HCA healthcare journal of medicine最新文献

{"title":"Pembrolizumab-Associated Acute Esophageal Necrosis: A Case Report and Literature Review.","authors":"Mark Tawfik, Elie Bou Sanayeh, Stephanie Chain, Ahmed Elfiky, Stephen Mulrooney","doi":"10.36518/2689-0216.1846","DOIUrl":"10.36518/2689-0216.1846","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. They pose challenges, particularly in the form of immune-related adverse events (irAEs). Although cases of gastrointestinal irAEs have been well-documented, acute esophageal necrosis (AEN) characterized by a circumferential blackening and fragility of the esophagus, weeks after immunotherapy discontinuation, has not been reported.</p><p><strong>Case presentation: </strong>A 75-year-old diabetic male who was recently diagnosed with high-grade papillary urothelial cancer with liver and retroperitoneal metastases and had undergone radical cystectomy with ileal conduit urinary diversion, presented to the hospital for sepsis secondary to a urinary tract infection. While in the hospital, he experienced hematemesis, with an acute drop in hemoglobin from 10.6 to 5.3 g/L and a rise in serum lactate from 1.5 to 3.6 mmol/L. An esophagogastroduodenoscopy (EGD) revealed diffuse circumferential eschar, exudate, and inflammation. He was diagnosed with acute esophageal necrosis (AEN), which was found to be secondary to his pembrolizumab use.</p><p><strong>Conclusion: </strong>Immune-related adverse events will remain a challenge in patients receiving ICI therapy. AEN is a rare life-threatening irAE associated with ICIs. Further research is warranted to clarify the exact mechanism of injury, optimal treatment strategies, and possible preventative measures.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095965","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":"Severity of SARS-CoV-2 Illness in Patients With Type 1 and Type 2 Diabetes Mellitus.","authors":"Anthony Shadiack, Alexis White, Prasad Munusamy, Jessica Oleske, Parisa Biazar, Serena Mitchell, Michael G Flynn, Nayda Parisio Poldiak","doi":"10.36518/2689-0216.1824","DOIUrl":"10.36518/2689-0216.1824","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a well-known risk factor for the severity of illness in patients with SARS-CoV-2 infection (COVID-19). However, there is less published data on illness severity differences between patients with type 1 (T1D) and type 2 (T2D) diabetes mellitus.</p><p><strong>Methods: </strong>We performed a retrospective review of records of patients with COVID-19 (March 2020 - November 2020) extracted from a large, private hospital system database. Of the 76 467 patients with COVID-19, 54 007 (70.6%) did not have a diabetes diagnosis (NON), 22 084 (28.9%) had T2D, and 376 (0.49%) had T1D. We further subgrouped diabetic patients into groups with A1C above 7% (T2D7 and T1D7) or above 8% (T2D8 and T1D8). Logistic regression analysis was used to determine the association between selected predictor variables and our primary outcome variables of ventilator, intensive care unit (ICU) admission, mortality, and length of stay.</p><p><strong>Results: </strong>Patients with T2D were substantially older (62.9 years) than NON (48.8) or T1D (43.2). The proportion of Black, White, and other race patients was similar, with a somewhat higher proportion of Black patients having T1D. Patients with T1D and T2D had significantly higher odds of requiring a ventilator, being admitted to ICU, and had a higher mortality rate than NON. As an example, T1D had 5.68 higher odds and T2D 1.82 higher odds of ICU admission compared to NON. T2D patients with A1C above 7% or 8% were roughly 2 times more likely to require a ventilator, were less likely to be admitted to the ICU, and had a roughly 3-day longer length of stay than T1D patients with A1C above 7% or 8%.</p><p><strong>Conclusion: </strong>Both T1D and T2D were independent predictors of illness severity for SARS-CoV-2 patients, leading to higher odds of requiring ventilation, ICU admission, mortality, and hospital stay duration. Our older patient group with T2D had somewhat worse outcomes and longer hospital stays than T1D.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"119-129"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095974","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":"From Molars to Bronchus; The Tale of an Aspirated Dental Instrument.","authors":"Yisroel Grabie, Sudeep Acharya, Fasih Sami Siddiqui, Gabriel A Chavez Reyna, Michel Chalhoub","doi":"10.36518/2689-0216.1876","DOIUrl":"10.36518/2689-0216.1876","url":null,"abstract":"<p><strong>Background: </strong>Aspiration of dental instruments is a rare event that carries potentially serious complications when it occurs, especially in older patients, where protective reflexes are diminished. Clinical management may be difficult because of the risk of granulation tissue and different retrieval strategies according to the object's characteristics. In this report, we describe the case of an 84-year-old man who aspirated a dental bur during a routine dental procedure, necessitating immediate intervention. Timely and precise management was essential to avert severe complications.