scholarly journals Blastoschizomyces capitatus pulmonary infections in immunocompetent patients: case report, case series and literature review

2017 ◽  
Vol 146 (1) ◽  
pp. 58-64 ◽  
Author(s):  
M. B. TANABE ◽  
S. A. PATEL
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Treatment Options ◽  
Case Series ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Infectious Risk ◽  
History Of ◽  
Blastoschizomyces Capitatus ◽  
Immunocompetent Patients

SUMMARYBlastoschizomyces capitatus is an uncommon opportunistic yeast associated with infections in neutropaenic patients secondary to haematological malignancies, with a special predilection for the lungs. Globalisation and population migration impact on the epidemiology of infection with this organism but its effect on the immunocompetent population has rarely been described. We present here a case report, an overview of 11 other cases published between 2000 and 2016, and a comprehensive literature review of Blastoschizomyces pneumonia in the non-immunocompromised. The median age at diagnosis was 68 years (range 40–86 years) and more than half the cases reported a positive history of either current or past tobacco smoking. Six cases had either clinical or radiological evidence of chronic obstructive pulmonary disease and three had a history of prior treated tuberculosis. Fluconazole and itraconazole, alone or in combination, was the most utilised treatment. We conclude that unlike most other invasive yeast species, B. capitatus poses an infectious risk for immunocompetent patients, usually of middle to older age with risk factors for distorted lung architecture. Further research is warranted into the pathophysiology of Blastoschizomyces infections in the immunocompetent, including standardised treatment options.

scholarly journals Spontaneous spinal extradural haematoma presenting with chest pain: a case report and literature review

2010 ◽  
Vol 9 (2) ◽  
pp. 76-79
Author(s):  
Jessica M Skilling ◽  
◽  
Nicola M Tempest ◽  
Ahmed H Abdelhafiz ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Back Pain ◽  
Case Report ◽  
Abrupt Onset ◽  
Chronic Obstructive ◽  
Extradural Haematoma ◽  
Past Medical History ◽  
Obstructive Pulmonary Disease ◽  
History Of

An 85 year old lady was admitted to hospital after experiencing an abrupt onset of right sided chest and mid thoracic back pain. This pain was exacerbated by movement and coughing but not by inspiration. There was no history of recent injury. Her past medical history included atrial fibrillation (AF), aortic stenosis, hypertension and chronic obstructive pulmonary disease. Medication on admission included bendrof lumethiazide 2.5mg od, digoxin 125 mcg od, doxazosin 4mg od, enalapril 20mg od, warfarin and salbutamol and seretide inhalers. Prior to the onset of the pain she had been independently mobile with a stick.

scholarly journals Stridor and respiratory failure due to tracheobronchomalacia: case report and review of the literature

2012 ◽  
Vol 130 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Ramon Andrade de Mello ◽  
Adriana Magalhães ◽  
Abílio José Vilas-Boas
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Rare Case ◽  
Rigid Bronchoscopy ◽  
Chronic Obstructive ◽  
Review Of The Literature ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
History Of

CONTEXT: Tracheobronchomalacia (TBM) results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of the cross-sectional area of the trachea and main bronchi. In this paper, we present a rare case of a patient with TBM who first presented with stridor and respiratory failure due to exacerbation of chronic bronchitis. CASE REPORT: An 81-year-old Caucasian man was admitted presenting coughing, purulent sputum, stridor and respiratory failure. He had a medical history of chronic obstructive pulmonary disease (COPD) and silicosis and was a former smoker. Axial computed tomography on the chest revealed marked collapse of the trachea in its middle third. Bronchoscopy showed characteristics compatible with TBM. He was treated with noninvasive ventilation, without any good response. Subsequently, a Dumon Y stent was placed by means of rigid bronchoscopy. After the procedure, he was discharged with a clinical improvement. CONCLUSION: TBM is fatal and often underdiagnosed. In COPD patients, stridor and respiratory failure may be helpful signs that should alert physicians to consider TBM as an early diagnosis. Thus, these signs may be important for optimizing the treatment and evolution of such patients.

Hafnia alvei pneumonia: a rare cause of infection in the multimorbid or immunocompromised

2020 ◽  
Vol 13 (12) ◽  
pp. e237061
Author(s):  
Austin Begbey ◽  
Joseph Henry Guppy ◽  
Chithra Mohan ◽  
Simon Webster
Keyword(s):  
Case Series ◽  
Chronic Obstructive ◽  
Productive Cough ◽  
Commensal Bacterium ◽  
Radiological Findings ◽  
Obstructive Pulmonary Disease ◽  
Hafnia Alvei ◽  
Night Sweats ◽  
History Of ◽  
Cultured Bacteria

Hafnia alvei is a rare, poorly understood commensal bacterium which has, on occasion, been shown to infect humans. We present two cases. The first patient presented with a 1-week history of dyspnoea, pleurisy and a productive cough, and the second with a prodrome of fatigue and night sweats. The former had a history of severe chronic obstructive pulmonary disease and the latter had a history of Crohn’s disease. Both patients had underlying comorbidities and immunosuppression, but differed in presentation, radiological findings and recovery. This case series aims to remind readers of the broad differential of pathogens that can lead to disease in the immunocompromised and that one should not dismiss atypical cultured bacteria as commensal too hastily.

