Respiratory medicine case reports
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Respir Med Case Rep · Jan 2019
Case ReportsTrajectory of lung function to pleuroparenchymal fibroelastosis late after haematopoietic stem-cell transplantation.
Pleuroparenchymal fibroelastosis is characterized by upper lobes subpleural intra-alveolar fibrosis and elastosis with visceral pleural fibrosis, which may occur after allogenic haematopoietic stem-cell transplantation (HSCT). The longitudinal changes of lung function preceding this complication have not been described. ⋯ Computed tomography showed the distinctive features of pleuroparenchymal fibroelastosis, confirmed by histology of specimen from apical resection after pneumothorax. This case report suggests that pleuroparenchymal fibroelastosis may occur after HSCT following bronchiolitis obliterans syndrome with a mixed (restrictive-obstructive) lung function pattern.
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Respir Med Case Rep · Jan 2019
Case ReportsUse of point-of-care ultrasound to assess esophageal insufflation during bag mask ventilation: A case report.
Bag-valve-mask ventilation is a basic airway management technique often used in patients with acute respiratory failure. Although highly effective in providing oxygenation and ventilation, this technique has been associated with gastric regurgitation and tracheal aspiration. In this case, the esophagus visualized with bedside ultrasonography during bag-mask ventilation of an unresponsive and critically ill patient. ⋯ Cricoid pressure did not prevent esophageal insufflation. Ultrasound-guided probe pressure attenuated esophageal insufflation. This case depicts a unique instance of using a novel method to assess breath delivery during bag mask ventilation of a critically ill patient.
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Respir Med Case Rep · Jan 2019
Case ReportsDisseminated tuberculosis with severe immune thrombocytopenia.
Immune thrombocytopenia is an autoimmune condition with increased platelet destruction. Immune thrombocytopenic purpura is an uncommon and rare manifestation of tuberculosis. ⋯ Due to severe thrombocytopenia patient was managed with IVIg and steroids along with anti tubercular therapy. Early diagnosis and treatment with Anti tubercular therapy is important for effective control of bleeding manifestations.
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Respir Med Case Rep · Jan 2019
Case ReportsHeat-not-burn cigarettes induce fulminant acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation.
Although the cause of acute eosinophilic pneumonia (AEP) has not yet been fully clarified, cigarette smoking is reported to be a risk factor for developing AEP. The heat-not-burn cigarette (HNBC) was developed to reduce the adverse effects of smoke on the user's surroundings. However, the health risks associated with HNBCs have not yet been clarified. We report a successfully treated case of fatal AEP presumably induced by HNBC use. ⋯ As far as we know, our patient is the first case of AEP induced by HNBC use successfully treated with ECMO. Emergency physicians must be aware that HNBCs can induce fatal AEP.
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Respir Med Case Rep · Jan 2019
Case ReportsBilateral pneumothorax after pacemaker placement "Buffalo chest".
Bilateral pneumothoraces following unilateral subclavian vein cannulation is a rare complication. It is usually associated with an intrapleural communication which can be congenital or formed following cardiothoracic and mediastinal surgeries, or trauma. The term Buffalo chest was used to define a single chest cavity with no anatomic separation of the two hemithoraces. ⋯ In distinction, the pleural cavities in humans are entirely separated. We describe an 83-year-old female without prior history of cardiothoracic surgery, trauma or lung disease, who underwent dual chamber pacemaker placement using a left subclavian vein access and developed bilateral pneumothoraces following the procedure. The bilateral pneumothoraces were completely resolved with single left-sided thoracostomy tube placement suggesting the patient had "Buffalo chest".