Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1237
Kenneth Nugent
{"title":"Recent COVID and Influenza activity in Texas","authors":"Kenneth Nugent","doi":"10.12746/swrccc.v11i49.1237","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1237","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1247
Tushi Singh, Dauod Arif
{"title":"Where is the primary? A rare form of lung cancer","authors":"Tushi Singh, Dauod Arif","doi":"10.12746/swrccc.v11i49.1247","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1247","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1223
Duc Le, Triet Le, Mark Fredrickson, John Norbury
Spinal epidural hematoma is a rare but severe medical condition that can cause neurological deficits and disability. In this case report, a 53-year-old man with poorly controlled hypertension and end-stage renal disease presented with hypertensive crisis and a one-week history of symptoms including back pain, abdominal pain, and pain radiating down his legs. Despite aggressive blood pressure control, the patient was found to have a 21mm ventral epidural hematoma at T10 causing thoracic cord compression and paraplegia. The patient underwent surgical hematoma evacuation but remained paraplegic with minimal motor and sensory recovery. Spinal epidural hematoma as a complication of hypertensive crisis is rare. Clinicians should be aware of the potential development of spinal epidural hematoma in patients with hypertensive crisis, even in cases with no obvious risk factors. Prompt diagnosis and treatment are crucial for preventing permanent neurological damage and improving patient outcomes. Further research is needed to better understand the underlying mechanisms and risk factors for spinal epidural hematoma in patients with hypertensive crisis.
{"title":"Class A ventral spinal epidural hematoma as a rare complication of hypertensive crisis","authors":"Duc Le, Triet Le, Mark Fredrickson, John Norbury","doi":"10.12746/swrccc.v11i49.1223","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1223","url":null,"abstract":"Spinal epidural hematoma is a rare but severe medical condition that can cause neurological deficits and disability. In this case report, a 53-year-old man with poorly controlled hypertension and end-stage renal disease presented with hypertensive crisis and a one-week history of symptoms including back pain, abdominal pain, and pain radiating down his legs. Despite aggressive blood pressure control, the patient was found to have a 21mm ventral epidural hematoma at T10 causing thoracic cord compression and paraplegia. The patient underwent surgical hematoma evacuation but remained paraplegic with minimal motor and sensory recovery. Spinal epidural hematoma as a complication of hypertensive crisis is rare. Clinicians should be aware of the potential development of spinal epidural hematoma in patients with hypertensive crisis, even in cases with no obvious risk factors. Prompt diagnosis and treatment are crucial for preventing permanent neurological damage and improving patient outcomes. Further research is needed to better understand the underlying mechanisms and risk factors for spinal epidural hematoma in patients with hypertensive crisis.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1249
Lauren Mazin, Christopher Peterson, Miles Thomas, Yunan Wang
Abstract: Trueperella bernardiae is an infrequently identified Gram-positive bacillus that has been isolated in various clinical infections. Here we report a case of T bernardiae infection in a paraplegic male and report antimicrobial susceptibilities.
Keywords: Trueperella bernardiae, polymicrobial infection, antibiotic resistance
{"title":"Trueperella bernardiae bacteremia in paraplegic patient with polymicrobial infection","authors":"Lauren Mazin, Christopher Peterson, Miles Thomas, Yunan Wang","doi":"10.12746/swrccc.v11i49.1249","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1249","url":null,"abstract":"Abstract: Trueperella bernardiae is an infrequently identified Gram-positive bacillus that has been isolated in various clinical infections. Here we report a case of T bernardiae infection in a paraplegic male and report antimicrobial susceptibilities.
 Keywords: Trueperella bernardiae, polymicrobial infection, antibiotic resistance","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1233
Kenneth Nugent
Cystic fibrosis (CF) is an autosomal recessive disorder that involves the cystic fibrosis transmembrane conductance regulator. This protein is an anion channel that transfers chloride and bicarbonate from an intracellular location to an extracellular location. This transfer supports the formation of a normal periciliary fluid layer that is essential for ciliary function and the clearance of particulates from bronchi. Changes in mucociliary function can result in chronic bronchitis and recurrent infections. Studies using micro computed tomography of explanted lungs from CF patients have demonstrated that there is a significant reduction in the number of terminal bronchi and that approximately 50% of these bronchi are obstructed with secretions. These airways become colonized with bacteria, such as Pseudomonas aeruginosa, which can form biofilms, and this results in chronic inflammation and chronic airway damage. Biofilm formation can be predicted when mucoid colonies of pseudomonas grow out on routine bacterial cultures of sputum. Studies on the prognosis of patients with CF have demonstrated that there is lack of clear genotype-phenotype correlation, but one recent longitudinal study did report an association between more severe CFTR genotypes and clinical outcomes. In addition, the degree of pulmonary dysfunction and pseudomonas colonization, especially with drug resistant pseudomonas, predict poor outcomes. Bacteria in biofilms are more resistant to antibiotics, and the structure of biofilms limits host defense responses. Treatment approaches include the use of more than one antibiotic, the addition of inhaled antibiotics, the use of enzymes that degrade biofilms, and the use of small molecules that inhibit community metabolism in biofilms.
