Internal medicine
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We describe a case with chronic bronchial foreign body presenting with recurrent hemoptysis mimicking a peripheral lung tumor, and the outcome of surgical resection. A 61-year-old female with recurrent hemoptysis had a peripheral nodule in the right lower lobe. ⋯ Surgical removal of the nodule contained a small branch of a white cedar. Chronic bronchial foreign body, while rare in adults, should be considered in the differential diagnosis of peripheral lung tumors associated with recurrent hemoptysis.
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We studied the clinical features of minocycline-induced pneumonitis in seven patients. Acute symptoms included fever, dry cough and dyspnea, indicating acute respiratory failure. ⋯ Cessation of minocycline led to rapid remission with no treatment or only short-term steroid therapy. The lymphocyte stimulation test for minocycline with peripheral blood lymphocytes was not found to be useful for diagnosis.
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We present a case of adenoid cystic carcinoma of the trachea. The tumor could not be resected due to extensive progression but it was effectively treated endoscopically with a Nd-YAG Laser followed by 70 Gy of conventional radiotherapy. Histologically-confirmed complete remission was achieved, and the patient has lived for nearly 9 years without recurrence of disease.
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Case Reports
Wegener's granulomatosis with multiple cranial nerve involvements as the initial clinical manifestations.
Wegener's granulomatosis (WG) is a disease of unknown origin characterized by necrotizing granulomas of both the upper and lower respiratory tracts and glomerulonephritis. A 62-year-old woman presenting unusual neurological manifestations is reported. The patient suffered from palsies of multiple cranial nerves without manifestation of respiratory tracts in the initial clinical course. ⋯ A diagnosis was made by a needle biopsy of the lung. Palsies of cranial nerves suspected to be due to meningeal involvement of WG. During the entire clinical course, no finding of glomerulonephritis was observed.
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Case Reports
Spontaneous resolution of an acute spontaneous spinal epidural hematoma without neurological deficits.
A 46-year-old woman presented with sudden severe pain in the interscapular region. Physical examination, including detailed neurological evaluation, did not disclose any abnormalities. ⋯ To our knowledge, this report documents the first case of a spontaneous spinal spidural hematoma without neurological deficits. Spinal epidural hematoma may be more common than previously thought because some cases have probably been misdiagnosed as transient back pain of unknown etiology.