scholarly journals A “Galactic” Chest X-ray

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 899
Author(s):  
Cristiano Carbonelli ◽  
Angela de Matthaeis ◽  
Antonio Mirijello ◽  
Concetta Di Micco ◽  
Evaristo Maiello ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Pulmonary Involvement ◽  
Diagnostic Techniques ◽  
Low Grade ◽  
X Ray ◽  
Endoscopic Techniques ◽  
Metastatic Lesions ◽  
Chest X Ray ◽  
Radiological Pattern ◽  
Specific Symptoms

Clinical manifestations accompanying respiratory failure with insidious and rapidly progressive onset are often non-specific. Symptoms such as a cough, dyspnea, and fever are common to a large number of inflammatory, infectious, or neoplastic diseases. During the COVID-19 pandemic it is essential to limit the use of hospital services and inappropriate diagnostic techniques. A particular radiological pattern can orient the clinical and laboratory scenario and guide the diagnostic workup. A 58-year-old woman was admitted to our COVID-19 unit for suspected coronavirus infection. She was complaining of worsening dyspnea, tachycardia, and low grade fever. A chest X-ray showed diffuse, alveolar, and interstitial lung involvement with micronodules tending to coalescence. This radiographic pattern known as “galaxy sign”, consistent with diffuse, coalescing nodular miliary pulmonary involvement, simulating a non-specific alveolar opacification of the lungs is typical of a few pneumological differential diagnoses, represented by sarcoidosis, tuberculosis, pneumoconiosis, and metastatic lesions, and virtually excludes an interstitial viral pneumonitis. The use of endoscopic techniques can, in such cases, confirm the clinical suspicion for initiating appropriate targeted therapies.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

Effectiveness of X-ray and computed tomography screening for assessing pulmonary involvement in patients with head and neck squamous cell carcinoma

2008 ◽  
Vol 122 (9) ◽  
pp. 961-966 ◽  
Author(s):  
S C L Leong ◽  
F Javed ◽  
S Elliot ◽  
S Mortimore
Keyword(s):  
Computed Tomography ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Pulmonary Involvement ◽  
Neck Squamous Cell Carcinoma ◽  
Newly Diagnosed ◽  
X Ray ◽  
Chest X Ray

AbstractObjectives:To evaluate the benefits of chest computed tomography and X-ray as screening tools in patients with newly diagnosed head and neck squamous cell carcinoma, to determine the incidence of lung metastases or synchronous pulmonary lesions, and to evaluate factors associated with positive radiological findings.Design:Five-year, retrospective survey of all newly diagnosed cases of head and neck squamous cell carcinoma.Results:We included 102 patients (63 men and 39 women), with a mean age of 67 years (range 33–91 years). The incidence of pulmonary involvement was 17 per cent. The sensitivity and specificity of computed tomography were 100 and 89.8 per cent, respectively. For chest X-ray, the sensitivity was 35.7 per cent and the specificity 92.7 per cent. The accuracy of computed tomography was 91.5 per cent and that of chest X-ray 83.1 per cent. There was a clear correlation between higher nodal stage and larger tumour with the development of distant metastases. In patients with a positive chest computed tomography scan, 86 per cent had T3or T4tumours, in contrast to 38 per cent of those with a negative chest scan (p < 0.05). In addition, 71 per cent of patients with positive findings had N2or N3nodal disease, compared with 29 per cent of those with negative findings (p < 0.05).Conclusion:There is currently no consensus on the use of chest X-ray and computer tomography for screening newly diagnosed cases of head and neck squamous cell carcinoma. We recommend routine scanning of high-staged head and neck squamous cell carcinoma. The National Institute of Health and Clinical Excellence guidelines should be reappraised.

scholarly journals Role of gene Xpert test in clinical TB suspect in children

2018 ◽  
Vol 5 (4) ◽  
pp. 1657
Author(s):  
Sheenu Gupta ◽  
Veerana Kotrashetti ◽  
Rizwan Ahmed
Keyword(s):  
Diagnostic Tests ◽  
Clinical Manifestations ◽  
Childhood Tuberculosis ◽  
Mantoux Test ◽  
Gastric Aspirate ◽  
X Ray ◽  
Tb Treatment ◽  
Childhood Tb ◽  
History Of ◽  
Chest X Ray

