Chest
-
Case Reports
Disseminated miliary blastomycosis leading to acute respiratory failure in an urban setting.
Disseminated blastomycosis, usually a chronic slowly progressive illness, primarily occurs in individuals with a history of exposure to a rural environmental source. We report a case of disseminated blastomycosis leading to acute respiratory failure in a young man confined to prison in an urban area.
-
Only one study has examined the clinical issues presented by critically ill obstetric patients with respect to medical indications for intensive care unit (ICU) admission and fetal and maternal morbidity and mortality. Therefore, a review of all obstetric patients admitted to a medical-surgical ICU in a large tertiary referral center over a five-year period was conducted. Obstetric, ICU-related, and diagnostic data were recorded for each patient. ⋯ Of the eight women admitted with viable pregnancies to the ICU, seven were delivered during the ICU stay and all fetuses survived. There was a high incidence of acute lung injury (25 percent) that was associated with nonpulmonary or pulmonary infection in all eight cases. However, the mortality was only 25 percent.
-
An attempt to access the central venous circulation in a patient with a persistent left pleural effusion resulted in positioning the catheter within the pleural space. Chest roentgenograms with injection of contrast material revealed catheter location. Compliance with standard preventive practices may not assure correct placement of a central venous catheter via the internal jugular route in a patient with a hemothorax or effusion of unknown composition.