Rhinosporidiosis of trachea: a clinical cause for concern

2008 ◽  
Vol 122 (4) ◽  
Author(s):  
R Arora ◽  
R Gupta ◽  
Amit Kumar Dinda
Keyword(s):  
Sri Lanka ◽  
Respiratory Distress ◽  
Rare Complication ◽  
Pathological Examination ◽  
Complete Excision ◽  
Severe Respiratory Distress ◽  
Risk Of Bleeding ◽  
Emergency Tracheostomy ◽  
Bronchoscopic Biopsy ◽  
Life Threatening

AbstractBackground:Rhinosporidiosis is a granulomatous infection usually affecting the nasal mucosa and conjunctiva. The disease is widely prevalent in India and Sri Lanka. Tracheo-bronchial involvement is extremely rare and is potentially life threatening. Diagnosis of tracheal involvement is a challenge due to the risk of bleeding during attempted bronchoscopic biopsy.Case:A 73-year-old man was admitted with severe respiratory distress, for which emergency tracheostomy was performed. At tracheostomy, a fleshy mass was seen emerging from the wound. Pathological examination of the mass confirmed rhinosporidiosis involving the trachea. Complete excision of the mass was performed after initial stabilisation of the patient.Conclusion:Tracheo-bronchial rhinosporidiosis, a rare complication of nasopharyngeal infection, should be considered in a known case presenting with severe respiratory distress.

scholarly journals Neonatal Respiratory Distress and Airway Emergency: Report of Two Cases

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 255
Author(s):  
Lorenzo Bresciani ◽  
Paola Grazioli ◽  
Roberta Bosio ◽  
Gaetano Chirico ◽  
Cesare Zambelloni ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Renal Dysplasia ◽  
Esophageal Intubation ◽  
Mask Ventilation ◽  
Anal Atresia ◽  
Severe Respiratory Distress ◽  
First Case ◽  
Emergency Tracheostomy ◽  
Vertebral Defects

We discuss two cases of congenital airway malformations seen in our neonatal intensive care unit (NICU). The aim is to report extremely rare events characterized by immediate respiratory distress after delivery and the impossibility to ventilate and intubate the airway. The first case is a male twin born at 34 weeks by emergency caesarean section. Immediately after delivery, the newborn was cyanotic and showed severe respiratory distress. Bag-valve-mask ventilation did not relieve the respiratory distress but allowed for temporary oxygenation during subsequent unsuccessful oral-tracheal intubation (OTI) attempts. Flexible laryngoscopy revealed complete subglottic obstruction. Postmortem analysis revealed a poly-malformative syndrome, unilateral multicystic renal dysplasia with a complete subglottic diaphragm, and a tracheo-esophageal fistula (TEF). The second case is a male patient that was vaginally born at 35 weeks. Antenatally, an ultrasound (US) arose suspicion for a VACTERL association (vertebral defects, anal atresia, TEF with esophageal atresia and radial or renal dysplasia, plus cardiovascular and limb defects) and a TEF, and thus, fetal magnetic resonance (MRI) was scheduled. Spontaneous labor started shortly thereafter, before imaging could be performed. Respiratory distress, cyanosis, and absence of an audible cry was observed immediately at delivery. Attempts at OTI were unsuccessful, whereas bag-valve-mask ventilation and esophageal intubation allowed for sufficient oxygenation. An emergency tracheostomy was attempted, although no trachea could be found on cervical exploration. Postmortem analysis revealed tracheal agenesis (TA), renal dysplasia, anal atresia, and a single umbilical artery. Clinicians need to be aware of congenital airway malformations and subsequent difficulties upon endotracheal intubation and must plan for multidisciplinary management of the airway at delivery, including emergency esophageal intubation and tracheostomy.

scholarly journals A Possible Path towards Rapid Development of Live-Attenuated SARS-CoV-2 Vaccines: Plunging into the Natural Pool