Background: Tuberculosis (TB) is a major global health problem. Childhood tuberculosis (TB) is common in our community but it is relatively neglected, due to greater challenges in diagnosis. Clinical manifestations of childhood TB differ from adults. The diagnosis in most cases is based on clinical evidence but chest X-ray, Mantoux test, history of Kochs contact, malnutrition and sputum/gastric sample microscopy are important supporting investigations. WHO recommended use of newer diagnostic tests like Gene Xpert in pediatric cases where TB is mostly paucibacillary and identification of TB bacilli is difficult for confirmation of diagnosis.Methods: This prospective study was conducted among admitted and OPD patients in the department of Pediatrics over a period of 1and half year. Clinically suspected cases of TB in the age group 0-12 years who met the diagnostic criteria made the study group. Refusal of consent by parent and children already on TB treatment were excluded from this study. Investigations like chest X-ray, Mantoux test, sputum/gastric aspirate microscopy and Gene Expert were done to confirm the clinical diagnosis.Results: Pulmonary tuberculosis was more common (28%), TB lymphadenitis 22%, TB meningitis 14%, Tubercular Pleural effusion 12 %. and rest were no TB. BCG scar was present in 90%. History of contact was present in 76% and Mantoux test was positive in 76%. Gene Expert was positive only in one case in our study rest 49 cases were negative. The most common symptoms were fever (72%), cough (52%) and weight loss (40%).Conclusions: This study supports that detailed history, clinical evaluation and active investigative workup in addition to newer diagnostic tests like Gene Xpert has a major role in diagnosing childhood tuberculosis.

scholarly journals Metastasis of Epidermoid Cervical Carcinoma Cell to The Orbit

2018 ◽  
Vol 12 (1) ◽  
pp. 31
Author(s):  
Widiastuti Widiastuti ◽  
Rachmi Fauziah Rahayu ◽  
Djoko Susianto ◽  
Rita Budianti ◽  
Heru Priyanto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Cancer ◽  
Public Hospital ◽  
Compression Fracture ◽  
Abdominal Ultrasonography ◽  
X Ray ◽  
Metastatic Lesions ◽  
Normal Chest ◽  
Chest X Ray ◽  
The Right

Orbital metastases of cervical cancer cell are very rare. There is only one case reported in Dr. Moewardi Public Hospital Surakarta between 1999 and 2017. A 45-year-old woman was admitted with the upper right orbital lesion. She had not received a routine gynecologic examination for more than 10 years. She had normal chest X-ray. Abdominal ultrasonography revealed a heteroechoic lesion poor defined edge in cervix utery expands to corpus utery and rectum. Bilateral uropathy obstruction occured. Bone survey demonstrated osteolytic bone metastasis in the right supra orbital bone and a compression fracture of the twelfth thoracal spine. Head and orbital Computed Tomography (CT) scan, which revealed multiple metastatic lesions in the right orbital expanding to extra cranial, was performed. Our diagnosis was cervical cancer FIGO IV-B stage with distant metastasis thus chemoradiation was given. The aim of this report is to give more references regarding this complicated clinical condition.  ABSTRAKKanker serviks metastasis ke orbita sangat jarang terjadi. Hanya satu kasus yang dilaporkan di Rumah Sakit Umum Daerah Dr. Moewardi Surakarta antara tahun 1999 - 2017. Seorang wanita usia 45 tahun dirawat oleh karena lesi di orbita kanan atas sejak 2 bulan yang lalu. Pasien tersebut belum pernah mendapatkan pemeriksaan kandungan rutin selama lebih dari 10 tahun. Foto Chest X Ray normal. Ultrasonografi abdomen tampak lesi heteroekoik batas tak tegas pada serviks uterus meluas ke korpus uterus dan rektum. Terjadi obstruksi uropati kanan dan kiri. Bone survei memperlihatkan gambaran metastasis tipe litik pada tulang supra orbita kanan dan fraktur kompresi pada tulang belakang toraks ke dua belas. Computed Tomography (CT) Kepala dan Orbita memperlihatkan beberapa lesi metastasis pada supra orbita kanan yang meluas ke tulang tengkorak. Diagnosis kami adalah kanker serviks tahap FIGO IV-B dengan metastasis jauh dan diberikan therapi kemoradiasi. Tujuan penulisan ini adalah untuk memberikan lebih banyak referensi data tentang kondisi klinis yang rumit ini.

