing exogenous pigments are commonly encountered in cytological specimens. Case Presentation: We present a case of tumor tattooing as an infrequent exogenous source of peritoneal fluid macrophagic pigment in a 76-year-old female. Discussion and Conclusion: Tattooing-derived ink can be a source of macrophagic pigment and should not be confused with other endogenous or exogenous pigments. The anatomical location and past medical history of the patient can aid in the diagnosis.

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