Biomolecules ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1438
Author(s):  
German Todorov ◽  
Vladimir N. Uversky
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Respiratory Distress ◽  
Vaccine Development ◽  
Wide Spectrum ◽  
Rapid Development ◽  
Healthcare Systems ◽  
Severe Respiratory Distress ◽  
The World ◽  
Fast Development ◽  
Life Threatening

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic spreading around the world, causing massive distress to the world’s economy and affecting healthcare systems worldwide. Although some exposed individuals have no symptoms and most symptomatic infections are not severe, COVID-19 cases span a wide spectrum, ranging from mild to critical and sometimes resulting in life-threatening complications, such as pneumonia, severe respiratory distress and cardiac problems. Currently, there is no curative drug for COVID-19 and vaccines are still under development. We are presenting here a strategy for the fast development of natural live-attenuated SARS-CoV-2 vaccines. Our proposed approach is based on screening for, identifying, analyzing and selecting naturally attenuated yet highly immunogenic SARS-CoV-2 strains, which may lead to a shorter cycle of vaccine development, as well as higher vaccine effectiveness.

scholarly journals Congenital pneumonia with empyema at birth; a rare presentation

2017 ◽  
Vol 4 (4) ◽  
pp. 1541
Author(s):  
Saransh Sabal ◽  
Kavita Tiwari ◽  
Lakhan Poswal
Keyword(s):  
Respiratory Distress ◽  
Chest Tube ◽  
Rare Complication ◽  
Empyema Thoracis ◽  
Tube Insertion ◽  
Successful Management ◽  
Rare Presentation ◽  
Severe Respiratory Distress ◽  
Tube Drainage ◽  
Case Characteristics

Empyema thoracis is a rare complication of congenital pneumonia in neonates. Case characteristics: A newborn presented with severe respiratory distress had empyema thoracis. Outcome: patient was managed with chest tube insertion and antibiotics. Message: empyema can be a rare complication of congenital pneumonia and along with appropriate antibiotics, chest tube drainage is required for successful management. 

scholarly journals Metallic Stents for Proximal Tracheal Stenosis: Is It Worth the Risk?

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sandeep Bansal ◽  
Shruti Dhingra ◽  
Babita Ghai ◽  
Ashok K. Gupta
Keyword(s):  
Respiratory Distress ◽  
Steel Wire ◽  
Wire Mesh ◽  
Metallic Stent ◽  
Severe Respiratory Distress ◽  
Best Management ◽  
Emergency Tracheostomy ◽  
Stainless Steel Wire Mesh ◽  
History Of ◽  
Steel Wire Mesh

Objective. To demonstrate the risk associated with blocked proximal tracheal stents when a patient presents with acute respiratory distress, with blockage of stent and what is the best management we can offer without damage to the stent and its associated complications.Case Report. A 22-yr-old, male patient, presented in severe respiratory distress. He had history of corrosive poisoning for which he was tracheotomised. A stainless steel wire mesh stent was placed in the trachea, from the subglottis, to just above the carina. One month later, he presented with a critically compromised airway with severe respiratory distress. Emergency tracheostomy was done and the metallic stent had to be cut open, in order to provide an airway.Conclusion. Management of blocked proximal stents with patient in respiratory distress remains a challenge. Formation of granulation tissue is common and fibreoptic bronchoscopic assisted intubation may not always be possible. A regular follow up of all patients with stents is essential. Placement of stents within a few centimetres of cricotracheal junction should not be encouraged for long term indications.

