Respirology Case Reports最新文献

Mycobacterium goodii, a rapidly growing non-tuberculous mycobacterium, rarely causes pulmonary diseases. A patient was admitted to our hospital with a fever and cough. Chest radiography revealed consolidation in the right middle lung. As he had previously been treated for organizing pneumonia (OP), he was diagnosed with OP recurrence and administered systemic corticosteroids. Although initial improvement was observed, the pulmonary consolidations worsened. Transbronchial lung cryobiopsy revealed an OP pattern. M. goodii was identified in sputum acid-fast bacilli cultures. The patient was diagnosed with M. goodii pulmonary disease and secondary OP. Although intravenous imipenem-cilastatin, amikacin, and ciprofloxacin led to initial improvement in pulmonary consolidations, the consolidations re-worsened. Systemic corticosteroids were initiated, resulting in improvement in the consolidations. The dose of systemic corticosteroids was tapered; oral antimycobacterial therapy was continued. M. goodii can cause pulmonary disease and induce OP; antimycobacterial therapy and systemic corticosteroids can be effective.

Chemical burns account for a small percentage of burn patients, and there are even fewer burn patients suffering from chemical burns combined with inhalation injury. As chemical substances corrode the airway, which leads to persistent necrotic shedding of the respiratory mucosa and scarring contracture as the airway heals, a proportion of patients develop airway stenosis, requiring more aggressive treatment or even surgery. A 38-year-old female chemical factory worker sustained an inhalation injury due to exposure to reactive substances (liquid and smoke) during production. She developed third- to fourth-grade airway stenosis and dyspnoea 2 months postinjury. Interhospital consultation led to referral to the Second Affiliated Hospital of Xi'an Jiaotong University for tracheotomy and endotracheal stent implantation. Postoperative dyspnoea improved, and regular follow-up was performed. The treatment process of this patient has provided us with valuable experience in the initial management and respiratory tract care of chemical burn patients.

We report a case of a 42-year-old female who had non-cardiogenic pulmonary edema following a setting position craniotomy to remove a left cerebellar pontine angle mass. During the operation, the patient experienced a sudden drop in her end-tidal CO2 levels, which needed an immediate intervention. After ruling out other potential causes, we determined that air venous embolism was the cause of this unexpected and serious complication. However, the condition was self-limited and resolved with supportive treatment after approximately 1 week. This case highlights the importance of recognizing and managing the unexpected complications of venous air embolism, as well as how prompt intervention and supportive treatment are critical for improving patient outcomes.

We present a case of pulmonary tuberculosis with a positive interferon-gamma release assay showing spontaneous regression followed by progression of radiological findings. Physicians should be aware that tuberculosis lesions can temporarily regress and careful follow up should be done if there are suspicious radiological findings.

Pulmonary artery aneurysmal rupture is a rare cause of massive hemoptysis. When the suspected origin of bleeding is the pulmonary artery, comprehensive evaluation is necessary to determine aetiology and guide appropriate management. Behçet's disease and Hughes-Stovin Syndrome (HSS) are important differentials to consider after infections and malignancy have been ruled out. Pulmonary artery aneurysms with aneurysmal wall enhancement and 'in-situ' thrombus should prompt the suspicion of HSS. Early diagnosis and treatment with immunosuppressants and endovascular interventions in selected patients may improve the prognosis and prevent episodes of fatal hemoptysis.

Totally implantable venous access devices (TIVADs) are frequently used in people with cystic fibrosis as a means of securing consistent vascular access, particularly in the context of severe disease and microbial colonization. Infection of TIVADs is not uncommon and typically associated with coagulase negative staphylococci, though infection with other organisms does occur too. We report on the first case of a TIVAD infection caused by Achromobacter xylosoxidans in person with cystic fibrosis. The TIVAD infection was complicated by a bacteraemia and an associated intracardiac infected thrombus at the superior atriocaval junction. We explore the complex management decisions surrounding the removal of the TIVAD and prolonged antibiotic treatment, with treatment ultimately resulting in a good outcome and full recovery. The case helps to serve as a timely reminder of requirement to review the necessity to retain TIVAD in the era of CFTR modulator therapy and associated improved health outcomes being experienced.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established technique for lung cancer staging and the diagnosis of mediastinal diseases. Recently, the paradigm of EBUS guided mediastinal sampling with conventional cytology has shifted over to histology specimens through the use of cryobiopsy. This case series explores the novel technique, key enablers, and potential advantages of endoscopic ultrasound with bronchoscope-guided transesophageal cryobiopsy (EUS-B-TEC). The findings of this case series suggest that EUS-B-TEC is a safe and valuable addition to the bronchoscopic procedural armamentarium. Further studies are warranted to validate the potential of EUS-B-TEC.

Rasmussen aneurysm is a rare complication of tuberculosis, where a pulmonary artery adjacent to a tuberculous cavity aneurysm may lead to life threatening hemoptysis. Sudden or severe hemoptysis is an emergency condition in TB patients who need prompt recognition and intervention, often through endovascular embolization, to prevent fatal outcomes.

Pulmonary tuberculosis with the simultaneous development of the complications of empyema, multiloculated pyopneumothorax, subcutaneous emphysema and pneumomediastinum is rare. The development of these complications leads to remarkably increased incidence of morbidity and mortality in patients. So appropriate and timely management needs to be ensured for better outcomes.

Small cell lung cancer with concurrent pleural effusion and superior vena cava obstruction is a rare presentation with high risk of respiratory and circulatory compromise warranting prompt and multidisciplinary treatment.