-
Respiratory Medicine Case Reports 2023Patients with injection drug use can have nonthrombotic pulmonary emboli (NTPE) of foreign insoluble particles that are either parts of the equipment used or mixed with...
Patients with injection drug use can have nonthrombotic pulmonary emboli (NTPE) of foreign insoluble particles that are either parts of the equipment used or mixed with the drug as an additive. These foreign particles can become a nidus for infection and inflammation. We present a case of a 31-year-old man with active intravenous drug use who initially presented with signs and symptoms of pleurisy and was found to have NTPE of septic refractile crystalline material as seen on bronchial wash and brush biopsy. We believe our patient likely had embolism of either crack particles, needle fragments or cotton-wool fragments that led to a localized inflammatory reaction and infection. This highlights the importance of obtaining detailed history and diagnostic workup. Once the diagnoses of bacterial endocarditis and thrombophlebitis are ruled out with blood cultures, transthoracic echocardiogram, -esophageal echocardiogram and/or CT scan (depending on the suspicion), NTPE should be considered and bronchoscopy with bronchoalveolar lavage with biopsy should be performed.
PubMed: 37577124
DOI: 10.1016/j.rmcr.2023.101884 -
Familial Mediterranean Fever in a 28-Year-Old Male Presented as a Painless Massive Pleural Effusion.Cureus Jul 2023This case describes the first patient with familial Mediterranean fever (FMF) with massive left pleural effusion as the first clinical manifestation, to whom a...
This case describes the first patient with familial Mediterranean fever (FMF) with massive left pleural effusion as the first clinical manifestation, to whom a video-assisted thoracoscopic surgery was performed to support the diagnosis. The patient was a 28-year-old male, who presented with dry cough and dyspnea but no fever. The lab findings showed hypoxemia (partial pressure of oxygen= 65 mm Hg) accompanied by elevated inflammatory markers, including C-reactive protein at 7 mg/dl (<0.5 mg/dl), erythrocyte sedimentation rate of 46 mm/h (<20 mm/h), and serum amyloid at 56.7 mg/L (<10 mg/L). X-ray indicated the left pleural effusion was part of a bilateral recurrent painless pleuritis, as the right pleural thickening implied. Numerous biopsies were taken during the thoracoscopy, and the histopathology examination reported non-specific fibrous pleurisy. Colchicine administration, at first empirically for upcoming pericarditis, at the end was a significant clue for the diagnosis. Positive molecular testing for mutations in the familial Mediterranean fever (MEFV) gene contributed to the diagnosis of FMF, which was based on the Tel-Hashomer clinical criteria. The purpose of this article is hopefully to raise further awareness about patients with FMF presented with unusual manifestations of the disease.
PubMed: 37575846
DOI: 10.7759/cureus.41776 -
Clinical Case Reports Aug 2023Linezolid (LZD) is an efficient addition antibiotic against multidrug-resistant strains. However, clinicians should pay attention to the adverse reactions such as...
KEY CLINICAL MESSAGE
Linezolid (LZD) is an efficient addition antibiotic against multidrug-resistant strains. However, clinicians should pay attention to the adverse reactions such as hypoglycemia and anemia in using LZD, especially in elderly patients and patients with abnormal liver and kidney function who need to use LZD for a long time.
ABSTRACT
Severe hypoglycemia and anemia caused by linezolid (LZD) are rare, with potentially serious adverse effects. The report of LZD-induced hypoglycemia and anemia is extremely rare. Thus far, this is the first report. We presented LZD-induced recurrent hypoglycemia and anemia in a 93-year-old patient who has been prescribed LZD 600 mg once daily for 42 days for treatment of tuberculosis (TB) pleurisy and pneumonia. The patient began to experience recurrent hypoglycemic episodes and anemia 5 days and 2 weeks after LZD medication, respectively. Using Naranjo's Adverse Drug Reaction Assessment Scale, the patient scored 8 points with the category of "probable". His hypoglycemia and anemia gradually improved 1 month after LZD withdrawal. Clinicians should pay attention to the adverse reactions such as hypoglycemia and anemia in using LZD, especially in elderly patients and patients with abnormal liver and kidney function who need to use LZD for a long time. Patients should regularly monitor blood routine, blood glucose, and liver and kidney functions during LZD exposure, which may avoid adverse reactions and improve their prognosis.
PubMed: 37529131
DOI: 10.1002/ccr3.7713 -
The Journal of International Medical... Jul 2023Pleurisy and pleural effusion caused by infection are rare. However, clinicians lack an understanding of these possibilities, and the underlying disorder is easy to...