</p><p><strong>Case presentation: </strong>During a routine dental procedure, an 84-year-old man aspirated a bud-shaped cross-cut carbide dental bur. Despite initial stability, within an hour he developed a cough and hemoptysis. A chest X-ray confirmed the presence of the foreign body in the right mainstem bronchus. After administering intravenous methylprednisolone, bronchoscopy was conducted using a flexible scope and laryngeal mask airway. Initial attempts at retrieval with forceps were unsuccessful, but the subsequent use of a foreign body \"grabber\" led to successful and intact removal of the bur. The patient recovered swiftly post-procedure and was discharged within a few hours.</p><p><strong>Conclusion: </strong>Swift bronchoscopic intervention is vital in managing aspirated dental instruments, especially in older patients. This case highlights the significance of preventive measures in clinical dentistry, using rubber dams and throat packs along with clear emergency protocols. The importance of timely identification and management is also equally emphasized. Furthermore, the administration of corticosteroids played a crucial role in this case by mitigating inflammation and preventing granulation tissue formation, and facilitating successful retrieval. Incorporating the use of corticosteroids for the management of aspirated dental instruments has the potential for better outcomes and fewer complications, particularly when used in older patients with weakened airway defense mechanisms.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"189-192"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096046","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":"Two 55-Word Stories: Reasonable Suspicion and There's an Art to This.","authors":"Angel Ogbeide","doi":"10.36518/2689-0216.1770","DOIUrl":"10.36518/2689-0216.1770","url":null,"abstract":"<p><p>Description Narrative medicine, specifically the 55-word story, provides clinicians an opportunity to reflect on experiences they encounter and garner significant meaning from them. These 2 stories discuss difficult situations I have experienced in my practice of medicine. \"Reasonable Suspicion\" is an internal reflection on the weight of the complex decisions providers are often faced with (mandatory reporting, etc) and are not emphasized enough in health care. Doing the right thing in a clinical situation is taught. How doing the right thing can make a provider feel is not. \"There's an Art to This\" discusses grief. How do you grieve a patient? How do you help a colleague grieve their patient? These are questions providers often wrestle with. These are questions I struggled to answer during my time covering craniofacial trauma.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"205"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096062","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":"Intracolonic Migration of a Dislocated Acetabular Cup Prosthesis.","authors":"Jack R Lubka, Cyrus Tamboli, Philip Brunetti, Sarosh Tamboli, Alex Davis, Hamish Patel, Olugbenga Oyesanmi, Michael Strobbe, Shaival Thakore, Subhasis Misra, Jeffrey Mino","doi":"10.36518/2689-0216.1506","DOIUrl":"10.36518/2689-0216.1506","url":null,"abstract":"<p><strong>Background: </strong>Acetabular cup migration is a rare complication of hip replacement surgery. If the acetabular socket of the ilium is weak, the prosthesis can erode or pass through it. There have been multiple reports of acetabular cup prosthesis migration to the colon, creating a coloarticular fistula between the hip joint and the cecum, sigmoid colon, or rectum. We report a rare presentation of a complete intracolonic migration of a prosthetic acetabular cup without creating a fistula.</p><p><strong>Case presentation: </strong>A 53-year-old female patient with a remote history of a total right hip replacement presented with abdominal pain and rectal bleeding. Computed tomography imaging revealed that the acetabular cup prosthesis was inside the colon. The patient underwent a colonoscopy as well as exploratory abdominal surgery, and the object was retrieved. The patient recovered without complications from the surgery. The acetabular cup migrated into the colon without formation of a residual fistula or any notable complications involving the hip joint despite the loss of the acetabular component.</p><p><strong>Conclusion: </strong>The mechanism is unknown for how the acetabular prosthesis was able to pass from the hip joint into the colon, without a fistula, bowel perforation, or significant hip injury. At the time of writing, this case appears to be the first to document a complete intracolonic migration of a hip prosthesis.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"157-161"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095963","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":"Combating Physician Burnout and Fostering Wellness in Graduate Medical Education for Resident Physicians.","authors":"Abdulaziz Mheir, Zohare Khan, Franklin Hernandez, Alaa Mohamed, Chandan Mitra","doi":"10.36518/2689-0216.1883","DOIUrl":"10.36518/2689-0216.1883","url":null,"abstract":"<p><strong>Background: </strong>Over the last 2 decades, there has been a cultural shift in the graduate medical education (GME) space, focusing on an important facet: physician burnout. Burnout is defined as a combination of emotional exhaustion, depersonalization, and a lack of personal accomplishment. With increasing awareness of physician burnout, various wellness initiatives have begun to be implemented throughout training programs, and their results have been measured for effectiveness in reducing burnout rates. Due to the increasing rates of burnout emerging throughout GME programs, an initiative to evaluate our internal medicine (IM) residency on this matter was discussed with all residents at forums and yielded several areas where improvement could help reduce burnout. This project aimed to measure the burnout rates among our IM resident physicians using the Maslach Burnout Inventory (MBI) self-assessment tool after implementing new wellness initiatives in the GME program.