DOZ047.33: Neonatal airway emergency: report of two cases

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
P Grazioli ◽  
R Bosio ◽  
C Baronchelli ◽  
A Santoro ◽  
G Chirico ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Main Bronchus ◽  
Vocal Folds ◽  
Renal Dysplasia ◽  
Severe Respiratory Distress ◽  
Vitro Fertilization ◽  
Emergency Tracheostomy ◽  
The Us ◽  
Multicystic Renal Dysplasia

Abstract Objective This paper discusses two cases of congenital airway malformations that presented in NICU in a four-month period. The aim is to present extremely rare evidences that inevitably lead to the death of the patient if not correctly identified during pregnancy. Case 1: male twin born at 34 weeks by emergency caesarean section to a 37-year-old mother. Antenatal history was notable for in vitro fertilization and renal dysplasia. Immediately after delivery, there was respiratory distress, cyanosis, with a 1- and 5-min Apgar score of 0 and 1, respectively. He required ventilation and was supposed intubated orally with significant difficulty with a 2.0 mm ETT. For persistent ventilation problems and severe combined acidosis, the neonatologists tried without success to reintubate the patient. Some hours later, the otolaryngologist was called and was again unable to intubate with flexible laryngoscopy due to an obstruction that prevented advancement of the endotracheal tube past the vocal folds, but since the baby general conditions had been already deteriorated a decision to withdraw the treatment was made. He died after few hours. Postmortem revealed a polymalformative syndrome with subglottic complete diaphragm, a tracheoesophageal fistula 1 cm caudally to the diaphragm and unilateral multicystic renal dysplasia. Case 2: male vaginally delivery at 35 weeks to a 43-year-old mother with gestational diabetes. Antenatally, ‘VACTERL’ association was suspected on the basis of the US and a MRI was planned but not performed because of the early delivery. Following the delivery, there was severe respiratory distress, no audible cry, and ventilation was not effective in relieving the respiratory distress. Subsequent intubation was unsuccessful. An emergency tracheostomy was attempted: the larynx was identified, but only a tracheal stump was present on neck exploration. Postmortem confirmed type II (according to Floyd) tracheal agenesis with the esophagus connect to the main bronchus, renal dysplasia, anal atresia, and single umbilical artery. Conclusion Clinicians need to be aware of congenital airway malformation and subsequent difficulties upon endotracheal intubation and they have to be prepared to plan a multidisciplinary management at the delivery including emergency intubation through esophageal fistula.

scholarly journals Ovarian hyperstimulation syndrome and pulmonary edema – a rare complication

2017 ◽  
Vol 6 (3) ◽  
pp. 1154
Author(s):  
Vineet Mishra ◽  
Priyankur Roy ◽  
Sumesh Choudhary ◽  
Rohina Aggarwal ◽  
Shaheen Hokabaj ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Ovarian Hyperstimulation Syndrome ◽  
Rare Complication ◽  
Clomiphene Citrate ◽  
Controlled Ovarian Hyperstimulation ◽  
Ovarian Hyperstimulation ◽  
Treatment Regimens ◽  
Life Threatening ◽  
Severe Ohss

Background: Ovarian Hyperstimulation Syndrome (OHSS) is a life-threatening complication of controlled ovarian stimulation almost exclusively associated with gonadotropins but occasionally with clomiphene citrate. Prevention of this syndrome lies in the recognition of risk factors and individualizing the treatment regimens. Causes of respiratory distress in patients with OHSS are pleural effusion, pulmonary embolism, and acute respiratory distress syndrome (ARDS). Pulmonary edema is rare but a grave complication of OHSS.Case report: We report, a case of severe OHSS with tense ascites and anasarca after controlled ovarian hyperstimulation (COH) for IVF. She was managed conservatively followed by paracentesis after which she developed pulmonary edema during the course of the treatment.Conclusion: OHSS is an iatrogenic complication which can be prevented by individualizing stimulation protocols and should be managed urgently with a multidisciplinary approach.

scholarly journals Modified transnasal endoscopic repair of bilateral choanal atresia with pulmonary atresia

2018 ◽  
Vol 4 (6) ◽  
pp. 1511
Author(s):  
Chandra Shekar Reddy ◽  
Natarajan Ramalingam ◽  
Jyotirmay S. Hegde ◽  
Sunil Kumar Saxena
Keyword(s):  
Respiratory Distress ◽  
Oxygen Saturation ◽  
Choanal Atresia ◽  
Pulmonary Atresia ◽  
Endoscopic Repair ◽  
Severe Respiratory Distress ◽  
Life Threatening ◽  
Adequate Surgery ◽  
Transnasal Endoscopic Repair ◽  
Prompt Diagnosis

