Respiratory medicine case reports
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Respir Med Case Rep · Jan 2020
Case ReportsSARS-CoV2 induced pulmonary embolism and complications from anticoagulation.
Coronavirus disease (COVID-19) pandemic has rapidly spread around the world. As new complications associated with the virus become more apparent, concerns in the medical community continue to grow. One of the more commonly encountered and more troubling complications in critically ill patients has been hypercoagulable state and subsequent thrombotic events. ⋯ Literature review suggests that pulmonary clot burden in COVID-19 patients could be due to pulmonary thrombus rather than pulmonary embolism and is triggered by profuse vascular damage and severe inflammatory response. Literature review also proposes changes to the diagnostic work up in COVID-19 patients, such as earlier screening for pulmonary embolism in critically ill. In addition, rare and severe complications of current anticoagulation therapy is illustrated and discussed through one of the cases presented.
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Respir Med Case Rep · Jan 2020
Case ReportsAcute Respiratory Distress Syndrome in a pregnant patient with COVID-19 improved after delivery: A case report and brief review.
Acute Respiratory Distress Syndrome (ARDS) can frequently occur as a complication of Coronavirus Disease 19 (COVID-19). As the number of COVID-19 cases increases around the world, it is inevitable that COVID-19 and ARDS will complicate some pregnancies. Currently, there is scant data to guide decision-making on the timing of delivery for these patients. We present the case of a 41-year-old patient with severe ARDS from COVID-19 who was also 32 weeks pregnant, whose respiratory status improved dramatically after delivery.
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Respir Med Case Rep · Jan 2020
Case ReportsLate presentation of lung adenocarcinoma in a stable solitary pulmonary nodule: A case presentation and review of the literature.
A 67-year-old patient has been followed by our pulmonary clinic for Chronic obstructive pulmonary disease (COPD) and a stable pulmonary nodule. Solitary pulmonary nodule (SPN) was detected on the lung cancer screening by low dose computed tomography (CT) scan of the chest. It remained stable on repeat CT scan at 6, 12 and 24-months interval. ⋯ The patient then underwent right upper lobectomy followed by chemoradiation therapy. Current guidelines do not recommend follow up for a solitary pulmonary nodules less than 6 mm nodule if it remains stable for 12-24 months. Our case report of the late presentation of lung adenocarcinoma in a stable solitary pulmonary nodule suggests the need to exercise increased caution in the management of incidental pulmonary nodules.
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Respir Med Case Rep · Jan 2020
Case ReportsA presentation of E-Cigarette vaping associated lung injury (EVALI) caused by THC-Containing electronic smoking device.
Several cases have recently been reported concerning the development of a syndrome of acute lung injury associated with the use of electronic cigarettes, leading to respiratory failure and several deaths. We present a case of a young veteran who presented with e-cigarette vaping associated lung injury (EVALI) to a primary care clinic and who required subsequent inpatient admission and home oxygen therapy after discharge. ⋯ This outpatient case of EVALI prompts primary care providers to raise suspicion of this condition, and enquire about the use of e-cigarettes, particularly THC-containing vaping products. Furthermore, in the setting of the COVID-19 pandemic, similar clinical and radiographic presentations between COVID-19 and EVALI can be seen.
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Respir Med Case Rep · Jan 2020
Case ReportsEfficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases.
Infection with COVID-19 potentially can result in severe outcomes and death from "cytokine storm syndrome", resulting in novel coronavirus pneumonia (NCP) with severe dyspnea, acute respiratory distress syndrome (ARDS), fulminant myocarditis and multiorgan dysfunction with or without disseminated intravascular coagulation. No published treatment to date has been shown to adequately control the inflammation and respiratory symptoms associated with COVID-19, apart from oxygen therapy and assisted ventilation. We evaluated the effects of using high dose oral and/or IV glutathione in the treatment of 2 patients with dyspnea secondary to COVID-19 pneumonia. ⋯ Oral and IV glutathione, glutathione precursors (N-acetyl-cysteine) and alpha lipoic acid may represent a novel treatment approach for blocking NF-κB and addressing "cytokine storm syndrome" and respiratory distress in patients with COVID-19 pneumonia.