Pub Date : 2023-01-24DOI: 10.12746/swrccc.v11i46.1121
D. Vangipuram
A trapped lung, one that cannot expand due to a restrictive fibrous visceral pleural peel, is caused by malignancy, chest trauma, thoracic surgery, complicated infection, and autoimmune conditions. Suspicion for and evaluation of this condition should be considered early on in a patient with history of the above conditions that presents with a chronic pleural effusion of stable volume. Diagnosis is reached with pleural fluid analysis, manometry that shows negative intrapleural pressure that is further reduced with fluid aspiration, and imaging that shows a chronic effusion and pleural thickening. Treatment is dependent on symptomatology and overall patient condition, and ranges from observation to fluid removal, fibrinolytic therapy, talc pleurodesis, indwelling pleural catheter, and surgical decortication. A review of English literature from the last 10 years including case reports, case series, and observational reviews was conducted. A majority of these patients presented with trapped lung due to malignancy, infection, or autoimmune conditions. Treatment varied depending on the cause of the trapped lung, underlying conditions, and patient preference; a majority of these patients received either pleurodesis, intrapleural fibrinolytic therapy, or surgical decortication.
{"title":"Trapped lung: a review of literature and recent cases","authors":"D. Vangipuram","doi":"10.12746/swrccc.v11i46.1121","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1121","url":null,"abstract":"A trapped lung, one that cannot expand due to a restrictive fibrous visceral pleural peel, is caused by malignancy, chest trauma, thoracic surgery, complicated infection, and autoimmune conditions. Suspicion for and evaluation of this condition should be considered early on in a patient with history of the above conditions that presents with a chronic pleural effusion of stable volume. Diagnosis is reached with pleural fluid analysis, manometry that shows negative intrapleural pressure that is further reduced with fluid aspiration, and imaging that shows a chronic effusion and pleural thickening. Treatment is dependent on symptomatology and overall patient condition, and ranges from observation to fluid removal, fibrinolytic therapy, talc pleurodesis, indwelling pleural catheter, and surgical decortication. A review of English literature from the last 10 years including case reports, case series, and observational reviews was conducted. A majority of these patients presented with trapped lung due to malignancy, infection, or autoimmune conditions. Treatment varied depending on the cause of the trapped lung, underlying conditions, and patient preference; a majority of these patients received either pleurodesis, intrapleural fibrinolytic therapy, or surgical decortication.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89629465","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1141
C. Peterson, A. Ammu, Audrey Mangwiro, Christopher J. Crist
Abstract The use of ivermectin for the treatment of COVID-19 infections has been a subject of significant interest and controversy. The drug has a history of off-label use for a variety of clinical disorders and has shown some potential as an antiviral drug in in vitro studies and animal studies, and it has a relatively favorable safety profile. Multiple studies have been published examining the use of ivermectin against COVID-19. While several studies suggested it could be an effective therapeutic, most of these studies were insufficiently robust, had design flaws, or did not report any changes in important clinical outcomes, such as mortality. A smaller number of more robust studies did not support ivermectin use for COVID-19 treatment. Therefore, at present, ivermectin cannot be recommended for the treatment of COVID-19. While further studies may be warranted, this decision must be weighed against the possibility that this research may not alter current recommendations on the use of ivermectin in COVID-19 infections. Keywords: COVID-19; ivermectin; prophylaxis, hospitalization, respiratory failure, mortality
{"title":"Ivermectin - an antiviral drug for the COVID-19 pandemic?","authors":"C. Peterson, A. Ammu, Audrey Mangwiro, Christopher J. Crist","doi":"10.12746/swrccc.v11i46.1141","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1141","url":null,"abstract":"Abstract \u0000The use of ivermectin for the treatment of COVID-19 infections has been a subject of significant interest and controversy. The drug has a history of off-label use for a variety of clinical disorders and has shown some potential as an antiviral drug in in vitro studies and animal studies, and it has a relatively favorable safety profile. Multiple studies have been published examining the use of ivermectin against COVID-19. While several studies suggested it could be an effective therapeutic, most of these studies were insufficiently robust, had design flaws, or did not report any changes in important clinical outcomes, such as mortality. A smaller number of more robust studies did not support ivermectin use for COVID-19 treatment. Therefore, at present, ivermectin cannot be recommended for the treatment of COVID-19. While further studies may be warranted, this decision must be weighed against the possibility that this research may not alter current recommendations on the use of ivermectin in COVID-19 infections. \u0000 \u0000Keywords: COVID-19; ivermectin; prophylaxis, hospitalization, respiratory failure, mortality \u0000 ","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91227164","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1123
Juthipong Benjanuwattra, N. Eshak, Mahmoud Abdelnabi
