Respiratory medicine case reports
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Respir Med Case Rep · Jan 2020
Case ReportsNebulized fentanyl for refractory dyspnea secondary to chronic obstructive pulmonary disease (COPD): A case report.
We present a case where we evaluated the effectiveness of nebulized fentanyl in the treatment of refractive dyspnea in a patient with chronic obstructive pulmonary disease (COPD) with major complications and comorbidities. Nebulized fentanyl was used to successfully decrease the subjective symptoms of refractory dyspnea in this given patient. Nebulized fentanyl appears to be a cost-effective treatment option in patients that experience episodes of severe shortness of breath (SOB).
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Respir Med Case Rep · Jan 2020
Case ReportsPulmonary cement embolism complicating percutaneous kyphoplasty: A case report.
Vertebral cement augmentation procedures, as kyphoplasty (KP) or percutaneous vertebroplasty (PVP), are commonly used for the management of pain of the vertebral column usually due to fractures related to traumatic injury, osteoporosis or metastatic lesion. It is a useful and safe technique with few complications. Among them, symptomatic pulmonary cement embolism (PCE) can happened, even rarely described in the literature, leading to severe cardio-respiratory manifestations depending on the location and size of the cement emboli. ⋯ In this case, the pulmonary cement embolism occurred after kyphoplasty, which is associated with less risk of PCE than vertebroplasty. The procedure was done under biplanar fluoroscopy and no leakage of cement was noted, which would raise suspicion for CPE. Repeat imagine after this procedure is not routinely done. This case demonstrates that systematic imaging post procedure should be considered.An anticoagulation with rivaroxaban seems to be effective in our patient.
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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 case of lymphocytic interstitial pneumonia presenting with a ground glass nodule as an initial finding.
A 65-year-old woman had a ground glass nodule, which was suspicious for lung cancer, in her right lung S6 by chest computed tomography. For diagnosis, video-assisted thoracoscopic surgery was performed, and the specimen showed a pathological pattern of lymphocytic interstitial pneumonia (LIP). ⋯ Subsequently, no other underlying diseases associated with LIP developed. The ground glass nodule was the initial lesion of LIP.
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Respir Med Case Rep · Jan 2020
Case ReportsRecurrence of emphysema post-lung transplantation in a patient with alpha 1 antitrypsin deficiency (AATD).
The genetic disorder alpha 1 antitrypsin deficiency (AATD) results in reduced levels of alpha 1 antitrypsin (AAT) in the lung and an imbalance between AAT anti-protease activity and the activity of proteases that degrade elastin and connective tissues. This imbalance commonly leads to the excessive proteolysis of structural tissue of the alveoli, causing chronic obstructive pulmonary disease (COPD)/emphysema. ⋯ Recurrence of COPD/emphysema was observed in a patient with AATD 2 years after initial successful lung transplantation and cessation of AAT therapy who recommenced smoking after no signs of disease at the 1-year assessment. This case demonstrates that smoking cessation is critical in patients with AATD, even after lung transplant, and it highlights that patients with AATD may benefit from AAT therapy post-lung transplant.