{"title":"An uncommon hazard: Pulmonary talcosis as a result of recurrent aspiration of baby powder","authors":"Czul Frank , Lascano Jorge","doi":"10.1016/j.rmedc.2011.02.001","DOIUrl":"https://doi.org/10.1016/j.rmedc.2011.02.001","url":null,"abstract":"<div><p>A previously healthy 52-year old woman presented to the hospital with a 6-month history of progressive dyspnea. Associated symptoms included a persistent dry cough that started 2 months prior admission and an unintentional weight loss of 20 pounds over the course of her illness. On lung examination revealed fine bilateral end-inspiratory crackles in both lower and upper lobes. Radiographic studies showed evidence of interstitial lung disease. The patient underwent bronchoscopy were transbronchial biopsies were taken and showed fibrosis of bronchial walls and lung parenchyma with prominent non-necrotizing granulomata that contained abundant polarizing crystalline material. Once the pathologic findings were known, the patient was re-interviewed. She reported that for the last 20-years, she used baby talcum powder regularly at least twice a day, usually after bathing for personal hygiene. In addition, she habitually applied it to her bed sheets nightly. She was started on prednisone at a dose of 0.5 mg/kg/day, which was gradually tapered and then maintained on a dose of 5 mg daily. Her symptoms rapidly improved over weeks to the point whereshe no longer required home oxygen therapy.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 3","pages":"Pages 109-111"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2011.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088783","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}
Charles Pirlet , Emmanuel Beck , André J. Scheen , Bernard Duysinx , Jean-Louis Corhay
{"title":"Hypocortisolism induces chronic respiratory failure","authors":"Charles Pirlet , Emmanuel Beck , André J. Scheen , Bernard Duysinx , Jean-Louis Corhay","doi":"10.1016/j.rmedc.2011.01.006","DOIUrl":"https://doi.org/10.1016/j.rmedc.2011.01.006","url":null,"abstract":"<div><p>Hypocortisolism is an uncommon condition. Its association with myopathy and respiratory failure has only rarely been described. We report the case of a 52 year-old woman presenting with progressive dyspnoea. Work-up revealed a severe restrictive syndrome with hypoxaemia. Further investigations showed hypocortisolism of pituitary origin. Response to hydrocortisone allowed us to conclude to an unusual case of hypocortisolic myopathy affecting the respiratory muscles.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 3","pages":"Pages 107-108"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2011.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088779","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}
M. Sanchez-Ortiz , M.J. Cruz , M. Viladrich , F. Morell , X. Muñoz
{"title":"Cryptogenic organizing pneumonia due to ortho-phenylenediamine","authors":"M. Sanchez-Ortiz , M.J. Cruz , M. Viladrich , F. Morell , X. Muñoz","doi":"10.1016/j.rmedc.2011.04.005","DOIUrl":"https://doi.org/10.1016/j.rmedc.2011.04.005","url":null,"abstract":"<div><p>Cryptogenic organizing pneumonia (COP) is a rare, potentially serious respiratory disease which may be idiopathic or secondary to other conditions. Exceptionally, cases of COP of occupational origin have been reported. We present the case of a laboratory researcher who developed COP after prolonged exposure to ortho-phenylenediamine. The diagnosis was made after a specific inhalation challenge (SIC). After clinical and radiological resolution, the patient has avoided the causal agent and remains asymptomatic.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 4","pages":"Pages 164-165"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2011.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137226499","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}
Ikjot Kaur , Agustina Saenz , Harish Iyer , Glenn Eiger , Robert Fischer , Vladimir Zagrebelsky
{"title":"A forty-year old man with advanced acquired immune deficiency syndrome and bilateral pulmonary infiltrates","authors":"Ikjot Kaur , Agustina Saenz , Harish Iyer , Glenn Eiger , Robert Fischer , Vladimir Zagrebelsky","doi":"10.1016/j.rmedc.2011.03.004","DOIUrl":"https://doi.org/10.1016/j.rmedc.2011.03.004","url":null,"abstract":"<div><p>This report describes a 40-year old man with a history of acquired immunodeficiency syndrome (AIDS) diagnosed with <em>Pneumocystis jiroveci</em> pneumonia (PJP) twice prior to this admission, who presented with 3 days of fever, non-productive cough and shortness of breath. The patient was treated empirically for PJP, but his condition deteriorated rapidly and he expired despite resuscitative efforts. The bronchoalveolar lavage (BAL) and blood cultures grew <em>Cryptococcus neoformans</em>. Very few cases of disseminated cryptococcosis presenting as acute respiratory failure have been reported. Cryptococcosis is a common opportunistic infection that should be considered in patients with AIDS presenting with bilateral pulmonary infiltrates and fever.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 4","pages":"Pages 184-186"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2011.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137225892","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}
Donall G. Forde , Brian McCullagh , Michael T. Henry , Sean P. Gaine , Desmond M. Murphy
