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B48. OCCUPATIONAL AND EXPOSURE-RELATED CASE REPORTS最新文献

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New Onset Asthma in a Nuclear Submariner Following Prolonged Exposure to Poor Air Quality 核潜艇艇员长期暴露于不良空气质量后新发哮喘
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2983
R. Kraus, C. S. Rose, R. Meehan
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引用次数: 0
Improvement in ECAC After Tracheoplasty in a "War on Terror" Veteran Following Afghanistan Deployment “反恐战争”老兵在阿富汗部署后气管成形术后ECAC的改善
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2984
S. Krefft, R. Meguid, C. S. Rose
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引用次数: 0
A Case of Occupational Exposure to Air Cooling Unit Cleaner Chemicals and Organic Material Resulting in Hypersensitivity Pneumonitis in an Immunocompromised Host 职业性接触空气冷却装置清洗剂化学物质和有机物质导致免疫功能低下宿主过敏性肺炎的一例
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2978
T. Czech
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引用次数: 0
Caffeine Overdose: More Than Just the Jitters 咖啡因过量:不仅仅是神经紧张
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2991
A. Chajkowski, W. Khan
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引用次数: 0
A Case of Probable Hypersensitivity Pneumonitis on a Fish Worker 一名养鱼工人疑似超敏性肺炎个案
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2981
G. Hernandez Romero, C. Rosenzvit, S. Spivack
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引用次数: 0
Crack Lung: A Clinical Diagnosis 裂肺:临床诊断
Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a2979
B. Ohiokpehai, V. Poddar, A. Mehari
IntroductionCrack lung is a clinically diagnosed form of diffuse alveolar hemorrhage that occurs acutely within 48 hours of smoking crack cocaine. The diagnosis of crack lung is based on history, clinical presentation, laboratory, and radiographic findings. Unlike most other forms of alveolar hemorrhage, crack lung does not require extensive or invasive work up and is managed symptomatically. We hereby present a case of acute diffuse alveolar hemorrhage secondary to crack cocaine which was clinically diagnosed and managed symptomatically. Case reportPatient was a 46-year-old female with a past medical history of type II diabetes mellitus, chronic obstructive pulmonary disease and polysubstance abuse that was brought to the emergency room after she was found unresponsive. 4mg of Narcan was administered and she became alert. Following Narcan administration, patient remained altered and confused. At the emergency room patient endorsed shortness of breath at rest which she associated it with a prior COVID-19 pneumonia one month ago. Vital signs were significant for a Temperature:99.2 blood pressure: 130/66, heart rate: 125, respiratory rate:27, Oxygen saturation: 95% on non-rebreather at 15L/min. Laboratory investigations were significant elevated creatinine (1.38, baseline unknown);white blood cell count (30.25), arterial blood gas was reported as 7.26/45/69 on 100%. Serum troponin was elevated at 3.12. Electrocardiogram showed sinus tachycardia, chest x-ray showed diffuse bilateral patchy airspace disease, computed tomography of the chest showed bilateral diffuse lung consolidation with small ground glass opacities (figure 1). Computed tomography of the head showed no acute intracranial process and urine drug screen was positive for cocaine. Patient was started on 4 mg of Narcan, 125 mg of methylprednisolone and transferred to the medical intensive care unit (MICU). In the MICU, blood, sputum and urine culture were obtained. Pt was empirically managed on vancomycin and piperacillin-tozabactam. Because of diffuse alveolar hemorrhage was in the differential, patient was continued on 80 mg of IV methylprednisolone every 8 hours. Patient was observed in the unit for 2 days. During stay in the MICU, repeat chest x-ray showed improvement in lung opacities bilaterally. Vitals were within normal range. Patient was weaned down from non-rebreather to 2 Liters of oxygen and then transferred to the general floor. ConclusionPatients with crack lung often present with shortness of breath, fever, cough with or without hemoptysis and sometimes hypoxemia within 48 hours of insult. Early diagnosis based on history, physical examination, laboratory and radiographic findings can ensure prudent management.
裂肺是一种临床诊断的弥漫性肺泡出血,在吸食快克可卡因后48小时内急性发生。裂性肺的诊断是基于病史、临床表现、实验室和影像学检查结果。与大多数其他形式的肺泡出血不同,裂性肺不需要广泛或侵入性的手术,并且可以对症治疗。我们在此报告一例急性弥漫性肺泡出血继发于快克可卡因,经临床诊断并对症处理。病例报告患者为46岁女性,既往有2型糖尿病、慢性阻塞性肺疾病和多种药物滥用病史,发现无反应后被送往急诊室。给她注射了4毫克的纳洛酮,她就清醒了。服用纳洛酮后,病人仍有改变和困惑。在急诊室,患者承认休息时呼吸急促,并将其与一个月前的COVID-19肺炎联系起来。生命体征显著a体温:99.2血压:130/66,心率:125,呼吸率:27,氧饱和度:95%,非换气15L/min。实验室检查发现肌酐显著升高(1.38,基线未知);白细胞计数(30.25),动脉血气报告为7.26/45/69(100%)。血清肌钙蛋白升高至3.12。心电图示窦性心动过速,胸部x线示弥漫性双侧斑片状空域病变,胸部ct示双侧弥漫性肺实变伴小磨玻璃影(图1)。头部ct示无急性颅内突,尿药物筛查可卡因阳性。患者开始服用4毫克纳洛酮,125毫克甲基强的松龙,并转移到医学重症监护病房(MICU)。在MICU中进行血、痰、尿培养。临床应用万古霉素和哌拉西林-托巴坦治疗。由于弥漫性肺泡出血,患者继续每8小时静脉注射80 mg甲基强的松龙。患者住院观察2天。在MICU住院期间,重复胸片显示双侧肺部混浊有所改善。生命体征在正常范围内。病人从无换气器转到2升氧气,然后转移到普通楼层。结论裂肺患者在发病48 h内多表现为呼吸短促、发热、咳嗽伴或不伴咯血,有时出现低氧血症。早期诊断基于病史,体格检查,实验室和放射检查结果可以确保谨慎的管理。
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引用次数: 0
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B48. OCCUPATIONAL AND EXPOSURE-RELATED CASE REPORTS
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