scholarly journals Use of mirtazapine in patients with chronic breathlessness: A case series

2018 ◽  
Vol 32 (9) ◽  
pp. 1518-1521 ◽  
Author(s):  
Natasha Lovell ◽  
Sabrina Bajwah ◽  
Matthew Maddocks ◽  
Andrew Wilcock ◽  
Irene J Higginson
Keyword(s):  
Lung Disease ◽  
Treatment Options ◽  
Symptom Control ◽  
Case Series ◽  
Care Physician ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Beneficial Effects ◽  
Period 2 ◽  
Case Outcome

Background: Breathlessness remains a common and distressing symptom in people with advanced disease with few effective treatment options. Repurposing of existing medicines has been effective in other areas of palliative care, for example, antidepressants to treat pain, and offers an opportunity to deliver improved symptom control in a timely manner. Previous case series have shown reduced breathlessness following the use of sertraline (a selective serotonin reuptake inhibitor) in people with chronic obstructive pulmonary disease. Cases: Six cases where mirtazapine, a noradrenergic and specific serotonergic antidepressant, was used to treat chronic breathlessness in advanced lung disease. Case management: All cases received mirtazapine at a starting dose of 15 mg, prescribed under the care of their primary care physician. Cases had been receiving mirtazapine for a variable time period (2 weeks to 5 months) at the time of the interviews. Case outcome: All cases reported less breathlessness and being able to do more. They described feeling more in control of their breathing, and being able to recover more quickly from episodes of breathlessness. Some cases also reported beneficial effects on anxiety, panic, appetite and sleep. No adverse effects were reported. Discussion: Patients with chronic breathlessness in this case series reported benefits during mirtazapine treatment. To determine the effectiveness of mirtazapine in alleviating breathlessness and improving quality of life in chronic lung disease, blinded randomised trials are warranted.

Fan therapy for cough: case report and literature review

2020 ◽  
pp. bmjspcare-2020-002363
Author(s):  
Anna Elizabeth Sutherland ◽  
Matthew Carey ◽  
Mary Miller
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Controlled Trial ◽  
Underlying Mechanism ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patient Reported ◽  
Infectious Pathogen ◽  
Randomised Controlled

This case report describes the care of a 59-year-old woman with metastatic small cell lung cancer and chronic obstructive pulmonary disease who was highly symptomatic with an intractable cough. The patient reported a subjective benefit from a table fan. The authors observed an objective improvement with a marked reduction in cough frequency when the fan was in use. A literature review was undertaken and identified one randomised controlled trial assessing the use of fan for cough. The proposed underlying mechanism of cough relief is stimulation of the trigeminal nerve, possibly by cooling. This mechanism is well described in breathlessness. It presents the possibility of a novel therapeutic approach to managing cough. Further studies of both the role of nasal receptors in cough pathophysiology and the role of fan therapy in cough, where there is no concern of an airborne infectious pathogen such as COVID-19, are warranted.

scholarly journals Pseudomonas otitidis bacteraemia in a patient with COPD and recurrent pneumonia: case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adriana L. Caixinha ◽  
Alexandros N. Valsamidis ◽  
Ming Chen ◽  
Mats Lindberg
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Case Report ◽  
Literature Review ◽  
Novel Species ◽  
Blood Cultures ◽  
Chronic Obstructive ◽  
Recurrent Pneumonia ◽  
Obstructive Pulmonary Disease ◽  
Case Presentation ◽  
Pneumonia Case

Abstract Background Pseudomonas otitidis is a novel species of Pseudomonas bacteria that has been isolated from patients with otic infections. Case presentation In this report, we describe a case of a 59-year-old known with moderate chronic obstructive pulmonary disease with bronchiectasis and recurrent pneumonia where blood cultures revealed the growth of P. otitidis. Conclusions This case describes the first report of bacteraemia to P. otitidis and raises questions regarding the misdiagnosis and underestimation of the incidence of infections caused by this novel pathogen.

scholarly journals A Bronchoscopic Steam Thermal Ablation (BTVA) Case Report in A 85-Year-Old Male Clinically Compromised

2020 ◽  
Author(s):  
Roberto Marchese ◽  
Federica Scaduto ◽  
Chiara Lo Nigro
Keyword(s):  
Case Report ◽  
Lung Volume ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Chronic Obstructive Lung Disease ◽  
Good Alternative ◽  
Volume Reduction ◽  
Chronic Obstructive ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease

Abstract Background: Bronchoscopic lung volume reduction (BLVR) techniques improve lung function and increase exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) and BLVR treatment is included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines for these patients. BTVA (Intervapor Uptake Medical, Tustin, CA, USA) represents a recent therapy of this group that allows to treat sublobar areas and for this reason is used clinically compromised patients, like in this case report.Case presentation: In this paper we describe a case report of an 85-year-old male with severe respiratory failure and a diagnosis of emphysema presented with dyspnea and clinical worsening, despite the best medical therapy practiced. For comorbidity and pathology’s features he was excluded from surgical treatment options, like lung volume reduction surgical (LVRS) and from positioning of endobronchial valves (EBV) for the presence of collateral ventilation and he was addressed to BTVA. The procedure was successful for this patient.Conclusions: This case supports recent suggestions that BTVA can be a good alternative treatment for patients properly selected.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

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