Pleurisy and pleural effusion caused by infection are rare. However, clinicians lack an understanding of these possibilities, and the underlying disorder is easy to misdiagnose. We report a 52-year-old male farmer who was admitted to hospital with a fever, chest pain, and shortness of breath. Closed chest drainage was performed by thoracocentesis, and the concentration of adenosine deaminase (ADA) in the pleural fluid was >45 U/L. Mononuclear cells in the pleural fluid accounted for 90% of the cells, and pathology indicated a large number of lymphocytes. The clinical diagnosis was tuberculosis with tuberculous pleurisy. However, subsequent pleural fluid culture results did not support tuberculous pleurisy. The results of pleural fluid culture indicated , and the results of tiger red plate agglutination indicated a titer of 1:400 (+++). The final diagnosis was brucellosis with pneumonia and pleurisy. After 12 weeks of oral treatment, the patient underwent follow-up chest radiographs. Radiography indicated complete resolution of the hydrothorax and pneumonia, and the patient reported no discomfort. The short-term curative effect was excellent. Pleurisy associated with brucellosis should be considered a differential for pleurisy in regions where brucellosis is endemic, to minimize the risk of misdiagnosis.
Topics: Male; Humans; Middle Aged; Tuberculosis, Pleural; Brucella; Pleurisy; Pleural Effusion; Brucellosis; Pneumonia; Diagnostic Errors
PubMed: 37523165
DOI: 10.1177/03000605231187952 -
International Journal of Molecular... Jul 2023(APP) is the causative pathogen of porcine pleuropneumonia, a highly contagious respiratory disease in the pig industry. The increasingly severe antimicrobial...
(APP) is the causative pathogen of porcine pleuropneumonia, a highly contagious respiratory disease in the pig industry. The increasingly severe antimicrobial resistance in APP urgently requires novel antibacterial alternatives for the treatment of APP infection. In this study, we investigated the effect of tea polyphenols (TP) against APP. MIC and MBC of TP showed significant inhibitory effects on bacteria growth and caused cellular damage to APP. Furthermore, TP decreased adherent activity of APP to the newborn pig tracheal epithelial cells (NPTr) and the destruction of the tight adherence junction proteins β-catenin and occludin. Moreover, TP improved the survival rate of APP infected mice but also attenuated the release of the inflammation-related cytokines IL-6, IL-8, and TNF-α. TP inhibited activation of the TLR/MAPK/PKC-MLCK signaling for down-regulated TLR-2, TLR4, p-JNK, p-p38, p-PKC-α, and MLCK in cells triggered by APP. Collectively, our data suggest that TP represents a promising therapeutic agent in the treatment of APP infection.
Topics: Animals; Swine; Mice; Pleuropneumonia; Actinobacillus pleuropneumoniae; Toll-Like Receptor 4; Actinobacillus; Tight Junctions; Lung; Actinobacillus Infections; Mycoplasma Infections; Tea; Swine Diseases
PubMed: 37511601
DOI: 10.3390/ijms241411842 -
Diagnostics (Basel, Switzerland) Jul 2023We present the case of a 35-year-old patient without pathological history who developed hemopneumothorax due to altitude barotrauma during a commercial airline flight....
We present the case of a 35-year-old patient without pathological history who developed hemopneumothorax due to altitude barotrauma during a commercial airline flight. The computed tomography (CT) of the chest identified the presence of right hydropneumothorax and emphysema "blebs" and bubbles. After the therapeutic insertion of a drain tube, the patient returned to the country by land transport. Three weeks later, he was diagnosed with right-sided pleurisy based on a CT scan with contrast material. A surgical intervention was then performed, and three biopsy samples were taken; the histopathological result highlighted suggestive elements for the diagnosis of desquamative interstitial pneumonia (DIP).
PubMed: 37510111
DOI: 10.3390/diagnostics13142367 -
JPMA. the Journal of the Pakistan... Jul 2023Long COVID is a term used to describe the persistence of symptoms in people who have had COVID-19 for an extended period. It affects multiple systems including...
Long COVID is a term used to describe the persistence of symptoms in people who have had COVID-19 for an extended period. It affects multiple systems including neurological (fatigue, brain fog, attention issues, memory issues), neuromuscular (sarcopenia, myositis, arthritis and myopathy), cardiovascular (myopericarditis, right ventricular dysfunction, vasculitis and aortic, arterial and venous thrombosis) and respiratory (pulmonary fibrosis, pleurisy, pulmonary embolism and pneumonitis). This results in functional impairments which adversely affect the quality of life of patients. The rehabilitation of persons who have experienced long COVID-19, also known as "long haulers," is a relatively new field of study. We have described potential rehabilitation interventions to improve functional capacity and quality of life in patients with long COVID. These rehabilitation interventions include but are not limited to, endurance, flexibility and strength training, pulmonary rehabilitation, task specific exercises to improve Activities of Daily Living (ADL), psychological rehabilitation, medical rehabilitation, pain management and management of dysphagia.