{"title":"Unusual cause of gastrointestinal bleeding in a patient with chronic pancreatitis","authors":"Juthipong Benjanuwattra, N. Eshak, Mahmoud Abdelnabi","doi":"10.12746/swrccc.v11i46.1123","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1123","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81322804","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1125
G. Berdine
{"title":"COVID Policy: The Sorcerer’s Apprentice","authors":"G. Berdine","doi":"10.12746/swrccc.v11i46.1125","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1125","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90841061","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1059
S. Tasnim, Dhara Dave, N. Dweik, Sinan Yaqoob, Naguib Tarek
Rhodococcus is a rare zoonotic infection causing cavitary pneumonia in immunocompromised humans. There had been very few reported incidences of Rhodococcus osteomyelitis. Our patient is a 27 years old male with human immunodeficiency virus (HIV) infection who was diagnosed with Rhodococcus osteomyelitis and bacteremia. He initially presented with right hip pain and was diagnosed with osteomyelitis and abscess based on a CT scan. IR guided drainage of the abscess was done and culture yielded R. equi. He failed antibiotic treatment multiple times and later was managed with surgical intervention. Although it is a rare case, physicians should keep it in mind especially in immunocompromised patients while deciding on diagnosis and treatment plans.
{"title":"A rare case of Rhodococcus osteomyelitis","authors":"S. Tasnim, Dhara Dave, N. Dweik, Sinan Yaqoob, Naguib Tarek","doi":"10.12746/swrccc.v11i46.1059","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1059","url":null,"abstract":"Rhodococcus is a rare zoonotic infection causing cavitary pneumonia in immunocompromised humans. There had been very few reported incidences of Rhodococcus osteomyelitis. Our patient is a 27 years old male with human immunodeficiency virus (HIV) infection who was diagnosed with Rhodococcus osteomyelitis and bacteremia. He initially presented with right hip pain and was diagnosed with osteomyelitis and abscess based on a CT scan. IR guided drainage of the abscess was done and culture yielded R. equi. He failed antibiotic treatment multiple times and later was managed with surgical intervention. Although it is a rare case, physicians should keep it in mind especially in immunocompromised patients while deciding on diagnosis and treatment plans.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86222119","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1113
Harrison Marsh, Addie Pederson, Coby Ray, K. Freedman
Canaliculitis is not considered to be a common condition and can be frequently misdiagnosed. The condition can also be challenging to eradicate. Canaliculitis accounts for 2-4% of lacrimal disease and is most often associated with Actinomyces israelii, Staphylococcus, and Strepococcus. However, these cases represent occasions of canaliculitis caused by uncharacteristic bacteria. We herein report three unique cases of canaliculitis that each required probing and irrigation of the infected lacrimal duct to culture bacteria following resistance to initial antibacterial treatment. Each case resulted in a different microbe, the cultures of the expelled purulent material grew Eikenella corrodens, Parvimonas micra, andCorynebacterium jeikeium respectively. All three cases occurred in rural west Texas woman with ages of 68, 70, and 40 years-old respectively. These cases highlight the importance of recognizing the possible involvement of uncharacteristic bacteria for the proper management of canaliculitis and proceeding to appropriate lacrimal procedures when empiric therapy is ineffective.
{"title":"Cases with uncharacteristic bacteria in canaliculitis","authors":"Harrison Marsh, Addie Pederson, Coby Ray, K. Freedman","doi":"10.12746/swrccc.v11i46.1113","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1113","url":null,"abstract":"Canaliculitis is not considered to be a common condition and can be frequently misdiagnosed. The condition can also be challenging to eradicate. Canaliculitis accounts for 2-4% of lacrimal disease and is most often associated with Actinomyces israelii, Staphylococcus, and Strepococcus. However, these cases represent occasions of canaliculitis caused by uncharacteristic bacteria. We herein report three unique cases of canaliculitis that each required probing and irrigation of the infected lacrimal duct to culture bacteria following resistance to initial antibacterial treatment. Each case resulted in a different microbe, the cultures of the expelled purulent material grew Eikenella corrodens, Parvimonas micra, andCorynebacterium jeikeium respectively. All three cases occurred in rural west Texas woman with ages of 68, 70, and 40 years-old respectively. These cases highlight the importance of recognizing the possible involvement of uncharacteristic bacteria for the proper management of canaliculitis and proceeding to appropriate lacrimal procedures when empiric therapy is ineffective.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"283 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73376560","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1087
Benjamin Lee, Christopher Peterson, Joshua Peterson, M. Lacy
Relapsing polychondritis remains a challenging diagnosis with cartilage inflammation being the hallmark disease pathology. Typical presentations include inflammation of auricular cartilage and joints, although multiple sites can be affected. Symptoms often overlap with other diseases and diagnosis is often delayed. Neurologic symptoms are rare and are attributed to CNS vasculitis. Here we report a rare case of relapsing polychondritis with neurological symptoms. This case illustrates both the challenges of diagnosis and the need to consider relapsing polychondritis in cases of cartilaginous inflammation.
