Respiratory medicine case reports
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Respir Med Case Rep · Jan 2020
Case ReportsCOVID-19 in a patient with a flare of systemic lupus erythematosus: A rare case-report.
This is a rare case-report of a young female with systemic lupus erythematosus and end-stage kidney disease (on maintenance hemodialysis) who was admitted to our intensive care unit due to life-threatening COVID-19. The patient was diagnosed with a flare of lupus; while being on maintenance hydroxychloroquine therapy. ⋯ In conclusion, patients with lupus may be affected by COVID-19 despite the administration of hydroxychloroquine. The administration of steroids may have a beneficial effect on mitigating both the flare of SLE and the COVID-19 associated hyperinflammation.
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Respir Med Case Rep · Jan 2020
Case ReportsSARS-CoV2 induced pulmonary embolism and complications from anticoagulation.
Coronavirus disease (COVID-19) pandemic has rapidly spread around the world. As new complications associated with the virus become more apparent, concerns in the medical community continue to grow. One of the more commonly encountered and more troubling complications in critically ill patients has been hypercoagulable state and subsequent thrombotic events. ⋯ Literature review suggests that pulmonary clot burden in COVID-19 patients could be due to pulmonary thrombus rather than pulmonary embolism and is triggered by profuse vascular damage and severe inflammatory response. Literature review also proposes changes to the diagnostic work up in COVID-19 patients, such as earlier screening for pulmonary embolism in critically ill. In addition, rare and severe complications of current anticoagulation therapy is illustrated and discussed through one of the cases presented.
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Respir Med Case Rep · Jan 2020
Case ReportsAcute Respiratory Distress Syndrome in a pregnant patient with COVID-19 improved after delivery: A case report and brief review.
Acute Respiratory Distress Syndrome (ARDS) can frequently occur as a complication of Coronavirus Disease 19 (COVID-19). As the number of COVID-19 cases increases around the world, it is inevitable that COVID-19 and ARDS will complicate some pregnancies. Currently, there is scant data to guide decision-making on the timing of delivery for these patients. We present the case of a 41-year-old patient with severe ARDS from COVID-19 who was also 32 weeks pregnant, whose respiratory status improved dramatically after delivery.
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Respir Med Case Rep · Jan 2020
Case ReportsLate presentation of lung adenocarcinoma in a stable solitary pulmonary nodule: A case presentation and review of the literature.
A 67-year-old patient has been followed by our pulmonary clinic for Chronic obstructive pulmonary disease (COPD) and a stable pulmonary nodule. Solitary pulmonary nodule (SPN) was detected on the lung cancer screening by low dose computed tomography (CT) scan of the chest. It remained stable on repeat CT scan at 6, 12 and 24-months interval. ⋯ The patient then underwent right upper lobectomy followed by chemoradiation therapy. Current guidelines do not recommend follow up for a solitary pulmonary nodules less than 6 mm nodule if it remains stable for 12-24 months. Our case report of the late presentation of lung adenocarcinoma in a stable solitary pulmonary nodule suggests the need to exercise increased caution in the management of incidental pulmonary nodules.
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Respir Med Case Rep · Jan 2020
Case ReportsNegative pressure pulmonary edema related with severe sleep apnea syndrome: A case report.
Negative pressure pulmonary edema (NPPE) caused by airway obstruction was often life-threatening. Major cause of NPPE in adult patients was reported as post-operative laryngospasm. Therefore, NPPE was recognized widely among surgeons and anesthesiologist, but physicians also could face NPPE case in several clinical situation. ⋯ Therefore, we thought that the NPPE could be caused by severe SAS in this case. Continuous positive airway pressure therapy could improve this patient's symptoms promptly, and this patient could discharge without a complication. We should consider SAS as a cause of NPPE when examining NPPE patients especially with onset during sleep.