1/212. A fluffy white traveller: imported Coccidiodes immitis infection in an Australian tourist.Pulmonary coccidioidomycosis is a rare cause of pulmonary nodules and respiratory infection in travellers to endemic areas. An Australian tourist suffered an acute respiratory illness while on holiday in mexico. She subsequently developed erythema nodosum and was noted to have a left pulmonary nodule on chest X-ray after return to australia. The diagnosis of coccidioides immitis infection was established by histology and culture of the resected lung lesion. The patient made an uneventful recovery and received one month of therapy with ketoconazole. culture of the fungus took place under controlled Class 3 conditions. An unusual fungal infection in australia, coccidioidomycosis poses special risks to staff of microbiology laboratories.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
2/212. lung mass due to amniotic fluid embolism--an intrathoracic complication of pregnancy.A 29-year-old woman with right chest pain was admitted for radiographic investigation and found to have a round mass in the right lower zone. This was initially suspected to be a hydatid lung cyst but was confirmed as a cystic mass by computed tomography and duly excised. Histologic examination revealed an amniotic fluid embolism. The patient had had a stillbirth three months earlier.- - - - - - - - - - ranking = 155.72866555926keywords = chest pain, pain (Clic here for more details about this article) |
3/212. infant pulmonary hemorrhage in a suburban home with water damage and mold (stachybotrys atra).The American Academy of pediatrics recently issued guidelines regarding the potential toxic effect of indoor molds. We now report another case of an infant with pulmonary hemorrhage whose residential environmental assessment revealed the presence of the toxigenic mold stachybotrys atra. We used a questionnaire to identify environmental factors that could predispose the home to fungal contamination. We collected air samples from multiple locations in the home that we felt would reflect areas of relevant exposure. Surface samples were collected with a piece of transparent tape for semiquantitative measurement of spores present. We classified spores into their respective genera based on shape, size, and color. We also measured mycotoxin levels. air sampling revealed significantly elevated total spore counts in the patient's bedroom and in the attic. aspergillus/penicillium species were predominant. stachybotrys spores were found in the air sampled in the patient's bedroom, as well as from surfaces sampled in the patient's closet and the attic ceiling. Additionally, a small patch of stachybotrys-contaminated area in the closet ceiling was sent for mycotoxin analysis. This material proved to be highly toxigenic. As the link between the presence of stachybotrys in the home and pulmonary hemorrhage in infants increases, further efforts should be made to educate physicians, health care providers, and new parents about the potential toxic effects of this mold.- - - - - - - - - - ranking = 2keywords = area (Clic here for more details about this article) |
4/212. Successful use of gonadotropin-releasing hormone agonist in a patient with pulmonary endometriosis.A 26-year-old single female was admitted to hospital with recurrent chest pain, cough and hemoptysis. The symptoms developed 5 months before admission coinciding with menstruation. The disease was diagnosed as pulmonary endometriosis. She was treated with a long-acting gonadotropin-releasing hormone analogue (GnRH agonist; sustained-release leuprolide acetate, 3.75 mg/month, i.m.) for 6 months. She remained asymptomatic for 16 months with regular menstruation even after discontinuing the treatment. This indicates that the initial treatment of pulmonary endometriosis with a GnRH agonist is an acceptable medical alternative, especially in patients with a short duration of the disease from the onset of the chest symptoms. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 155.72866555926keywords = chest pain, pain (Clic here for more details about this article) |
5/212. hypoventilation after high unilateral cervical chordotomy in a patient with preexisting injury of the phrenic nerve.Unilateral cervical chordotomy for the relief of intractable pain is a well accepted procedure but is not without hazard. Postoperative respiratory failure is not an uncommon occurrence, but the likelihood increases with a number of factors, particularly preexisting pulmonary abnormalities or previous contralateral cervical chordotomy. Preoperative assessment of the pulmonary function of patients who are about to have cervical chordotomy is emphasized to predict and anticipate potential postoperative respiratory failure.- - - - - - - - - - ranking = 1.3118123679652keywords = pain (Clic here for more details about this article) |
