{"title":"Management of postintubation tracheal stenosis with bronchoscope methods-An experience from two centers.","authors":"Arvindran Alaga, Vineet Simhan, Srivatsa Lokeshwaran, Sunil Kumar K, Sanjana Chetana Shanmukhappa","doi":"10.1002/rcr2.70014","DOIUrl":"10.1002/rcr2.70014","url":null,"abstract":"<p><p>Tracheal stenosis is a common complication of endotracheal intubation or tracheostomy, resulting in significant morbidity and mortality. Bronchoscope interventions have been proposed as a safe alternative for the management of post-intubation post-intubation tracheal stenosis (PITS). Data for patients diagnosed with PITS across two hospitals, between 2021 and 2022, encompassing demographic, clinical, and procedural details were gathered from electronic medical records, and analysed. Primary outcomes centred on assessing the incidence and severity of PITS through bronchoscope examination and radiological imaging, and the efficacy of bronchoscope interventions, including stenting and the application of mitomycin C. Twelve patients were managed for PITS. Majority of patients were females (9/12) with mean age of 46.41 years. Presenting signs and symptoms were dyspnea, rhonchi and failed extubation, the mean duration of intubation/ tracheostomy is 16.41 days (range: 3-40 days). Most common comorbidity was type 2 diabetes, (5 patients, 41.6%). The lesions mean length was 3.09 cm and Cotton-Meyer Grade II and III. Prompt evaluation is crucial, in these patients. The Cotton-Meyer grade is pivotal in treatment decisions, with intubating times correlating with the severity of stenotic disease. Our case series demonstrates the increasing utility of bronchoscopy in managing these cases.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-08eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70017
Hee Yun Seol, Ganghee Chae, Jin Hyoung Kim, Yun Seong Kim, Seong Hoon Yoon, Taehoon Lee
{"title":"Intubated or rigid bronchoscopy under high-flow oxygenation and deep sedation without ventilator or anesthesiologist: A report on a new technique.","authors":"Hee Yun Seol, Ganghee Chae, Jin Hyoung Kim, Yun Seong Kim, Seong Hoon Yoon, Taehoon Lee","doi":"10.1002/rcr2.70017","DOIUrl":"https://doi.org/10.1002/rcr2.70017","url":null,"abstract":"<p><p>As the demand for advanced bronchoscopic procedures increases, prolonged sedation with adequate oxygenation has become essential. Traditionally, these procedures require an anesthesiologist to provide (positive-pressure or jet) ventilator support. However, recent innovations have enabled advanced bronchoscopy under high-flow endotracheal oxygenation and deep sedation without these requirements. Following oropharyngeal lidocaine anaesthesia, deep sedation was induced using fentanyl and remimazolam. Thereafter lidocaine was instilled into the larynx, trachea, and main bronchi using a flexible bronchoscope with a spray catheter. Finally, either an uncuffed endotracheal tube (Case 1) or a rigid bronchoscope (Case 2) was inserted, and advanced bronchoscopic procedures, such as cryobiopsy and stent insertion, were successfully performed without a ventilator or an anesthesiologist. Our novel technique is expected to facilitate the easier and adequate performance of advanced high-level bronchoscopic procedures by pulmonologists, even in resource-limited settings.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical treatment of lung cancer associated with Werner's syndrome: A case report and review of the literature.","authors":"Fumihiro Ishibashi, Joji Horio, Kaori Tachibana, Jiro Terada, Kiyoshi Shibuya","doi":"10.1002/rcr2.70018","DOIUrl":"https://doi.org/10.1002/rcr2.70018","url":null,"abstract":"<p><p>Werner's syndrome is a rare progressive disorder that is characterized by a variety of clinical manifestations which mimic features of advanced ageing. Malignancy is one of the most problematic complications of Werner's syndrome. Lung cancer associated with Werner's syndrome is rare. A 54-year-old woman with Werner's syndrome was referred to our department because an abnormal shadow had been detected on routine chest radiography. Chest computed tomography revealed an abnormal nodule in the left upper lobe. Bronchoscopic examination revealed the presence of squamous cell carcinoma. Other imaging studies showed no metastatic lesions; therefore, the patient was diagnosed with stage IA3 squamous cell carcinoma. She underwent left upper lobectomy and lymph node dissection without major complications, and no recurrence was found for 2 years postoperatively.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-08eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70020
