Chest
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A 43-year-old man urgently was referred to the hospital complaining of rapidly worsening dyspnea and right-side chest wall discomfort for 1 hour. Two hours later, he experienced acute respiratory failure that subsequently required intubation and invasive mechanical ventilation, thus he was transferred to ICU. He had no fever, weight loss, or bleeding tendency. He was previously healthy with no history of trauma and was not currently on any medication.
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A 27-year-old man was hospitalized in the burn unit after sustaining an acute inhalational injury and facial burns after an accidental occupational exposure to an industrial disinfectant consisting of a mixture of hydrogen peroxide (15%-30%), acetic acid (5%-15%), and peracetic acid (5%-15%). He demonstrated cough, shortness of breath, and hoarseness of voice at presentation that had developed 6 h after exposure. In addition to the inhalational injury of the vocal cords and lower airways on bronchoscopy (Fig 1), the patient also was diagnosed with acute inhalational pneumonitis based on the findings of hypoxemic respiratory failure and bilateral perihilar airspace opacities on chest radiography (Fig 2). ⋯ However, symptoms of productive cough and shortness of breath on exertion persisted, and he was rehospitalized 27 days after exposure. He was a nonsmoker with no prior history of atopy, asthma, or lung disease. His medical history was remarkable for hypertension and severe obesity with a BMI of 34.7 kg/m2.
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Case Reports
Eosinophilic Pleural Effusion in a Young Woman With Pleural Nodularity and Lytic Skeletal Lesions.
A 21-year-old woman, a housewife with no known comorbidities, presented to the outpatient department with complaints of dry cough, left-sided pleuritic chest pain, modified Medical Research Council grade II breathlessness and backache. She had started developing these symptoms 1 month earlier. There was no history of fever, hemoptysis, or significant weight loss. ⋯ She was married for 1 year and had no children. Her sleep, bowel, and bladder habits were normal. No significant family history or medication history was noted.
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Although resuscitation with IV fluids is the cornerstone of sepsis management, consensus regarding their association with improvement in clinical outcomes is lacking. ⋯ In this single-center retrospective study, we found that by broadly defining respiratory failure as an increase in oxygen requirements, a conservative initial IV fluid resuscitation strategy did not correlate with decreased rates of hypoxemic respiratory failure.