Case Reports in Pulmonology最新文献

{"title":"Covered Stent of the Left Common Carotid and Subclavian Arteries Assist the Invasive Tumor Resection.","authors":"Yo Tsukamoto,&nbsp;Takeo Nakada,&nbsp;Soichiro Fukushima,&nbsp;Mitsuo Yabe,&nbsp;Naoki Toya,&nbsp;Tadashi Akiba,&nbsp;Takashi Ohtsuka,&nbsp;Takao Ohki","doi":"10.1155/2020/8882080","DOIUrl":"https://doi.org/10.1155/2020/8882080","url":null,"abstract":"<p><strong>Background: </strong>Some recent reports have described the usefulness of thoracic aortic stent grafts to facilitate en bloc resection of tumors invading the aortic wall. We report on malignant peripheral nerve sheath tumor resection in the left superior mediastinum of a 16-year-old man with neurofibromatosis type 1. The pathological margin was positive at the time of the first tumor resection, and radiation therapy was added to the same site. After that, a local recurrence occurred. The tumor was in wide contact with the left common carotid and subclavian arteries and was suspected of infiltration. After stent graft placement of these arteries to avoid fatal bleeding and cerebral ischemia by clamping these arteries and bypass procedure, we successfully resected the tumor without any complications.</p><p><strong>Conclusion: </strong>s. Here, we report the usefulness of the prior covered stent placement to aortic branch vessels for the resection of invasive tumor.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8882080"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38762397","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":"Recurrent Pneumothorax with CPAP Therapy for Obstructive Sleep Apnea.","authors":"Kartikeya Rajdev,&nbsp;Pretty Sara Idiculla,&nbsp;Shubham Sharma,&nbsp;Susanna G Von Essen,&nbsp;Peter J Murphy,&nbsp;Sabin Bista","doi":"10.1155/2020/8898621","DOIUrl":"https://doi.org/10.1155/2020/8898621","url":null,"abstract":"<p><p>Pulmonary barotrauma such as pneumothorax (PTX) is a known complication of invasive mechanical ventilation. However, it is uncommonly reported with the use of noninvasive positive pressure ventilation (NPPV) and CPAP (continuous positive airway pressure) therapy. We present a case of a 66-year-old female who presented with chronic dyspnea on exertion secondary to right-sided diaphragmatic hernia. The patient also underwent a home sleep study which suggested obstructive sleep apnea (OSA) for which she was initiated on CPAP. She then underwent surgical repair of her right diaphragmatic hernia. The patient developed pneumothorax three times over the course of the following several months, once on the right side and twice on the left side. The patient's incidences of PTX had a temporal association with the CPAP initiation. Her CPAP therapy was discontinued permanently after the third occurrence of PTX. With this case report, we highlight the risk of barotrauma with the use of CPAP for OSA. There are very few reported cases of PTX in association with NPPV therapy for OSA. The lung-protective ventilation strategies and limiting the positive airway pressures can help reduce the risk of pulmonary barotrauma with CPAP.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8898621"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25315947","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":"The First Case of L. pseudomesenteroides Pulmonary Infection and Literature Review.","authors":"Liwan Dai,&nbsp;Yishi Li,&nbsp;Xiaobing Zhang,&nbsp;Ming Ding,&nbsp;Shuliang Guo","doi":"10.1155/2020/8818491","DOIUrl":"https://doi.org/10.1155/2020/8818491","url":null,"abstract":"<p><p>L. pseudomesenteroides is a very rare bacterium that infects human beings, and it has been used as an industrial fermentation bacterium. At present, only a few cases have been reported about this bacterium infecting the human body, but most reports are mainly about sepsis. We will report on a woman with lymphoma who was successfully diagnosed by the use of transbronchial cryobiopsy (TBCB) with L. pseudomesenteroides pulmonary infection.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8818491"},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8818491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38341026","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":"E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) Mimicking COVID-19 Disease.","authors":"Jose A Rodriguez,&nbsp;Alejandra A Roa,&nbsp;Juan C Lemos-Ramirez","doi":"10.1155/2020/8821289","DOIUrl":"https://doi.org/10.1155/2020/8821289","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus 2 (SARS-CoV-2) is the virus associated with the coronavirus disease (COVID-19) causing a pandemic worldwide in 2020. There are other noninfectious diseases that can present exactly as COVID-19, and the management and approach are completely different, hence the importance of understanding and having a wide differential in patients presenting with similar characteristics. <i>Case Report</i>. A 23-year-old male, with a history of childhood asthma, presented to the Emergency Department in a hospital in south Florida in the USA with complaints of a 2-day duration of subjective fever, chills, dry cough, dyspnea, and myalgia. His vital signs were blood pressure 135/65 mmHg, temperature 39°C, pulse 134 bpm, respiratory rate 22 breaths per minute, and saturation of oxygen 96% in room air. Laboratory analysis was significant for white blood cells 15.3 × 10³/<i>μ</i>L, ALT 69 U/L, AST 66 U/L, ferritin 375.6 ng/mL, C-reactive protein 27.70 mg/dL, and procalcitonin 1.43 ng/mL. A respiratory pathogen panel (RPP) and a SARS-CoV-2 test were both negative. The patient was given empiric antibiotic treatment and hydroxychloroquine. Two more tests for SARS-CoV-2 were negative, and the patient reported that he smoked marijuana through an e-cigarette. The patient was started on high-dose steroids, and symptoms improved.