Sushil Agwan, Lai-Ying Zhang, Thomas Baker, Michael Lane, David Godbolt, John A Mackintosh
{"title":"A vexing case of a 73-year-old man with fevers, orbital cellulitis, and asymptomatic interstitial lung disease.","authors":"Sushil Agwan, Lai-Ying Zhang, Thomas Baker, Michael Lane, David Godbolt, John A Mackintosh","doi":"10.1002/rcr2.70020","DOIUrl":"https://doi.org/10.1002/rcr2.70020","url":null,"abstract":"<p><p>VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is a rare and recently identified disease resulting from a somatic mutation in the X-linked UBA1 gene in cells of myeloid lineage. It can present in a myriad of ways with the potential to affect various organ systems, including the lungs. VEXAS is usually steroid responsive, but no strong data exists for the use of a steroid-sparing agent. There is limited emerging evidence for haematopoietic stem cell transplantation in a select number of cases. Regardless, prognosis for this condition is poor and a treatment algorithm remains a priority. Herein, we present a case of VEXAS that came to attention with discovery of a relatively asymptomatic interstitial lung disease and led to recurrent febrile episodes with evolving multi-organ involvement.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-08eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70023
Atsuhiko Sunaga, Takuya Inoue
{"title":"Successful treatment of rheumatoid arthritis-associated interstitial lung disease with filgotinib: A case report on janus kinase 1 inhibition.","authors":"Atsuhiko Sunaga, Takuya Inoue","doi":"10.1002/rcr2.70023","DOIUrl":"https://doi.org/10.1002/rcr2.70023","url":null,"abstract":"<p><p>Filgotinib, a janus kinase 1 (JAK1) inhibitor, is used in the treatment of rheumatoid arthritis (RA). RA-associated interstitial lung disease (RA-ILD) is a severe RA complication with no established effective treatment. We report the case of a patient with RA-ILD successfully treated with filgotinib. A 46-year-old woman with RA and RA-ILD, presenting with a non-specific interstitial pneumonia pattern, was refractory to abatacept and prednisolone but responded to filgotinib. Both arthritis and RA-ILD improved significantly, and the patient remained in remission for over 12 months. Basic research indicates that JAK1 plays a role in the cytokine signal transduction in ILD; however, there are no clinical reports on the efficacy of filgotinib in RA-ILD. This case suggests filgotinib as a potential treatment for patients with RA-ILD, particularly in the early stages of this disease.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-08eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70022
Parker Cordial, Ian D Bentley, Jeffrey C Horowitz, Kevin Ho
{"title":"Eosinophilic reactive airways disease after immune checkpoint inhibitor treatment.","authors":"Parker Cordial, Ian D Bentley, Jeffrey C Horowitz, Kevin Ho","doi":"10.1002/rcr2.70022","DOIUrl":"https://doi.org/10.1002/rcr2.70022","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICI) are increasingly utilized as first-line treatment for many solid tumour malignancies. One downside of ICI therapy is autoimmune-mediated organ inflammation, or immune-related adverse events (irAE). ICI-related pneumonitis, or non-infectious inflammation of the lung, is a well-described irAE. While guidelines surrounding ICI-related pneumonitis are well established, other ICI-related pulmonary toxicities, including reactive airways disease, are rarely described in the literature. Here, we present a series of patients without pre-existing COPD or asthma who developed reactive airways disease with peripheral eosinophilia after ICI therapy and without radiographic evidence of pneumonitis. The patients were treated with typical therapies for reactive airways disease, including- inhaled steroids, bronchodilators, systemic steroids, and in one instance, dupilumab. All experienced symptomatic improvement with these therapies, enabling some of the patients to continue receiving ICI therapy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-06eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70002
