Chest
-
A 31-year-old Asian male never-smoker living in the upper Midwest with a past medical history of congenital bilateral hearing loss sought treatment with a 1-week history of fever, fatigue, right-sided pleuritic chest pain, shortness of breath, productive cough with mild intermittent hemoptysis, night sweats, and unintentional 10-lb weight loss over 4 weeks. He was adopted from South Korea as an infant, and thus the family history was unknown. ⋯ He travelled to South Korea and New Hampshire approximately 9 months previously. He did not take any medication.
-
Congenital tracheoesophageal fistula is usually diagnosed at an early age, but may remain undetected into adulthood if atresia is absent and if the fistula is small. A tracheoesophageal fistula should be suspected in patients with unexplained episodes of respiratory distress or pneumonia; however, more subtle signs can be an important symptom for early recognition of the disease. ⋯ In the present case, air movement between the esophagus and the trachea through the fistula caused a high-pitched sound, which the patient described as a "catlike cry." The high-pitched sound ceased after surgical closure of the fistula. We report here the symptom of "catlike cry" as one manifestation of tracheoesophageal fistula.
-
Case Reports
A 37-Year-Old Man With Structural Focal Epilepsy and Paroxysmal Nocturnal Breathing Arrests.
A 37-year-old male patient was referred to our sleep laboratory with suspected sleep-disordered breathing. His partner reported periods of breathing arrest accompanied by an odd expiratory noise during sleep, occurring on a near to weekly basis. ⋯ The patient was medicated with phenytoin (100 mg), and reported being seizure-free within the last year. He said that he was otherwise in good health.