</p><p><strong>Conclusion: </strong>COVID-19 is an emergent lung disease that is affecting the population worldwide; many other noninfectious diseases can mimic its presentations and laboratory characteristics; the importance of having a broad differential diagnosis especially in causing confusion during pandemic times is valuable in the management of patients with such presentations, such as EVALI, and glucocorticoids will be indicated in this circumstances.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8821289"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8821289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38720794","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":"Rare Complication of Pneumomediastinum and Pneumopericardium in a Patient with COVID-19 Pneumonia.","authors":"Anshika Singh, Jessica Bass, David H Lindner","doi":"10.1155/2020/8845256","DOIUrl":"10.1155/2020/8845256","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently discovered coronavirus which has caused a global outbreak of severe pneumonia with complications leading to hypoxic respiratory failure, acute respiratory distress syndrome (ARDS), cytokine storm, disseminated intravascular coagulation (DIC), and even gastrointestinal symptoms. While ground-glass opacity (GGO) is a typical radiographic finding associated most frequently with COVID-19 pneumonia, other less commonly noted atypical radiographic lung features include isolated lobar or segmental consolidation without GGO, discrete small nodules (centrilobular, \"tree-in-bud\"), lung cavitation, and smooth interlobular septal thickening with pleural effusion. Pneumomediastinum in COVID-19 patients has rarely been reported. A finding of pneumopericardium is unusual too. This report discusses the case of a young male with COVID-19 pneumonia who was found to have both these features on computed tomographic (CT) scans of his chest on presentation.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8845256"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38617344","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":"Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients.","authors":"Samshol Sukahri,&nbsp;Lily Diana Zainudin,&nbsp;Mohd Firdaus Hadi,&nbsp;Mohd Al-Baqlish Mohd Firdaus,&nbsp;Muhammad Imran Abdul Hafidz","doi":"10.1155/2020/8840920","DOIUrl":"https://doi.org/10.1155/2020/8840920","url":null,"abstract":"<p><p>Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of <i>Nocardia</i> species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8840920"},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8840920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38687467","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":"Efficacy of Omalizumab Therapy in an Asthmatic with Low IgE.","authors":"Divya R,&nbsp;Rajesh Venkitakrishnan,&nbsp;Jolsana Augustine,&nbsp;Melcy Cleetus","doi":"10.1155/2020/8898454","DOIUrl":"https://doi.org/10.1155/2020/8898454","url":null,"abstract":"<p><p>Asthma is one of the most common respiratory diseases encountered in clinical practice. Although the vast majority of asthmatics can be adequately controlled with inhaled steroids and other preventer medications, a small proportion remain uncontrolled. Anti-IgE treatment with omalizumab has been proposed in patients as a preferred approach in step 5 asthma therapy according to GINA guidelines. Although therapy with this molecule is approved for patients with atopic asthma and pretreatment serum IgE levels of 30-1500 only, there have been a few reports of its efficacy in subjects outside this reference IgE range. We report the case of a middle-aged lady with severe corticosteroid-dependent asthma and low serum IgE levels who was successfully treated with 9 months of omalizumab therapy. She gained good asthma control and was tapered off steroid use by the fifth month of therapy with omalizumab. The case report stresses the need for further investigation into expanding the spectrum of omalizumab usage in asthma beyond the current IgE suitability range.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8898454"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8898454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453478","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":"Pulmonary Vein Occlusion and Lung Infarction after Radiofrequency Ablation of Atrial Fibrillation.","authors":"Julyan Al Fori,&nbsp;Maryam Al Belushi,&nbsp;Mohammed Al Shuraiqi,&nbsp;Ghalia Al Mohanny,&nbsp;Rashid Al Umairi,&nbsp;Nasser Al Busaidi","doi":"10.1155/2020/2357846","DOIUrl":"https://doi.org/10.1155/2020/2357846","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein (PV) radiofrequency ablation (RFA) is an effective technique for a selected group of patients with atrial fibrillation (AF) refractory to antiarrhythmic drugs (Alfudhili et al., 2017). However, pulmonary vein occlusion is a potentially rare, sometimes severe, complication which may present clinically as nonspecific respiratory symptoms, signifying pulmonary vein stenosis, that are often underrecognized or misdiagnosed, leading to progression of the low-grade stenosis to complete occlusion if not treated with timely intervention (Alfudhili et al., 2017). <i>Case Presentation</i>. We report the first case of haemoptysis, three months postradiofrequency ablation (i.e., late complication) secondary to pulmonary vein occlusion that was diagnosed by computed tomography angiogram (CTA), which showed occlusion of 2 out of 4 native pulmonary veins.