Topics: Humans; Activities of Daily Living; Post-Acute COVID-19 Syndrome; Quality of Life; COVID-19; Exercise Therapy
PubMed: 37469084
DOI: 10.47391/JPMA.23-54 -
Annals of Medicine and Surgery (2012) Jul 2023Bladder metastases are rare, representing only 2% of all bladder tumors, secondary bladder localization from a primary lung is exceptional.
UNLABELLED
Bladder metastases are rare, representing only 2% of all bladder tumors, secondary bladder localization from a primary lung is exceptional.
CASE PRESENTATION
The authors describe the case followed for lung adenocarcinoma with an exceptional metastatic site, which is the bladder. A computed tomography scan showed a left suprahilar bronchial tumor with pleurisy (Fig. 1A), which biopsies concluded to a moderately differentiated adenocarcinoma. The patient is treated with palliative cisplatin-based chemotherapy. And died 11 months after diagnosis.
CLINICAL DISCUSSION
Bladder metastases are rare, representing only 2% of all malignant bladder tumors. Metastatic lesions of the bladder are generally revealed by hematuria. Confirmation of bladder invasion is immunohistochemical, facilitated by knowledge of the primitive.
CONCLUSION
In the presence of any adenocarcinoma of the bladder, a thoracic-abdominal-pelvic computed tomography scan must be requested in search of a primary extra-vesical cancer who can facilitate the diagnosis.
PubMed: 37427244
DOI: 10.1097/MS9.0000000000000872 -
GMS Hygiene and Infection Control 2023Healthcare workers (HCWs) are at increased risk of becoming infected with complex (Mtbc). (Review)
Review
BACKGROUND
Healthcare workers (HCWs) are at increased risk of becoming infected with complex (Mtbc).
OBJECTIVE
To assess the magnitude of Mtbc transmission by children under the age of 15 years to HCW.
METHODS
Medline, Google Scholar and Cochrane library were searched to select primary studies in which a child was the presumed index case and exposed HCW were screened for latent TB infection (LTBI).
RESULTS
Of 4,702 abstracts, 15 original case reports covering 16 children with TB were identified. In sum, 1,395 HCW were contact persons and underwent testing. Ten of the studies reported TST conversion, amounting to 35 (2.9%) of the 1,228 HCW tested. In three of the TST-based and both of the studies that used IGRA testing, conversion was absent. 12 of the 15 studies (80%) reported exposure of HCW in neonatal intensive units (NICUs) to premature infants suffering from congenital pulmonary TB. One study including two infants addressed possible pulmonary Mtbc transmission in a general pediatric ward. Extrapulmonary transmission by aerosolized Mtbc was suggested in two patients, an infant with tuberculous peritonitis and a 12-year-old adolescent with pleurisy, and culture-confirmed only after the child had undergone video-assisted thoracoscopic surgery. Routine use of protective facemasks by HCW before exposure was not mentioned in any of the included studies.
CONCLUSIONS
The results suggest that the risk of Mtbc transmission from children to HCW is low. Particular attention should be paid to infection risk during respiratory manipulations in NICUs. The consistent wearing of facemasks may further reduce the risk of Mtbc transmission.
PubMed: 37405249
DOI: 10.3205/dgkh000439 -
Frontiers in Public Health 2023Currently, tuberculous pleurisy (TP) remains a serious problem affecting global public health, including in China. Our purpose was to comprehensively understand and...
BACKGROUND
Currently, tuberculous pleurisy (TP) remains a serious problem affecting global public health, including in China. Our purpose was to comprehensively understand and identify the incidence of TP in mainland China between 2005 and 2018.
METHODS
The data on registered TP cases from 2005 to 2018 were acquired from the National Tuberculosis Information Management System. We analyzed the demographics, epidemiology, and time-space distribution of TP patients. Then, the effects of potentially influential factors on TP incidences, such as medical expenses per capita, GDP per capita, and population density, were assessed using the Spearman correlation coefficient.
RESULTS
The incidence of TP increased in mainland China from 2005 to 2018, with a mean incidence of 2.5 per 100,000 population. Interestingly, spring was the peak season for TP, with more notified cases. Tibet, Beijing, Xinjiang, and Inner Mongolia had the highest mean annual incidence. A moderate positive relationship was found between TP incidence, medical expenses per capita, and GDP per capita.
CONCLUSIONS
The notified incidence of TP had an elevated trend from 2005 to 2018 in mainland China. The findings of this study provide insight into the knowledge of TP epidemiology in the country, which can help optimize resource allocation to reduce the TP burden.
Topics: Humans; Tuberculosis, Pleural; Incidence; China; Tibet; Population Density
PubMed: 37397728
DOI: 10.3389/fpubh.2023.1180818