scholarly journals Increased mRNA Expression of Key Cytokines Among Suspected Cases of Pneumocystis Jirovecii Infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Idiopatic fibrosing alveolitis in a newborn

2019 ◽  
Vol 64 (5) ◽  
pp. 226-229
Author(s):  
N. Kh. Gabitova ◽  
I. N. Cherezova ◽  
K. A. Cherezova
Keyword(s):  
Clinical Symptoms ◽  
Dynamic Control ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Symptomatic Therapy ◽  
Fibrosing Alveolitis ◽  
X Ray ◽  
Chest X Ray ◽  
Lung Tissue Damage

The article describes a clinical case of idiopathic fibrosing alveolitis – a rare antenatal disease of a newborn. The disease began with the clinical manifestations of transient tachypnea in a full-term child born in the operative way. Chest X-ray was used for dynamic control of lung tissue damage. Due to the absence of specific clinical symptoms of interstitial lung damage, the disease was considered as a course of congenital pneumonia. The researchers used antibacterial and symptomatic therapy. Despite treatment, the respiratory failure progressed, resulting in fatal outcome.

scholarly journals Testicular Tuberculosis with Tuberculoma of Brain in an HIV Negative Patient

2017 ◽  
Vol 34 (2) ◽  
pp. 112-114
Author(s):  
Mehrunnissa Khanom
Keyword(s):  
Pulmonary Involvement ◽  
Symptomatic Improvement ◽  
Sudden Onset ◽  
Cerebellar Hemisphere ◽  
Low Grade ◽  
Negative Patient ◽  
Csf Analysis ◽  
Chest X Ray ◽  
Intravenous Steroids ◽  
Hiv Negative

Isolated testicular tuberculosis without renal or pulmonary involvement has not been reported much earlier. The case of a young HIV negative patient with testicular tuberculosis and tuberculoma of brain has been presented. A 32 years old normotensive, non-diabetic farmer presented to emergency facility with sudden onset of severe headache, vertigo and vomiting that developed over 24 hours and mild pain, swelling of right hemiscrotum associated with low grade fever for last one month. On examination, patient was conscious, oriented, pulse rate was 72/min, blood pressure was recorded 130/80 mm Hg, body temperature was 99 degree F, genital examination revealed swelling of right hemiscrotum with enlarged, firm and mildly tender right testis. He refused full neurological examination due to severe Journal of Bangladesh College of Physicians and Surgeons Vol. 34, No. 2, April 2016 headache and vertigo. MRI of brain revealed multiple, hyperintense, ring-enhancing lesions over right cerebellar hemisphere and corpus callosum. Aspiration of scrotal fluid revealed about 50 ml of yellowish pus, microbiology confirmed presence of few acid-fast-bacilli and plenty of pus cells. FNAC from right testicular mass revealed presence of granuloma and caseation necrosis. His chest X-ray and CSF analysis were normal, ESR was 20, USG of abdomen, hepatic and renal work-up was normal. Soon the patient was started with category I antituberculosis drug along with intravenous steroids. An excellent symptomatic improvement developed on 5th day of initiating drug therapy, he was closely monitored and followed up after discharge. This case report was prepared with his full consent.J Bangladesh Coll Phys Surg 2016; 34(2): 112-114

scholarly journals Appendiceal mucocoele with midgut malrotation

2016 ◽  
Vol 98 (7) ◽  
pp. e138-e140 ◽  
Author(s):  
D Yap ◽  
J Hassall ◽  
GL Williams ◽  
ES McKain
Keyword(s):  
English Literature ◽  
Cystic Mass ◽  
General Surgeon ◽  
Low Grade ◽  
Significant Past Medical History ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Upper Abdominal ◽  
Initial Blood