</p><p><strong>Conclusion: </strong>The cause of haemoptysis in this patient was pulmonary vein occlusion, secondary to radiofrequency ablation, as demonstrated in the CTA.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"2357846"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2357846","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38278925","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":"Azathioprine Hypersensitivity Syndrome during Treatment of Severe Interstitial Lung Disease with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis.","authors":"Eri Nakano,&nbsp;Tomohiko Asakawa,&nbsp;Mea Asou,&nbsp;Eri Nohara,&nbsp;Tomoyuki Seki,&nbsp;Makoto Araki","doi":"10.1155/2020/8852441","DOIUrl":"https://doi.org/10.1155/2020/8852441","url":null,"abstract":"<p><p>Azathioprine is used to treat anti-neutrophil cytoplasmic antibody- (ANCA-) associated vasculitis. Azathioprine hypersensitivity syndrome is often missed. An 81-year-old man undergoing treatment for interstitial pneumonia developed a high fever and was diagnosed with ANCA-associated vasculitis based on an elevated myeloperoxidase- (MPO-) ANCA titer and renal biopsy findings. After induction therapy, his clinical symptoms improved, but his MPO-ANCA remained elevated (>300 U·L^-1) and hematuria persisted. Prednisolone plus azathioprine was administered as maintenance therapy. Three exacerbations of the inflammatory response occurred during the subsequent 3 months. In each instance, we suspected opportunistic infection or a flare-up of vasculitis. The first exacerbation was treated with an increased prednisolone dose and antibiotics. At the onset of the second exacerbation, which was accompanied by systemic erythema, we stopped azathioprine and administered antibiotics. The third exacerbation, which occurred the day after restarting azathioprine, involved a fever with chills and an acute inflammatory reaction; we therefore suspected an azathioprine allergy. A drug provocation test was performed, and a hyperinflammatory response was observed. The patient received prednisolone (15 mg·day^-1) monotherapy; no further fever was observed during the subsequent 2 months. We therefore diagnosed azathioprine hypersensitivity syndrome. Under treatment with prednisolone (5 mg·day^-1) and mycophenolate mofetil (1 g·day^-1) (replacing the azathioprine), no signs of relapse or infection have occurred for more than two years. Renal function and the pulmonary lesions are stable, although the high MPO-ANCA titer and hematuria persist. The diagnosis of azathioprine hypersensitivity is often delayed because of the difficulty in identifying the relationship between immunosuppressive agents and hypersensitivity and in distinguishing this from infection or relapse of the primary disease. The misdiagnosis of azathioprine hypersensitivity leads to unnecessary treatment; thus, clinicians should consider allergic reactions specific to azathioprine when switching from induction to maintenance therapy.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8852441"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8852441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38186180","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":"Postpartum Pulmonary Hypertension Masquerading as Submassive Pulmonary Embolism: A Case Report and a Literature Review.","authors":"Mahmood Mubasher,&nbsp;Amir Hanafi,&nbsp;Tausif Syed,&nbsp;Abir Zinal,&nbsp;Ibrahim Y Abubeker,&nbsp;Mouhand F H Mohamed,&nbsp;Mohan Rao,&nbsp;Ryan Hoefen,&nbsp;Mohammed Danjuma","doi":"10.1155/2020/8899562","DOIUrl":"https://doi.org/10.1155/2020/8899562","url":null,"abstract":"<p><p>Postpartum pulmonary hypertension (PPPHT) is an extremely rare disorder, with few reported cases. Late diagnosis and treatment are associated with significant morbidity and mortality. We present an 18-year-old female patient who presented four-week postpartum with a typical submissive pulmonary embolism picture subsequently diagnosed as postpartum pulmonary hypertension. The patient had an excellent response to treatment, with a dramatic improvement in her functional status. The authors aim to urge physicians to keep this rare disorder in mind as timely and accurate diagnosis is crucial for management-additionally, the importance of counseling patients about the imminent risks associated with planned future pregnancies.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"8899562"},"PeriodicalIF":0.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8899562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38145847","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}