Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1997
Case Reports[Extracorporeal membrane oxygenation for acute respiratory failure induced by Legionella pneumoniae. (Case report)].
We report a case of severe legionella pneumonia with acute respiratory failure, successfully managed with veno-venous extracorporeal membrane oxygenation (VV-ECMO). The patient presented with 4-day history of fever and cough. He was in critical condition, with exacerbated respiratory failure. ⋯ VV-ECMO was maintained for 92 hours, mechanical ventilation was successfully discontinued 11 days after and the patient was discharged 82 days after cessation of ventilator support. Serum antibody examination proved legionella infection. VV-ECMO may have a role in the management of patients with acute respiratory failure caused by bacterial pneumonia.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1997
Case Reports[A case of Sairei-to-induced pneumonitis diagnosed by lymphocyte stimulation test of bronchoalveolar lavage fluid].
A 51-year-old woman was admitted with fever, cough and dyspnea. She had been taking Sairei-to, a traditional Chinese medicine, for 2 months. On admission, chest X-ray revealed a ground-glass appearance in the lung fields bilaterally and serum LDH was elevated. ⋯ Sairei-to-induced pneumonitis was diagnosed based on the clinical course, laboratory findings, BALF cell analysis and LST of BALF. Only 4 cases of pneumonitis due to Sairei-to have been reported. This case suggests that LST of BALF is useful for diagnosing drug-induced pneumonitis.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1997
Case Reports[A case of acute eosinophilic pneumonia due to Sho-saiko-to].
A 16-year-boy who had taken a common over-the-counter cold remedy containing Sho-saiko-to, presented with fever, severe cough, sputum and dyspena. Two days later, he was admitted because a negative density, pulmonary edema-like shadow was noted on chest X-ray. A diagnosis of drug-induced pneumonia was strongly suspected, because an arterial blood gas analysis showed severe hypoxemia and leukocytosis with eosinophilia, and the chest X-ray showed a diffuse negative density pulmonary edema like shadow bilaterally. ⋯ The patient ceased taking the cold remedy, and prednisolone was given. The clinical symptoms, severe hypoxemia, and chest X-ray findings markedly improved. To the best of our knowledge, there have been no previous reports of acute eosinophilic pneumonia induced by Sho-saiko-to.
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Nihon Kyobu Shikkan Gakkai Zasshi · Nov 1997
Case Reports[An adult case of Williams-Campbell syndrome associated with pulmonary hypertension and a severe decrease in ventilatory response].
Williams-Campbell syndrome is a unique form of bronchiectasis caused by a congenital defect in bronchial cartilage, and is rare in Japan. A 34-year-old man was admitted to our hospital with a fever, and a productive cough. Arterial blood gas analysis revealed severe type II-respiratory failure. ⋯ Despite severe hypoxia, he did not suffer from dyspnea. We examined ventilatory response to hypercapnea (HCVR) and hypoxia (HVR), and both HCVR and HVR were abnormal. In addition, the mean pulmonary artery pressure was 26 mmHg, indicating pulmonary hypertension.
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Nihon Kyobu Shikkan Gakkai Zasshi · Nov 1997
Review Case Reports[A clinical study of 5 cases of acute eosinophilic pneumonia--the relationship between beginning to smoke and acute eosinophilic pneumonia].
We encountered 5 cases of acute eosinophilic pneumonia. All cases were young men who had recently begun smoking, and they showed an acute onset hypoxemia, diffuse shadows on chest X-ray, an elevation of eosinophils in the peripheral blood and broncho-alveolar lavage fluid, and rapid recovery. One of the 5 cases showed a re-elevation of eosinophils in the peripheral blood and broncho-alveolar lavage fluid after a smoking challenge test. It appears that one of the causes of acute eosinophilic pneumonia is beginning to smoke.