1/11. Extraction of a rubber bullet from a bronchus after 1 year: complete resolution of chronic pulmonary damage.inhalation of a foreign body (FB) into the bronchial tree rarely occurs asymptomatically and, if leading to recurrent pneumonia, can be very difficult to diagnose. The present report deals with the case of a 10-year-old boy who had three episodes of pneumonia in the left lower lobe caused by the asymptomatic inhalation of a FB 12 months before. Standard thoracic CT, done during the third episode, revealed a slight reduction in the volume of the left lung with air bronchograms, multiple areas of bronchiectasis, and parenchymal consolidation of a segment of the lower lobe. Flexible fiberoptic bronchoscopy revealed a FB at the distal end of the left lower lobar bronchus, surrounded by granulation tissue and fully obstructing the anterior basal segmental bronchus. High-resolution CT (HRCT) images showed an inverted C-shaped image obstructing a bronchus. Removal of the FB was successful only with rigid bronchoscopy under total anesthesia. The FB was an air-pistol rubber bullet that the boy remembered playing with 12 months before. Two months after removal of the FB (ie, 14 months from its asymptomatic inhalation) and treatment with oral steroids, antibiotics, and respiratory physiotherapy, the patient recovered completely, and HRCT showed complete normalization of the lung. We conclude that, when the radiographic density of the FB is greater than the surrounding pulmonary parenchyma, HRCT can reveal the FB, and diagnostic flexible fiberoptic bronchoscopy can be avoided.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/11. Fulminant clostridium difficile colitis in a patient with spinal cord injury: case report.BACKGROUND: In certain patients with clostridium difficile colitis (CDC), a life-threatening systemic toxicity may develop despite appropriate and timely medical therapy. DESIGN: literature search and case report. FINDINGS: A 39-year-old man with T10 paraplegia presented with a distended, quiet abdomen following recent treatment with antibiotics for pneumonia. diarrhea was not present. Complete blood counts demonstrated a marked leukocytosis. A CT scan of the abdomen demonstrated a state of diffuse pancolonic inflammation with peritoneal fluid. The patient was taken to the operating room and underwent total abdominal colectomy with oversewing of the rectal stump and end ileostomy for treatment of the fulminant CDC. CONCLUSION: patients with spinal cord injury (SCI) often receive antibiotics for infections of the aerodigestive tree and urinary tract and for problems with skin integrity. A heightened awareness of the development of fulminant CDC remains essential in the care of patients with SCI. Any unexplained abdominal illness after recent antibiotic administration should alert the physician to CDC and its potential as a fulminant, potentially fatal illness.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/11. Human pulmonary infection with corynebacterium equi.A 28 year old man with no underlying disease developed a cavity and multiple nodules in the lung from which corynebacterium equi was isolated. He experimented with organic solvents and microorganisms including corynebacterium species for several years. Computed tomography of his pulmonary lesions revealed that these nodules were related to the bronchial tree. Histologically, the lesions were compatible with nonspecific inflammatory changes. The clinician must suspect the pulmonary infections with corynebacterium species even if the patient has no underlying disease.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/11. Strongyloides infections in transplant recipients.Solid organ transplant recipients can experience serious disease and death from infection due to the parasitic roundworm strongyloides stercoralis. This parasite lives in soil contaminated with human feces. Domestic dogs and cats may be another reservoir. Larvae can penetrate the skin, are carried hematogenously to the lungs, migrate up the bronchial tree, and then can be passed to the upper small intestine. Autoinfection occurs in the setting of immunosuppression when invasive larvae penetrate the gut wall and cause disseminated infection. Polymicrobial sepsis is sometimes seen due to enteric organisms adhering to the parasite. Transplant recipients are at highest risk during the first 3 months posttransplant. Many organ systems may be affected. Pulmonary symptoms include cough, wheezing, sputum production, dyspnea, hemoptysis, tachypneas, and pleuritic pain. Hyperinfection, an augmentation of the normal skin-lung-intestine life cycle, occurs in roughly two-thirds of infected transplant recipients, with dissemination in the remainder. Diagnosis is made primarily by examination of the stool or intestinal secretions for ova and parasites. Occasionally, parasites are noted in the sputum. New serologic tests show promise. The parasite may remain in the host for over 25 years before immunosuppression causes either dissemination or hyperinfection. thiabendazole given for 3 to 7 days is the treatment of choice for organ transplant recipients. Repeat courses may be needed to eradicate infection.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/11. Endobronchial foreign body demonstrated by xerotomography.A case of pneumonia secondary to aspirated foreign body is presented. Xerotomography was useful in detecting abnormalities of the tracheobronchial tree and in demonstrating endobronchial foreign bodies.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/11. invasive pulmonary aspergillosis complicating influenza A pneumonia in a previously healthy patient.A rare occurrence of invasive pulmonary aspergillosis complicates influenza pneumonia in a previously healthy adult. Five other similar cases are reported in the literature. Both transient depression of cell-mediated immunity and loss of ciliary function in the tracheobronchial tree occurs during acute influenzal illness and may predispose to fungal superinfection. early diagnosis and treatment of opportunistic aspergillus infection complicating influenza is mandatory in view of the high mortality associated with this complication.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/11. Respiratory diseases and food allergy.Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect such as gastroesophageal reflux, a congenital defect of the heart or tracheo-bronchial tree, an immunodeficiency syndrome such as isolated IgA or IgG4 deficiency, or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy. When it occurs in conjunction with lung disease, it may be a helpful indicator of activity of the allergic lung disease and of the patient's compliance in following a specific diet. Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. Lower respiratory tract involvement is generally associated with a greater delay in onset of symptoms and with a larger quantity of allergen ingestion than chronic rhinitis. food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/11. Endobronchial lipoma.We have described three cases of endobronchial lipoma, which is among the least common neoplasms found in the tracheobronchial tree. If these tumors, which occur most commonly in men, are not recognized early and removed, they may produce progressive bronchial obstruction and cause recurrent bouts of obstructive pneumonitis, irreversible bronchiectasis, and pulmonary damage. Endobronchial lipomas are usually accessible to endoscopic excision, preventing permanent lung damage.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/11. Grassheads in the tracheobronchial tree: two different outcomes.Many vegetable foreign bodies can produce serious pulmonary complications because of chemical irritation to the airway. Barley grass, a type of grasshead, does not induce such a reaction because of its resistance to organic decay. Complications which may occur are illustrated by the clinical course of two patients with aspiration of this foreign body. In the first patient the grasshead entered the trachea with the flowering unit first and the stem following. In the second patient the stem entered the trachea first. Recurrent pneumonias were noted in the first patient. Despite its presence in the right stem bronchus for three years, no further episodes of pneumonia followed its removal. In the second patient the grassheads could not be removed endoscopically. They migrated into the right lower lobe producing pneumonia and ultimately resulting in a brain abscess. The difference of entry of the same foreign body into the trachea, stem first versus flowering unit first, is an essential factor in altering the clinical outcome.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
10/11. Repeated insertion of foreign bodies into the tracheobronchial tree via tracheostomy.A case of persistent pneumonia in a depressed adult woman occurring as a complication of the repeated insertion of foreign bodies into the trachea via a tracheostomy is presented. This is an unusual complication of tracheostomy but should be considered in cases of persistent or unusual pulmonary infection in tracheostomy patients.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
| | Next -> |