Kevin Ziyi Wen, Ricky Tanujaya Lim, Andrew Dimitri, Lisa Noonan, Jonathan Williamson
{"title":"Complete removal of a ruptured pulmonary hydatid cyst during conscious sedation bronchoscopy: A case report and literature review.","authors":"Kevin Ziyi Wen, Ricky Tanujaya Lim, Andrew Dimitri, Lisa Noonan, Jonathan Williamson","doi":"10.1002/rcr2.70002","DOIUrl":"10.1002/rcr2.70002","url":null,"abstract":"<p><p>The complete removal of a pulmonary hydatid cyst by bronchoscopy occurs rarely in clinical practice. We describe a 22-year-old male originally from Lebanon, with suspected hydatid cyst rupture on computed tomography chest after experiencing sudden onset fevers and cough whilst taking empiric anthelmintic therapy. Bronchoscopy revealed white gelatinous material in the posterior segment of the left lower lobe. The complete membranes of a hydatid cyst were removed with grasping forceps. Histologic examination confirmed the diagnosis of echinococcosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-02eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70016
Li Li, Yuanxiang Wang, Longwei Sun, Wenjian Wang
{"title":"A seven-month-old baby presenting excessive crying for pulmonary sequestration with torsion: A case report and literature review.","authors":"Li Li, Yuanxiang Wang, Longwei Sun, Wenjian Wang","doi":"10.1002/rcr2.70016","DOIUrl":"10.1002/rcr2.70016","url":null,"abstract":"<p><p>Pulmonary sequestration with torsion is a rare condition. We describe a seven-month-old baby presenting excessive crying for pulmonary sequestration with torsion. Contrast-enhanced chest computed tomography demonstrated an oval-shaped mass in the posteromedial right lower chest, no systemic arterial supply was evident. The edge of the mass showed slight linear reinforcement, and its interior had no reinforcement. Thoracoscopic segmentectomy was carried out and histology confirmed pulmonary sequestration with torsion.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-02eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70011
Dzufar Halim, David Breen
{"title":"Pull-up surprise: Chronic foreign body aspiration.","authors":"Dzufar Halim, David Breen","doi":"10.1002/rcr2.70011","DOIUrl":"https://doi.org/10.1002/rcr2.70011","url":null,"abstract":"<p><p>Foreign body aspiration is rare in adults but can be life-threatening. This case highlights the subtlety of chronic foreign body aspiration presentation and the importance of judicious use of radiological tool and comprehensive history-taking especially in patients with chronic cough.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respirology Case ReportsPub Date : 2024-09-02eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70015
Alireza Mohammad Hosseini, Parisa Farshchi, Hanieh Hosseini, Fatemeh Zarei
{"title":"<i>Escherichia coli</i> community-acquired necrotizing pneumonia, an uncommon presentation of a common pathogen: A case report and literature review.","authors":"Alireza Mohammad Hosseini, Parisa Farshchi, Hanieh Hosseini, Fatemeh Zarei","doi":"10.1002/rcr2.70015","DOIUrl":"10.1002/rcr2.70015","url":null,"abstract":"<p><p>Community-acquired necrotizing pneumonia is a rare but potentially fatal infection, mainly caused by specific pathogens such as <i>Streptococcus pneumoniae</i>, <i>Staphylococcus aureus</i>, <i>Klebsiella pneumoniae</i>, <i>Haemophilus influenzae</i>, and <i>Pseudomonas aeruginosa</i>. <i>Escherichia coli</i> is extremely rare as a pathogen for community-acquired necrotizing pneumonia, typically accompanied with bloodstream infection. Here, we report an unusual case of a 60-year-old man with uncontrolled diabetes mellitus and no bloodstream infections, who had severe necrotizing <i>E. coli</i> pneumonia leading to massive hemoptysis and death. Clinicians should be aware of this pathogen in respiratory infections, as it requires immediate pathogen detection and usually aggressive antibiotic treatment.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}