Introduction Malrotation of the midgut and appendiceal mucocoele are both extremely rare pathological conditions in adults. To our knowledge, there are only two reported cases in the English literature with a combination of both conditions. Case History A 65-year-old man presented with a 10-day history of upper abdominal pain associated with abdominal bloating and weight loss. He was otherwise fit and healthy with no significant past medical history. On examination, his abdomen was soft with tenderness and palpable fullness over the left upper quadrant. The initial blood test, chest x-ray and abdominal x-ray demonstrated no significant abnormality. Computed tomography showed a 17cm x 8cm x 6cm elongated cystic mass with possible malrotation of the intestines. Histopathology showed a low grade mucinous tumour of the appendix. At 12 months following surgery, there was no evidence of recurrence or postoperative complications and the patient was discharged from the care of the colorectal team. Conclusions We report a patient with a combination of two rare conditions. This case illustrates how a combination of pathologies can present a challenge to the unwary general surgeon.

scholarly journals Atypical presentation of COVID-19 in a frail older person

2020 ◽  
Vol 49 (4) ◽  
pp. 523-524 ◽  
Author(s):  
Hui Sian Tay ◽  
Rowan Harwood
Keyword(s):  
Healthcare Professionals ◽  
Community Acquired Pneumonia ◽  
Low Grade ◽  
Older Person ◽  
Frail Older People ◽  
X Ray ◽  
Atypical Symptoms ◽  
Repeat Chest ◽  
Chest X Ray ◽  
Screening Assessment

Abstract Common symptoms of pandemic coronavirus disease (COVID-19) include fever and cough. We describe a 94-year-old man with well-controlled schizoaffective disorder, who presented with non-specific and atypical symptoms: delirium, low-grade pyrexia and abdominal pain. He was given antibiotics for infection of unknown source, subsequently refined to treatment for community-acquired pneumonia. Despite active treatment, he deteriorated with oxygen desaturation and tachypnoea. A repeat chest X-ray showed widespread opacification. A postmortem throat swab identified COVID-19 infection. He was treated in three wards over 5 days with no infection control precautions. This has implications for the screening, assessment and isolation of frail older people to COVID-specific clinical facilities and highlights the potential for spread among healthcare professionals and other patients.

scholarly journals Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry

2015 ◽  
Vol 41 (4) ◽  
pp. 331-342 ◽  
Author(s):  
Alexandre Melo Kawassaki ◽  
Daniel Antunes Silva Pereira ◽  
Fernando Uliana Kay ◽  
Ieda Maria Magalhães Laurindo ◽  
Carlos Roberto Ribeiro Carvalho ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Smoking Status ◽  
Pulmonary Involvement ◽  
Diagnostic Methods ◽  
Test Results ◽  
Cross Sectional ◽  
X Ray ◽  
Significant Difference ◽  
History Of ◽  
Chest X Ray

AbstractObjective: To determine whether simple diagnostic methods can yield relevant disease information in patients with rheumatoid arthritis (RA).Methods: Patients with RA were randomly selected for inclusion in a cross-sectional study involving clinical evaluation of pulmonary function, including pulse oximetry (determination of SpO2, at rest), chest X-ray, and spirometry.Results: A total of 246 RA patients underwent complete assessments. Half of the patients in our sample reported a history of smoking. Spirometry was abnormal in 30% of the patients; the chest X-ray was abnormal in 45%; and the SpO2 was abnormal in 13%. Normal chest X-ray, spirometry, and SpO2 were observed simultaneously in only 41% of the RA patients. A history of smoking was associated with abnormal spirometry findings, including evidence of obstructive or restrictive lung disease, and with abnormal chest X-ray findings, as well as with an interstitial pattern on the chest X-ray. Comparing the patients in whom all test results were normal (n = 101) with those in whom abnormal test results were obtained (n = 145), we found a statistically significant difference between the two groups, in terms of age and smoking status. Notably, there were signs of airway disease in nearly half of the patients with minimal or no history of tobacco smoke exposure.Conclusions: Pulmonary involvement in RA can be identified through the use of a combination of diagnostic methods that are simple, safe, and inexpensive. Our results lead us to suggest that RA patients with signs of lung involvement should be screened for lung abnormalities, even if presenting with no respiratory symptoms.

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