SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
In a 39-year-old man radiologic examination could not distinguish definitely between a hydropneumothorax and total destruction of one lung. Introduction of a fiberoptic bronchoscope through the opening for the chest drainage tube permitted direct inspection of the air space. A definite diagnosis of a destroyed lung was made, permitting appropriate modification of the treatment.
Pleural involvement in nocardiosis is rarely reported from India. A case of hydropneumothorax due to Nocardia asteroides in a patient with diabetes mellitus is reported. Tube thoracostomy drainage and therapy with trimethoprim-sulphamethoxazole for seven months prevented reaccumulation of pleural fluid and improved the general condition but failed to expand the lung. Bronchoscopy may be useful if multiple sputum examinations are negative in diagnosing pulmonary nocardiosis.
INTRODUCTION: We report a case of Lemierre's syndrome. CLINICAL PICTURE: A previously healthy 36-year-old woman presented with a 2- to 3-month history of fever, cough, dyspnoea and sore throat, which had worsened in the week prior to presentation. Computed tomography of the thorax showed multiple bilateral cavitating lesions and a right-sided hydropneumothorax with mediastinal shift. Blood cultures grew Fusobacterium and Bacteroides species. TREATMENT: Broad-spectrum antibiotics were commenced, a chest drain was inserted, and the patient was transferred to the intensive care unit due to worsening respiratory failure. OUTCOME: Despite intensive supportive care with broad-spectrum antibiotics, aggressive fluid resuscitation and high-dose inotropic support, the patient developed acute renal failure, disseminated intravascular coagulation and intractable shock, and succumbed 8 days later. CONCLUSIONS: Although this condition is uncommon, it should be considered in the differential diagnosis of patients with pulmonary cavitating lesions, especially in the context of fever and rigors preceded by a sore throat.
A case of pulmonary sarcoidosis involving the pleura and complicated by spontaneous hydropneumothorax is reported. Diagnosis is made by cytological features of pleural effusion and confirmed by mediastinal biopsy. The rare occurrence of this clinical situation must be diagnosed because of the important therapeutic implications, but in any event it indicates the severity of granulomatous disease.
A case of pulmonary hydatid disease which ruptured to produce a hydropneumothorax is reported. Radiologically the patient presented with an oval opacity which enlarged with an appearance of air crescent. Diagnosis was established by cytological examination of aspirated pleural fluid and an histopathological examination of tissue found in the drainage tube. The patient was managed conservatively with intercostal drainage, albendazole therapy and other supportive measures.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pulmonary tuberculosis, a disease largely limited to third-world populations only 15 years ago, is increasingly becoming a public health problem again in the U.S. We review an emergent presenting feature of tuberculosis--spontaneous pneumothorax--that may now be seen more commonly in emergency departments (EDs). Pneumothorax must be quickly and effectively managed in the ED. In addition, the emergency physician should readily consider tuberculosis as an etiology in any patient with a spontaneous pneumothorax and a significant prodromal illness or a history of exposure to tuberculosis so that contagion precautions may be instituted promptly.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This case of Boerhaave's Syndrome had several unusual features including a delayed presentation and right-sided esophageal perforation. The patient's initial episode of hematemesis may have been caused by a small mucosal laceration in the area of the Barrett's lesion that later ruptured. On the other hand, if initially there was an esophageal rupture, it did not violate the parietal pleura or mediastinum. The overlying pleura remained intact until digested by gastric contents, thereby causing a right-sided hydropneumo thorax and a marked increase in symptoms, which promoted the patient to come to the ED. Because the patient initially appeared stable and had a history of emesis 4 days before presentation, and because an initial chest X-ray interpretation overlooked the right-sided apical pneumothorax, Boerhaave's Syndrome was not considered initially. Aspiration pneumonia, pancreatitis, alcoholic gastritis, or active peptide ulcer disease were in our initial differential. It was only after the repeat chest X-ray, which more obviously showed the pneumothorax, and insertion of the chest tube that the correct diagnosis was made. Had the pneumothorax not been overlooked initially, the diagnosis may have been made earlier. It is apparent from this case and a review of the literature that Boerhaave's Syndrome is an uncommon clinical entity and has varying modes of presentation, making the diagnosis a difficult clinical challenge. Boerhaave's Syndrome should be considered in all ill-appearing patients presenting with the combination of gastrointestinal and respiratory complaints. The single most important test may be the upright chest X-ray. However, if it is normal, and there is a high index of suspicion, esophagograms and or chest CT may be required to demonstrate the lesion. Because survival is directly related to the time to diagnosis and treatment, a high clinical suspicion can decrease the substantial morbidity and mortality associated with Boerhaave's Syndrome.