6/212. Diffuse alveolar hemorrhage syndrome due to 'silent' mitral valve regurgitation.A variety of clinical diseases are associated with diffuse alveolar hemorrhage. Although mitral valve disease can cause hemoptysis, it rarely is associated with diffuse alveolar hemorrhage at presentation. A 49-year-old woman was admitted to the hospital with the abrupt onset of fever, anemia, dyspnea, azotemia, and diffuse alveolar infiltrates. Two-dimensional echocardiography done several months earlier to evaluate atypical chest pain had been unremarkable. Fiberoptic bronchoscopy 2 days after admission to the hospital revealed fresh blood throughout the tracheobronchial tree. The infiltrates resolved rapidly and completely during systemic steroid therapy only to reappear as the steroids were tapered, suggesting a beneficial therapeutic response. Results of serologic evaluation were negative. Transbronchial biopsies showed inflammation and hemosiderin-laden macrophages; no specific diagnosis was established. The patient was scheduled for open lung biopsy. The surgeon was concerned about the history of chest pain and requested placement of a pulmonary artery catheter, which revealed severe pulmonary hypertension. Transesophageal echocardiography and subsequent cardiac catheterization showed severe mitral regurgitation. mitral valve replacement resulted in complete elimination of symptoms.- - - - - - - - - - ranking = 311.45733111852keywords = chest pain, pain (Clic here for more details about this article) |
7/212. Pulmonary manifestation of systemic mast cell disease.Systemic mast cell disease is a rare disease of unknown aetiology. Systemic infiltration and proliferation of mast cells in skin, bone marrow, gastrointestinum and lymph nodes is the central pathological feature. This study reports a patient with mastocytosis of the skin (urticaria pigmentosa) for 10 yrs. The patient was referred to hospital for dyspnoea. Chest radiograph showed moderate reticular infiltration of both lungs, computerized tomography revealed multiple lymph nodes of the mediastinum and faint nodular lesions of middle and upper areas of lungs. Transbronchial biopsy demonstrated mast cell infiltration of the lung with formation of mast cell granuloma. According to the current literature, systemic mast cell disease with pulmonary involvement is a very rare entity. After a treatment with interferon alpha-2a over 6 months, the patient's condition and particularly dyspnoea showed improvement in parallel with an amelioration of the lesions as demonstrated by thorax computed tomography.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
8/212. Radioisotope bone scanning in pulmonary alveolar microlithiasis.A 30-year-old woman was examined for a history of exertional breathlessness, swelling of her feet, and a mild dry cough of 4 to 5 months' duration. Her symptoms developed during the last month of her pregnancy, with gradually increasing dyspnea, swelling of the feet, and reduced urinary output. There was no history of expectoration, hemoptysis, chest pain, or tuberculosis. General physical examination showed no evidence of clubbing of the nails or lymphadenopathy. Chest auscultation revealed a few end-inspiratory crepitations at both lung bases. Bronchial alveolar lavage showed calcium particles, whereas results of the transbronchial lung biopsy were consistent with alveolar microlithiasis.- - - - - - - - - - ranking = 155.72866555926keywords = chest pain, pain (Clic here for more details about this article) |
9/212. Pulmonary migratory infiltrates and pachypleuritis in a patient with Crohn's disease.Crohn's disease can be associated with several respiratory manifestations. We report here a case of pulmonary migratory infiltrates associated with bilateral pleural thickening and peripheral eosinophilia. The histopathological findings show an association of necrotizing nodules, eosinophilic infiltration in the non-abscessed lung tissue, areas of non-caseating epithelioid granulomas, and an extensive pleural fibrosis. The different histopathological findings are detailed and the responsibility of either Crohn's disease or treatment by mesalazine is discussed.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
10/212. A case report of video-assisted thoracoscopic pneumonectomy for pulmonary atypical mycobacteriosis.We report a case of a 61-year old woman with pulmonary atypical mycobacteriosis. Although she had been treated with chemotherapy, image findings gradually deteriorated. Chest X-ray and CT scan demonstrated that the advanced destruction with cavity formation and diffused shadow in the right lung. She underwent a right pneumonectomy under the video-assisted thoracic surgery (VATS) approach. The operation time was 4.9 hours, and the amount of intraoperative bleeding was 550 ml. The postoperative course was uneventful and the patient was discharged from hospital on 13th postoperative day. At present, two years after the operation, there is no progress of the pathogen into the other lung, and the patient is doing well with no postoperative complaint. Anatomically, pneumonectomy is a simple procedure, and in consideration of postoperative quality of life with alleviation of pain as well, VATS is worth trying in the cases where the status and nature of the disease are suitable for this technique.- - - - - - - - - - ranking = 1.3118123679652keywords = pain (Clic here for more details about this article) |
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