<p>Congenital choanal atresia is due to failure in the development of communication between the nasal cavity and nasopharynx in newborns. This condition is life threatening when it is bilateral and causes severe respiratory distress immediately after birth as children are obligatory nose breathers. We present a one day old child who presented to us with severe respiratory distress, which we diagnosed as choanal atresia. The child also had tertology of fallot with pulmonary atresia and had to be intubated as oxygen saturation was not adequate. Surgery was undertaken on emergency basis on day one of life which helped in extubation of the child. This case highlights the importance of prompt diagnosis of a case bilateral choanal atresia, and also the importance of early surgery which can lead to significant improvement.</p>

scholarly journals Surgical Management of Life-Threatening Thyroid Haematoma following Occult Blunt Neck Trauma

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ronak Ved ◽  
Neil Patel ◽  
Michael Stechman
Keyword(s):  
Respiratory Distress ◽  
Follicular Adenoma ◽  
Definitive Treatment ◽  
Multinodular Goitre ◽  
Neck Trauma ◽  
Anterior Neck ◽  
Severe Respiratory Distress ◽  
Blunt Neck Trauma ◽  
Threatening Condition ◽  
Life Threatening

A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day. Pathology revealed the lesion to be a ruptured follicular adenoma within his multinodular goitre. Signs of this rare but life-threatening condition may be subtle on initial presentation, particularly if the patient is obtunded. Patients with suspected blunt neck trauma should be observed for signs of respiratory distress. If this develops, the patient should be intubated to facilitate CT scan, and if thyroid haematoma is confirmed, emergency thyroidectomy is the definitive treatment.

Acute Respiratory Distress Syndrome in a Carrier of an Interleukin-36 Receptor Antagonist Mutation With Generalized Pustular Psoriasis

2021 ◽  
pp. 247553032110517
Author(s):  
Avital Baniel ◽  
Efrat Bar-Ilan ◽  
Yuval Hilerowicz ◽  
Ilan Merdler ◽  
Eden Shkury ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Receptor Antagonist ◽  
Distress Syndrome ◽  
Novel Mutation ◽  
Rare Complication ◽  
Pustular Psoriasis ◽  
Generalized Pustular Psoriasis ◽  
Life Threatening

Background Generalized pustular psoriasis of von Zumbusch is a rare variant of psoriasis often accompanied by systemic, sometimes life-threatening, symptoms. Generalized pustular psoriasis sometimes arises in pregnancy. Case report A 31-year-old female, with a history of schizophrenia and recurrent episodes of gestation-associated pustular psoriasis, was admitted to our department because of a generalized pustular rash during the 22nd week of her fifth pregnancy. Clinical and histopathological examinations were suggestive of generalized pustular psoriasis (von Zumbusch type). During this hospitalization, she developed acute dyspnea, fever, tachycardia, and marked leukocytosis. An extensive workup failed to reveal an infectious, cardiac, or pulmonary abnormality, while severe respiratory distress necessitated mechanical ventilation. Radio-imaging revealed diffuse alveolar infiltrates consistent with acute respiratory distress syndrome (ARDS). In the absence of any other plausible cause, ARDS was considered as secondary to her skin disease. Genetic base was suspected, and genetic analysis uncovered a novel mutation in IL36RN encoding the IL-36 receptor antagonist. Only 15 cases of ARDS secondary to psoriasis have been described to date. This is the first report of this very rare complication in a known carrier of an IL36RN mutation. The fact that IL36RN is abundantly expressed in the lung as well as in the epidermis may underlie the unusual clinical features of this dramatic case. Conclusion The present case suggests the need to carefully monitor patients with pregnancy-associated generalized pustular psoriasis for possible life-threatening pulmonary complications and the possible link to IL36RN mutation.

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