Key words: cystic fibrosis transmembrane conductance regulator, extracellular secretions, periciliary fluid, Pseudomonas aeruginosa, biofilms
{"title":"Cystic fibrosis and pulmonary biofilms","authors":"Kenneth Nugent","doi":"10.12746/swrccc.v11i49.1233","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1233","url":null,"abstract":"Cystic fibrosis (CF) is an autosomal recessive disorder that involves the cystic fibrosis transmembrane conductance regulator. This protein is an anion channel that transfers chloride and bicarbonate from an intracellular location to an extracellular location. This transfer supports the formation of a normal periciliary fluid layer that is essential for ciliary function and the clearance of particulates from bronchi. Changes in mucociliary function can result in chronic bronchitis and recurrent infections. Studies using micro computed tomography of explanted lungs from CF patients have demonstrated that there is a significant reduction in the number of terminal bronchi and that approximately 50% of these bronchi are obstructed with secretions. These airways become colonized with bacteria, such as Pseudomonas aeruginosa, which can form biofilms, and this results in chronic inflammation and chronic airway damage. Biofilm formation can be predicted when mucoid colonies of pseudomonas grow out on routine bacterial cultures of sputum. Studies on the prognosis of patients with CF have demonstrated that there is lack of clear genotype-phenotype correlation, but one recent longitudinal study did report an association between more severe CFTR genotypes and clinical outcomes. In addition, the degree of pulmonary dysfunction and pseudomonas colonization, especially with drug resistant pseudomonas, predict poor outcomes. Bacteria in biofilms are more resistant to antibiotics, and the structure of biofilms limits host defense responses. Treatment approaches include the use of more than one antibiotic, the addition of inhaled antibiotics, the use of enzymes that degrade biofilms, and the use of small molecules that inhibit community metabolism in biofilms.
 
 Key words: cystic fibrosis transmembrane conductance regulator, extracellular secretions, periciliary fluid, Pseudomonas aeruginosa, biofilms","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.12746/swrccc.v11i49.1219
Shakira Meltan, Ethan Matthew, Michelle Tarbox
This case report describes a 73-year-old Caucasian male who contracted COVID-19 and struggled with chronic, severe pruritus after that. The patient's pruritus resisted numerous conventional and unconventional therapy modalities, highlighting the difficulty of treating post-COVID-19 dermatological symptoms. Pruritus in the patient was significantly alleviated due to therapy with Dupixent, a monoclonal antibody that inhibits interleukin-4 and interleukin-13 signaling. Treatment of the condition improved significantly with the use of Dupixent. The report describes the story of the patient's journey, from the first-time symptoms showed up after COVID-19 infection, through several treatments that was not effective, to when the patient's symptoms disappeared after starting Dupixent. The patient's recent SARS-CoV-2 infection may be connected to the immune-mediated process shown by the patient's histopathological results. Even though these results are based on a single instance, they highlight COVID-19's ability to cause chronic pruritus and recommend Dupixent as a possible treatment approach. More study is required to confirm these findings and investigate possible immunological connections between COVID-19 and chronic pruritus.