</p><p><strong>Methods: </strong>We sought to actively address the physician burnout phenomenon using a multi-factorial approach that involved several stakeholders and focused on aspects our IM residents outlined during held forums, which included education, financial, physical, mental, and social wellness. Once areas of improvement were identified, steps to improve each field were implemented. The MBI Survey 1 was the primary assessment tool used to measure the rates of burnout after interventions. Survey data were collected, and burnout rates were averaged across postgraduate year (PGY) 1, 2, and 3 residents.</p><p><strong>Results: </strong>Depersonalization was significantly reduced (<i>P</i> = .0224) for PGY1 residents following intervention. Emotional exhaustion (<i>P</i> = .0014) and depersonalization (<i>P</i> = .0345) were significantly lower for PGY3 residents following interventions. There were no significant changes for PGY2 residents.</p><p><strong>Conclusion: </strong>Based on preliminary data showing improved outcomes following interventions in various aspects, we aim to grow our wellness initiative using data to guide our efforts to reduce burnout and improve the overall well-being of our residents.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 2","pages":"131-137"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096044","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":"Plasma Cell-Rich Lymphoid Neoplasm in an Endocervical Polyp of the Uterine Cervix in a Perimenopausal 52-Year-Old Woman.","authors":"Anjali Patel, Jacqueline Haas, Angela Kueck","doi":"10.36518/2689-0216.1809","DOIUrl":"10.36518/2689-0216.1809","url":null,"abstract":"<p><strong>Background: </strong>The adaptive immune system consists of T and B lymphocytes, with some B lymphocytes further differentiating into plasma cells that secrete antibodies and make up the humoral immune system. Extramedullary plasmacytoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and plasmablastic lymphoma are all plasma cell-rich lymphoid neoplasms that rarely present in the female genital tract. To date, few case reports of these malignancies arising within the uterine cervix exist.</p><p><strong>Case presentation: </strong>This case report describes a 52-year-old perimenopausal woman who presented to her primary obstetrician-gynecologist for an annual exam with the complaint of light spotting following an endometrial ablation that occurred several years prior. During the pelvic exam, we discovered and subsequently biopsied an endocervical polyp. The pathological examination of this polyp demonstrated atypical plasma cells and lymphocytes, indicating a leading diagnosis of extramedullary plasmacytoma. The results of further workup, which included a complete blood count, comprehensive metabolic panel, bone marrow biopsy, and a whole-body PET-CT scan, all came back negative for systemic disease. A surgical resection, including a total hysterectomy and bilateral salpingectomy, was performed. Bilateral ovarian conservation was performed due to this patient's perimenopausal status as well as the positive cardiovascular, cognitive, and bone benefits. A secondary pathology review of the endocervical polyp broadened the differential diagnosis to include MALT and plasmablastic lymphoma.</p><p><strong>Conclusion: </strong>Extramedullary plasmacytomas, MALT lymphomas, and plasmablastic lymphomas carry a risk of progression to multiple myeloma and systemic disease, requiring close surveillance. A total hysterectomy is the most definitive treatment for confined neoplasms. Removing the bilateral ovaries in premenopausal or perimenopausal women places the patient in surgical menopause, which is vastly detrimental to the overall health of the patient. Therefore, thoughtful consideration regarding the benefits and risks of a bilateral oophorectomy versus ovarian conservation is imperative. Additionally, plasma cell-rich lymphomas are not estrogen-driven cancers like other gynecologic cancers, which support ovarian conservation.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 1","pages":"89-94"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607020","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":"Ethical Considerations of Percutaneous Endoscopic Gastrostomy Tube Placement in a Patient With Creutzfeldt-Jakob Disease and Advanced Dementia.","authors":"Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira","doi":"10.36518/2689-0216.1836","DOIUrl":"10.36518/2689-0216.1836","url":null,"abstract":"<p><strong>Background: </strong>Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.