Respiratory medicine case reports
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Respir Med Case Rep · Jan 2018
Case ReportsAn autopsy case of bird-related chronic hypersensitivity pneumonitis presenting with repeated acute exacerbation.
A 68-year-old woman was admitted to our hospital with a dry cough in 2010. Chest computed tomography showed the appearance of a nonspecific interstitial pneumonia (NSIP) pattern. Video-assisted thoracoscopic surgery (VATS) was performed, and the specimens prominently showed a usual interstitial pneumonia (UIP) pattern. ⋯ Even though she was treated with corticosteroids and immunosuppressants and recommended to avoid bird-related antigens, she had a progressive course with repeated acute exacerbation episodes and died of respiratory failure. The autopsy findings showed diffuse alveolar damage superimposed on UIP. Clinicians should be aware that BRCHP patients especially with histopathologically UIP pattern may experience acute exacerbation.
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Respir Med Case Rep · Jan 2018
Case ReportsCement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report.
Vertebroplasty is a procedure most commonly used for vertebral compression fractures. Although it is a relatively safe procedure, complications have been reported. Cement embolism is seen in 2.1%-26% of patients after percutaneous vertebroplasty. ⋯ in patients with pulmonary cement embolism, conservative treatment may be recommended rather than a surgical removal except when the obstruction is extensive enough to cause hemodynamic changes. Given that all the related studies have suggested that pulmonary thromboembolism can occur as a complication due to bone cement leakage, discovering new cement alternatives and/or injection devices, seems beneficial.
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Respir Med Case Rep · Jan 2018
Case ReportsAcute respiratory distress syndrome after the use of gadolinium contrast agent.
Acute respiratory distress syndrome (ARDS) is a life-threatening medical emergency. The etiology of ARDS can involve various causes. ARDS associated with the use of iodinated contrast media is rarely reported, and the literature includes only one case of ARDS due to gadobutrol. ⋯ She was treated for anaphylaxis, then immediately evaluated using chest x-ray and arterial blood gas analysis. Based on the findings, she was diagnosed with ARDS and started on continuous positive airway pressure (CPAP) ventilatory support and methylprednisolone at a dose of 1 mg/kg/day. On day 3 of follow-up, all symptoms had completely regressed.
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Respir Med Case Rep · Jan 2018
Case ReportsPartial neuromuscular blockage to promote weaning from mechanical ventilation in severe ARDS: A case report.
Spontaneous breathing efforts during mechanical ventilation can lead to patient self-inflicted lung injury (P-SILI). In order to prevent P-SILI, patients are generally heavily sedated and receive muscle relaxation, resulting in a slower weaning process. We present a case in which we applied partial neuromuscular blockage in order to prevent P-SILI while allowing spontaneous breathing but with limited efforts during assist mechanical ventilation.
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Respir Med Case Rep · Jan 2017
Case ReportsA unilateral hyperlucent lung - Swyer-James syndrome: A case report and literature review.
Swyer-James-Macleod syndrome (SJMS) is a rare etiology of a unilateral hyperlucent hemithorax but an important one, which should be considered in any individual with such findings. Presentation usually occurs in adulthood with an asymptomatic history in many cases or with a history of childhood infections. Clinically, symptomatic patients may present with productive cough, dyspnea on exertion, hemoptysis, decreased exercise tolerance and recurrent pulmonary infections. ⋯ However, some patients may require surgical intervention. SJMS can be easily misdiagnosed and must be suspected for example, in any patient diagnosed with asthma who does not respond to therapy. We report a case of a 51-year-old African American male diagnosed with SJMS on the basis of his medical history, clinical presentation and x-rays and computed tomography chest scans findings.