scholarly journals Atypical Infections in Chronic Myeloid Leukaemia- Staphylococcus furunculosis and Aspergillosis

2020 ◽  
Vol 07 (01) ◽  
pp. 17-19
Author(s):  
Sharon T Mathews ◽  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Blast Crisis ◽  
Middle Lobe ◽  
Imatinib Therapy ◽  
X Ray ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
One Year ◽  
The Right

Incidence of opportunistic infection in patients of Chronic Myeloid Leukemia (CML) on Imatinib therapy is low. We report a case of a 47 year old lady, a known case of CML for one year on imatinib therapy who presented with CML in blast crisis with Staphylococcus furunculosis. Two weeks later she developed fever, cough and expectoration. She had cavitatory lesion in the right middle zone on chest x-ray. CECT Chest was suggestive of aspergilloma in right middle lobe. Infections in chronic myeloid leukemia are not very common. Also, developing such infections within such a short span of time, within one year of initiation of imatinib therapy is also rare. Hence, this case of CML with Staphylococcal furunculosis and Aspergillosis is being reported.

Radiographic Abnormalities in Acute Asthma in Children

PEDIATRICS ◽  
1974 ◽  
Vol 54 (4) ◽  
pp. 442-449
Author(s):  
Peyton A. Eggleston ◽  
Byron H. Ward ◽  
William E. Pierson ◽  
C. Warren Bierman
Keyword(s):  
Acute Asthma ◽  
Middle Lobe ◽  
Pulmonary Complications ◽  
Common Finding ◽  
X Ray ◽  
Age Dependent ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
Asthma In Children ◽  
The Right

To determine the incidence of radiographic abnormalities in acute asthma of children and adolescents, and to examine the contribution of the chest x-ray to their care, 515 asthma admissions were reviewed. Of these, 479 had admission chest films, 22.3% of which were abnormal. Significant perihilar infiltrates were the most frequent abnormality seen; atelectasis, especially of the right middle lobe, was the next most frequent. Pneumomediastinum was also a common finding. Both pneumomediastinum and infiltrates were strikingly age-dependent: 15.5% over 10 years old had pneumomediastinum; none under 2 years old had this complication; infiltrates occurred in nearly 25% of younger children but in only 8.3% over 10 years old. Since pulmonary complications substantially alter therapeutic management, a chest x-ray should be part of the initial evaluation of any child hospitalized with acute asthma.

scholarly journals Successful Treatment of Bulla with Endobronchial Valves

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Erdoğan Çetinkaya ◽  
Mehmet Akif Özgül ◽  
Şule Gül ◽  
Hilal Boyacı ◽  
Ertan Cam ◽  
...  
Keyword(s):  
Lung Function ◽  
Treatment Options ◽  
Forced Expiratory Volume ◽  
Middle Lobe ◽  
Functional Improvement ◽  
X Ray ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
The Right ◽  
End Stage

Emphysematous bullae are a complication of end-stage COPD. Patients with large bullae and poor respiratory function have limited treatment options. Surgical resection is a recognized treatment, but functional improvement after bullectomy is not satisfactory in patients with forced expiratory volume in 1 s (FEV1) < 35% predicted. When this 59-year-old male end-stage COPD patient was assessed, he was cachectic and lung function tests showed a FEV1 of 0.56 L (19% predicted) and a RV of 7 L (314% predicted), while 6MWT was 315 m and MRC dyspnea score was 4. Chest X-ray revealed a massive bulla of 10 cm in diameter in the right middle lobe. A fibrobronchoscopy was performed under local anesthesia and 2 Zephyr 4.0 valves were placed in the right middle lobe. Chest X-ray and CT scan performed 36 days later showed the complete resolution of the bulla. Seven months later, the patient demonstrated an improvement in FEV1 (+30%) and a decrease in RV from 314 to 262% predicted. This case report shows that the Zephyr valves may be successfully used to treat a large bulla in the right middle lobe in a patient with diffuse emphysema and severely impaired lung function.

scholarly journals Prolonged RNA shedding of the 2019 novel coronavirus in an asymptomatic patient with a VP shunt

2020 ◽  
Vol 13 (9) ◽  
pp. e237720
Author(s):  
Firas El-Baba ◽  
Danielle Gabe ◽  
Allan Frank
Keyword(s):  
Paranoid Schizophrenia ◽  
Middle Lobe ◽  
Psychiatric Facility ◽  
Vp Shunt ◽  
Viral Shedding ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
Novel Coronavirus ◽  
The Right ◽  
Inpatient Psychiatric Facility

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.

scholarly journals Hydropneumothorax Revealing a Pneumoblastoma in Children

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karima El Fakiri ◽  
Ghizlane Draiss ◽  
Noureddine Rada ◽  
Mohammed Bouskraoui ◽  
Abderrachid Hamdaoui ◽  
...  
Keyword(s):  
Outer Segment ◽  
Middle Lobe ◽  
High Grade ◽  
Cystic Lesions ◽  
Type Ii ◽  
Pathological Study ◽  
X Ray ◽  
Thoracic Drainage ◽  
Chest X Ray ◽  
The Right