</p><p><strong>Case presentation: </strong>We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light on the ethical challenges surrounding the use of endoscopically assisted PEG tube placement for patients with confirmed or suspected CJD.</p><p><strong>Conclusion: </strong>Ethical consideration for patients with dementia, especially with CJD, includes evaluating harm and benefit, considering legal and societal responsibilities, respecting autonomy, and managing transmission risks. Based on our findings, we encourage interdisciplinary collaboration when navigating complex medical decision-making for patients with human prion diseases and advanced dementia.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 1","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606734","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":"Risk Factors Associated With Worse Outcomes in Trauma Patients Aged 55 and Older.","authors":"Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A Javier, Marcela Ramirez, Orlando Morejón","doi":"10.36518/2689-0216.1830","DOIUrl":"10.36518/2689-0216.1830","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.</p><p><strong>Methods: </strong>Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020-22). We collected the subject's age, gender, PECs, and outcome data. Then we performed multiple logistic regression to assess which PECs were associated with in-hospital mortality, acute kidney injury (AKI), ventilator-associated pneumonia (VAP), and unplanned intensive care unit (ICU) admission.</p><p><strong>Results: </strong>We identified 5168 trauma patients 55 years old and older, of which 54.9% were female. Chronic renal failure (CRF) increased the odds of in-hospital mortality (adjusted odds ratio [aOR] = 2.30, <i>P</i> < .001), unplanned ICU admission (aOR = 1.73, <i>P</i> = .033), and AKI (aOR = 2.97, <i>P</i> < .001). Congestive heart failure (CHF) increased the odds of in-hospital mortality (aOR = 1.75, <i>P</i> < .001), unplanned ICU admission (aOR = 2.64, <i>P</i> < .001), and VAP (aOR = 2.42, P = .047). Cirrhosis increased the odds of in-hospital mortality (aOR = 3.78, <i>P</i> = .007), unplanned ICU admission (aOR = 3.11, <i>P</i> = .007), and AKI (aOR = 3.78, <i>P</i> = .007).</p><p><strong>Conclusion: </strong>Our analysis showed an association between certain comorbidities and poor outcomes in geriatric trauma patients 55 years old and older; namely, CRF, CHF, and cirrhosis were linked to increased in-hospital mortality, unplanned ICU admission, and the development of complications. Identifying these risk factors can aid in developing protocols to improve monitoring and complication-reduction strategies.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607200","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":"Acute Exacerbation of Idiopathic Pulmonary Fibrosis in the Setting of Acute Eosinophilic Pneumonia.","authors":"Duncan A McKinney, Noah R Kosnik, Shahzeib Syed, Gretchen Junko","doi":"10.36518/2689-0216.1802","DOIUrl":"10.36518/2689-0216.1802","url":null,"abstract":"<p><p>Description Idiopathic pulmonary fibrosis (IPF) is a progressive disease characterized by gradual destruction and replacement of pulmonary parenchyma with fibrous tissue, which occurs in conjunction with chronic inflammation. It is often considered a prototypical interstitial lung disease and is both the most prevalent and perhaps the most dangerous in that family. Although the disease is uncommon in the general population, its prevalence increases with age and is typically diagnosed around the age of 65. This does not preclude the development of IPF in younger individuals, and the mean survival is 2 to 5 years post-diagnosis regardless of age. Contemporary studies have provided insight into how altered pulmonary parenchyma results in increased susceptibility to opportunistic infections. It has also been demonstrated that pulmonary insults that cause inflammation, such as pneumonia, may accelerate the progression of IPF. Eosinophilic pneumonias are a collection of pulmonary diseases in which eosinophil-mediated inflammation results in respiratory compromise. Early recognition and appropriate intervention are imperative to minimize the risk of residual pulmonary function deficits, a risk that is increased in individuals with separate pulmonary risk factors. While prompt diagnosis and pharmacologic interventions are associated with improved outcomes, patients with IPF remain at risk of deterioration to the point of requiring lung transplantation. Early screening for those at risk continues to be a topic of interest. Despite the prevalence of IPF, its pathogenesis remains poorly understood and few management options are available. In this article, we document a unique case of previously undiagnosed IPF in a young individual that acutely worsened in the setting of acute eosinophilic pneumonia and the involvement of an opportunistic organism, <i>Aspergillus niger</i>. The case section will serve as a transition into a discussion of each of the major pathologic factors at play, supported by a review of recent literature.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"6 1","pages":"11-21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607455","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}