{"title":"Relapsing polychondritis presenting as otitis externa","authors":"Benjamin Lee, Christopher Peterson, Joshua Peterson, M. Lacy","doi":"10.12746/swrccc.v11i46.1087","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1087","url":null,"abstract":"Relapsing polychondritis remains a challenging diagnosis with cartilage inflammation being the hallmark disease pathology. Typical presentations include inflammation of auricular cartilage and joints, although multiple sites can be affected. Symptoms often overlap with other diseases and diagnosis is often delayed. Neurologic symptoms are rare and are attributed to CNS vasculitis. Here we report a rare case of relapsing polychondritis with neurological symptoms. This case illustrates both the challenges of diagnosis and the need to consider relapsing polychondritis in cases of cartilaginous inflammation.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84698553","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1083
S. Tasnim, B. Mohanakrishnan, Nandini Ray, Manish Patel
Thumbtack aspiration is a medical emergency as the sharp end poses a risk of injuring the respiratory tract and potentially causing fatal complications. Its removal can be difficult, even under bronchoscopy guidance, as the sharp end can potentially lead to bronchial mucosal tears and perforation. We present a case of a 16-year-old male who was admitted following the unintentional ingestion of a thumbtack which was removed via flexible bronchoscopy. These sharp metal objects are commonly removed using rigid bronchoscopy, but removal by flexible bronchoscopy, although challenging, is still possible.
{"title":"Tic-“tack”-toe, out I go: A strategic implementation of flexible bronchoscopy in the removal of an aspirated thumbtack","authors":"S. Tasnim, B. Mohanakrishnan, Nandini Ray, Manish Patel","doi":"10.12746/swrccc.v11i46.1083","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1083","url":null,"abstract":"Thumbtack aspiration is a medical emergency as the sharp end poses a risk of injuring the respiratory tract and potentially causing fatal complications. Its removal can be difficult, even under bronchoscopy guidance, as the sharp end can potentially lead to bronchial mucosal tears and perforation. We present a case of a 16-year-old male who was admitted following the unintentional ingestion of a thumbtack which was removed via flexible bronchoscopy. These sharp metal objects are commonly removed using rigid bronchoscopy, but removal by flexible bronchoscopy, although challenging, is still possible.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72646589","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 : 2023-01-24DOI: 10.12746/swrccc.v11i46.1135
G. Berdine
{"title":"Comparisons between health care practices in Nazi Germany and the current United States","authors":"G. Berdine","doi":"10.12746/swrccc.v11i46.1135","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1135","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86478358","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 : 2023-01-08DOI: 10.12746/swrccc.v11i46.1091
Christopher Peterson, Benjamin Lee, Mark Lacy
Carotid cavernous fistula is a serious vascular pathology that is commonly misdiagnosed due to clinical signs that overlap with several other pathologies and the need for sensitive imaging techniques, most notably digital subtraction angiography, to make the diagnosis. Here we present a case of carotid cavernous fistula mimicking orbital cellulitis, ultimately diagnosed with magnetic resonance venography.
{"title":"Carotid cavernous fistula presenting as orbital cellulitis","authors":"Christopher Peterson, Benjamin Lee, Mark Lacy","doi":"10.12746/swrccc.v11i46.1091","DOIUrl":"https://doi.org/10.12746/swrccc.v11i46.1091","url":null,"abstract":"Carotid cavernous fistula is a serious vascular pathology that is commonly misdiagnosed due to clinical signs that overlap with several other pathologies and the need for sensitive imaging techniques, most notably digital subtraction angiography, to make the diagnosis. Here we present a case of carotid cavernous fistula mimicking orbital cellulitis, ultimately diagnosed with magnetic resonance venography.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76731936","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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