{"title":"Chronic thromboembolic disease and necrotizing granulomatous vasculitis – A case report","authors":"Donall G. Forde , Brian McCullagh , Michael T. Henry , Sean P. Gaine , Desmond M. Murphy","doi":"10.1016/j.rmedc.2011.07.003","DOIUrl":"https://doi.org/10.1016/j.rmedc.2011.07.003","url":null,"abstract":"<div><p>A 32 year old male presented to our services with severe, progressive breathlessness. Following a detailed clinical work-up he was found to have severe pulmonary arterial hypertension due to chronic thromboembolic disease. No risk factor for venous thromboembolism,was identified at this time. Vasculitic screen including anti-neutrophil cytoplasmic antibody (ANCA) was normal. He was referred for pulmonary artery endarterectomy which was performed successfully and with good initial improvement in his symptom complex. He represented with breathlessness four months later. He was diagnosed with necrotizing granulomatous vasculitis (known formerly as Wegner's Granulomatosis). While an association between necrotizing granulomatous vasculitis and venous thromboembolic disease is well described, to our knowledge this is the first case of a patient with chronic thromboembolic pulmonary hypertensive disease subsequently developing fulminant necrotizing granulomatous vasculitis.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 4","pages":"Pages 149-150"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2011.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137226496","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 adenocarcinoma masquerading as diffuse inflammatory interstitial lung disease","authors":"Vikas Pathak, Iliana Samara Hurtado Rendon","doi":"10.1016/j.rmedc.2010.09.003","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.09.003","url":null,"abstract":"<div><p>Pulmonary adenocarcinoma has long intrigued both internists and pulmonologists because it seems to have unique epidemiologic, pathologic and clinical features. We report a case of multifocal well-differentiated adenocarcinoma, mimicking honeycombing and diffuse inflammatory interstitial lung disease.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 2","pages":"Pages 67-69"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137401428","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":"An unusual cause of “disappearing” endobronchial lesions","authors":"Pratheega Mahendra, Graeme P. Currie","doi":"10.1016/j.rmedc.2010.05.002","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.05.002","url":null,"abstract":"","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 1","pages":"Page 40"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137091392","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 tuberculosis masquerading as community acquired pneumonia","authors":"Lancelot Mark Pinto, Arpan Chandrakant Shah, Kushal Dipakkumar Shah, Zarir Farokh Udwadia","doi":"10.1016/j.rmedc.2010.11.004","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.11.004","url":null,"abstract":"<div><p>Pulmonary tuberculosis usually has a smouldering onset and progression, and patients typically present with the symptoms of cough, weight loss, anorexia, night sweats and malaise that is usually present for a few weeks before presentation.</p><p>A 22-year old man presented with symptoms, signs and radiological features of an acute severe community acquired pneumonia(CAP), a presentation that can delay the diagnosis of TB, and cause institution of antibiotics that may transiently cause clinical improvement, only to be followed by deterioration. We discuss the features that should make a physician suspect that possibility of TB, and illustrate how in a high-burden country, even in the absence of these features, TB must be considered in the differential diagnosis of any patient presenting with a CAP.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 3","pages":"Pages 138-140"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137087988","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}
S. Hammami , K. Harrathi , S. Hadded , L. Ghédira Besbès , A. Elkorbi , S. Chouchane , Ch. B. Meriem , A. Gassab , M.N. Guediche
{"title":"Hereditary angio-oedema: Long-term prophylaxis with danazol","authors":"S. Hammami , K. Harrathi , S. Hadded , L. Ghédira Besbès , A. Elkorbi , S. Chouchane , Ch. B. Meriem , A. Gassab , M.N. Guediche","doi":"10.1016/j.rmedc.2010.01.006","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.01.006","url":null,"abstract":"<div><p>Hereditary angio-oedema is a rare autosomal dominant disease characterized by recurrent attacks of subcutaneous oedema and caused by a deficiency of the plasma protein C1 inhibitor. Hereditary angio-oedema attacks carry a high risk of morbidity or even mortality. In literature, there are only a few publications on the treatment and follow-up of paediatric patients. We report the case of a 14-year-old male with known hereditary angio-oedema since the age of six years, revealed by a recurrent acute abdominal pain and oedema in subcutaneous tissues of extremities and face, and he was admitted once for sub mucosal oedema of larynx with suffocation, treated by fresh-frozen plasma with favourable outcome. Danazol was used for long-term prophylaxis. Clinical course improved over a follow-up of 12 months.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 1","pages":"Pages 15-16"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92013238","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":"Disseminated BCG disease: A case report","authors":"Sinan R. Eccles , Rohan Mehta","doi":"10.1016/j.rmedc.2010.12.003","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.12.003","url":null,"abstract":"<div><p>Disseminated BCG disease is a rare life-threatening complication of BCG administration, characterised by miliary pulmonary nodules. Presentation can mimic tuberculosis, both in symptoms and on radiological imaging. Here we report a case of disseminated BCG disease following intravesical BCG treatment for superficial bladder cancer that responded to anti-tuberculous treatment and corticosteroids, and briefly review the literature on disseminated BCG disease.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"4 3","pages":"Pages 112-113"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088782","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}