Chest
-
A 50-year-old woman who was a nonsmoker presented to the out-patient-department with history of dry cough and breathlessness on exertion for the past 4 months along with onset of dull aching chest pain for the last 2 weeks. Her breathlessness had gradually deteriorated to the point that she experienced dyspnea even on walking a few steps on level ground. ⋯ There was no history of fever, night sweats, orthopnea, paroxysmal nocturnal dyspnea, hemoptysis, dysphagia, hoarseness of voice, edema, headache, visual disturbance, weakness of any extremity, or drooping of eyelids. Her medical history revealed that she had undergone hysterectomy 8 years earlier for removal of a probable uterine mass, for which no documentation was available.
-
Editorial Comment
Maximum Respiratory Pressure Assessment: Standardization Is Required.
-
Case Reports
A 44-Year-Old Woman with Dyspnea and Hemoptysis in the Setting of Remote Bariatric Surgery.
A 44-year-old woman was transferred to the ED from an outside hospital because of hemoptysis and concern for left-sided pulmonary infiltrate with associated pleural effusion. The patient presented to this outside hospital multiple times over the past 3 months because of left-sided shoulder pain, diffuse myalgias, and supraventricular tachycardia. On her third visit, she was found to have a left-sided pleural effusion and underwent diagnostic and therapeutic thoracentesis; 1.5 L of fluid was removed. ⋯ Before her transfer, the patient experienced foul-smelling, maroon-colored hemoptysis as well as anemia that required a higher level of care. On arrival to the ED, she was in acute hypoxic respiratory failure. The patient was intubated emergently and was admitted to the medical critical care unit for further treatment.
-
A 62-year-old White man with a history of orthotopic liver transplantation 16 years ago for alcoholic liver cirrhosis on chronic immunosuppression and recurrent decompensated cirrhosis of his graft liver complicated by ascites, hepatic encephalopathy, and esophageal varices presented to the hospital with altered mental status. Over the last few weeks, he had reduced frequency of bowel movements and subsequently developed altered sensorium 3 days before presentation. On arrival to the hospital, he was disoriented and had asterixis consistent with hepatic encephalopathy. ⋯ He subsequently underwent a bronchoscopy with BAL and transbronchial biopsy. BAL fluid was negative for bacterial, fungal, and acid-fast bacilli cultures. Pathology from the transbronchial biopsy showed atypical epithelioid cells in intravascular spaces.