{"title":"Revealing the therapeutic potential of dupilumab: a case report on managing post-COVID-19 chronic pruritus in a geriatric patient","authors":"Shakira Meltan, Ethan Matthew, Michelle Tarbox","doi":"10.12746/swrccc.v11i49.1219","DOIUrl":"https://doi.org/10.12746/swrccc.v11i49.1219","url":null,"abstract":"This case report describes a 73-year-old Caucasian male who contracted COVID-19 and struggled with chronic, severe pruritus after that. The patient's pruritus resisted numerous conventional and unconventional therapy modalities, highlighting the difficulty of treating post-COVID-19 dermatological symptoms. Pruritus in the patient was significantly alleviated due to therapy with Dupixent, a monoclonal antibody that inhibits interleukin-4 and interleukin-13 signaling. Treatment of the condition improved significantly with the use of Dupixent. The report describes the story of the patient's journey, from the first-time symptoms showed up after COVID-19 infection, through several treatments that was not effective, to when the patient's symptoms disappeared after starting Dupixent. The patient's recent SARS-CoV-2 infection may be connected to the immune-mediated process shown by the patient's histopathological results. Even though these results are based on a single instance, they highlight COVID-19's ability to cause chronic pruritus and recommend Dupixent as a possible treatment approach. More study is required to confirm these findings and investigate possible immunological connections between COVID-19 and chronic pruritus.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.12746/swrccc.v11i48.1191
Ola Al-Jobory, A. Dweik, Anees Muhammed, W. Rasheed, I. Mohammed, K. Mcmaster, R. Gulati
Noonan syndrome is a rare genetic disease with multisystemic manifestations, typically diagnosed in infancy and childhood. This case report presents a 53-year-old woman with no significant medical history who presented with shortness of breath and was subsequently diagnosed with Noonan syndrome. The patient exhibited characteristic facial dysmorphology, including a narrow face, low set ears, and pectus excavatum. Physical examination revealed a crescendo-decrescendo ejection murmur and bilateral lower limb edema. Atrial flutter with rapid ventricular response was detected, and further investigations revealed a large secundum atrial septal defect (ASD) and other cardiac abnormalities consistent with Noonan syndrome. The patient was transferred to a tertiary center for evaluation and management by adult congenital disease specialists. This case highlights the atypical presentation of Noonan syndrome in adulthood and emphasizes the importance of recognizing this condition in patients with cardiac anomalies, as it can impact perioperative management and necessitates genetic counseling. Keywords: Noonan syndrome, genetic disease, multisystemic manifestations, atrial septal defect, adult presentation
{"title":"Late presentation of Noonan syndrome as atrial flutter in an adult","authors":"Ola Al-Jobory, A. Dweik, Anees Muhammed, W. Rasheed, I. Mohammed, K. Mcmaster, R. Gulati","doi":"10.12746/swrccc.v11i48.1191","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1191","url":null,"abstract":"Noonan syndrome is a rare genetic disease with multisystemic manifestations, typically diagnosed in infancy and childhood. This case report presents a 53-year-old woman with no significant medical history who presented with shortness of breath and was subsequently diagnosed with Noonan syndrome. The patient exhibited characteristic facial dysmorphology, including a narrow face, low set ears, and pectus excavatum. Physical examination revealed a crescendo-decrescendo ejection murmur and bilateral lower limb edema. Atrial flutter with rapid ventricular response was detected, and further investigations revealed a large secundum atrial septal defect (ASD) and other cardiac abnormalities consistent with Noonan syndrome. The patient was transferred to a tertiary center for evaluation and management by adult congenital disease specialists. This case highlights the atypical presentation of Noonan syndrome in adulthood and emphasizes the importance of recognizing this condition in patients with cardiac anomalies, as it can impact perioperative management and necessitates genetic counseling. \u0000Keywords: Noonan syndrome, genetic disease, multisystemic manifestations, atrial septal defect, adult presentation","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79800721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-19DOI: 10.12746/swrccc.v11i48.1187
Addie Pederson, R. B. Coleman, M. Irving
Micrococcus luteus is a common organism in the human skin flora. It is an uncommon cause of pathogenic bloodstream infections, which occur mostly in immunocompromised patients. We report the clinical course of an 82-year-old man who underwent complex management of multiple diverticular abscesses and had three serial positive blood cultures for M. luteus. Despite treatment with vancomycin, the patient ultimately died due to septicemia secondary to mixed gastrointestinal flora and M. luteus. A source this infection was never definitely identified.
{"title":"An unknown source of Micrococcus luteus bacteremia","authors":"Addie Pederson, R. B. Coleman, M. Irving","doi":"10.12746/swrccc.v11i48.1187","DOIUrl":"https://doi.org/10.12746/swrccc.v11i48.1187","url":null,"abstract":"Micrococcus luteus is a common organism in the human skin flora. It is an uncommon cause of pathogenic bloodstream infections, which occur mostly in immunocompromised patients. We report the clinical course of an 82-year-old man who underwent complex management of multiple diverticular abscesses and had three serial positive blood cultures for M. luteus. Despite treatment with vancomycin, the patient ultimately died due to septicemia secondary to mixed gastrointestinal flora and M. luteus. A source this infection was never definitely identified.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81344644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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