Pneumoblastoma is a rare primary childhood tumor. We report the observation of an infant aged 2 years and 8 months who presented with dry cough and dyspnea. The physical examination found mixed pleural effusion syndrome on the right. The chest X-ray revealed a right pneumothorax. Biology has shown leukocytosis at 16,000/mm3. The CT scan revealed parenchymal air cystic lesions affecting the outer segment of the middle lobe mimicking a pulmonary malformation. Thoracic drainage brought back 100 ml of the fluid. Two months later, when a pyopneumothorax appeared, a medium lobectomy was performed. Pathological study specimen showed a high-grade type II pneumoblastoma The extension assessment identified a secondary hepatic location. Chemotherapy has been indicated. This observation illustrates the diagnosis challenge of pneumoblastoma in children.

scholarly journals Ponatinib as a Valid Alternative Strategy in Patients with Blast Crisis-Chronic Myeloid Leukemia Not Eligible for Allogeneic Stem Cells Transplantation and/or Conventional Chemotherapy: Report of a Case

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Cristina Bucelli ◽  
Daniele Cattaneo ◽  
Valeria Ferla ◽  
Manuela Zappa ◽  
Caterina de Benedittis ◽  
...  
Keyword(s):  
Stem Cells ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Blast Crisis ◽  
Cytogenetic Response ◽  
Molecular Response ◽  
T315i Mutation ◽  
Stem Cells Transplantation ◽  
One Year

Currently, imatinib and dasatinib are the only tyrosine-kinase inhibitors approved in the US and Europe for the treatment of blast crisis of chronic myeloid leukemia (BC-CML) at diagnosis, while ponatinib is the only inhibitor used in patients bearing T315I mutation. Here we report the case of a 61-year-old man diagnosed with B-cell lymphoid BC-CML, initially treated with imatinib 800 mg day and then with dasatinib 140 mg day because of intolerance. A complete cytogenetic response (CCyR) was achieved at three months; however, three months later a relapse was observed, and the T315I mutation was detected. Ponatinib 45 mg once daily was then started together with a short course of chemotherapy. Bone marrow evaluation after six months of therapy showed the regaining of CCyR, together with the achievement of a deep molecular response. However, one year from ponatinib start the patient experienced a new disease relapse; he was effectively treated with ponatinib and chemotherapy once again, but in the meanwhile an ischemic stroke was detected. This case report confirms the high efficacy of ponatinib monotherapy in BC-CML patients, representing a valid option for non-allogeneic stem cells transplantation eligible cases and the only one available for those carrying the T315I mutation.

Progression of Chronic Myeloid Leukemia to Blast Crisis During Treatment With Imatinib Mesylate

2004 ◽  
Vol 128 (9) ◽  
pp. 980-985
Author(s):  
Yin Xu ◽  
Andrea E. Wahner ◽  
Phuong L. Nguyen
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Chronic Myeloid Leukemia ◽  
Imatinib Mesylate ◽  
Marrow Transplantation ◽  
Myeloid Leukemia ◽  
Blast Crisis ◽  
Chronic Phase ◽  
Imatinib Therapy

Abstract Context.—Previous investigators have reported discrepancies between hematologic, marrow morphologic, and cytogenetic responses to imatinib mesylate among patients with chronic myeloid leukemia (CML). In addition to disease refractoriness, rare instances of disease progression from chronic phase to blast crisis during imatinib therapy have recently been anecdotally reported. Objectives.—To describe the clinicopathologic features of 3 patients with CML who rapidly progressed from chronic phase to blast crisis while taking imatinib and to perform a review of the literature. Design.—Morphologic, immunophenotypic, and cytogenetic analyses were performed on the 3 patients at the time of initial diagnosis, during imatinib therapy, and at blast crisis. Results.—The 3 patients were men, aged 39, 42, and 43 years. Two had been treated with hydroxyurea for 16 and 21 months before imatinib therapy, while 1 was started on a regimen of imatinib following diagnosis. Despite a hematologic response in all 3 patients, none of them achieved cytogenetic remission, and all progressed to blast crisis at 7 to 10 months of imatinib therapy. Blood findings during blast transformation were heterogeneous, including normal blood morphologic findings in 1 patient, leukocytosis with circulating blasts and basophilia in 1, and marked pancytopenia in 1. All 3 marrow specimens demonstrated moderate to marked diffuse reticulin fibrosis with more than 20% blasts. Clonal cytogenetic evolution was evident in 2 of the 3 patients and included an extra Philadelphia chromosome in both. All 3 patients underwent allogeneic bone marrow transplantation. One was alive with no evidence of disease at 14 month follow-up, while 2 had residual disease after bone marrow transplantation and died of complications at 4 and 5 months after transplantation. Conclusions.—Blood data did not always reflect marrow status. Therefore, bone marrow follow-up is critical for monitoring of response. Our findings suggest that significant progression of marrow reticulin fibrosis during imatinib therapy can be an indicator for a return or progression of CML and, in some patients with CML, imatinib may promote cytogenetic clonal evolution, resulting in a poor response to treatment.

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