scholarly journals Prolonged RNA shedding of the 2019 novel coronavirus in an asymptomatic patient with a VP shunt

2020 ◽  
Vol 13 (9) ◽  
pp. e237720
Author(s):  
Firas El-Baba ◽  
Danielle Gabe ◽  
Allan Frank
Keyword(s):  
Paranoid Schizophrenia ◽  
Middle Lobe ◽  
Psychiatric Facility ◽  
Vp Shunt ◽  
Viral Shedding ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
Novel Coronavirus ◽  
The Right ◽  
Inpatient Psychiatric Facility

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.

Radiographic Abnormalities in Acute Asthma in Children

PEDIATRICS ◽  
1974 ◽  
Vol 54 (4) ◽  
pp. 442-449
Author(s):  
Peyton A. Eggleston ◽  
Byron H. Ward ◽  
William E. Pierson ◽  
C. Warren Bierman
Keyword(s):  
Acute Asthma ◽  
Middle Lobe ◽  
Pulmonary Complications ◽  
Common Finding ◽  
X Ray ◽  
Age Dependent ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
Asthma In Children ◽  
The Right

To determine the incidence of radiographic abnormalities in acute asthma of children and adolescents, and to examine the contribution of the chest x-ray to their care, 515 asthma admissions were reviewed. Of these, 479 had admission chest films, 22.3% of which were abnormal. Significant perihilar infiltrates were the most frequent abnormality seen; atelectasis, especially of the right middle lobe, was the next most frequent. Pneumomediastinum was also a common finding. Both pneumomediastinum and infiltrates were strikingly age-dependent: 15.5% over 10 years old had pneumomediastinum; none under 2 years old had this complication; infiltrates occurred in nearly 25% of younger children but in only 8.3% over 10 years old. Since pulmonary complications substantially alter therapeutic management, a chest x-ray should be part of the initial evaluation of any child hospitalized with acute asthma.

scholarly journals Atypical Infections in Chronic Myeloid Leukaemia- Staphylococcus furunculosis and Aspergillosis

2020 ◽  
Vol 07 (01) ◽  
pp. 17-19
Author(s):  
Sharon T Mathews ◽  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Blast Crisis ◽  
Middle Lobe ◽  
Imatinib Therapy ◽  
X Ray ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
One Year ◽  
The Right

Incidence of opportunistic infection in patients of Chronic Myeloid Leukemia (CML) on Imatinib therapy is low. We report a case of a 47 year old lady, a known case of CML for one year on imatinib therapy who presented with CML in blast crisis with Staphylococcus furunculosis. Two weeks later she developed fever, cough and expectoration. She had cavitatory lesion in the right middle zone on chest x-ray. CECT Chest was suggestive of aspergilloma in right middle lobe. Infections in chronic myeloid leukemia are not very common. Also, developing such infections within such a short span of time, within one year of initiation of imatinib therapy is also rare. Hence, this case of CML with Staphylococcal furunculosis and Aspergillosis is being reported.

scholarly journals Successful Treatment of Bulla with Endobronchial Valves

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Erdoğan Çetinkaya ◽  
Mehmet Akif Özgül ◽  
Şule Gül ◽  
Hilal Boyacı ◽  
Ertan Cam ◽  
...  
Keyword(s):  
Lung Function ◽  
Treatment Options ◽  
Forced Expiratory Volume ◽  
Middle Lobe ◽  
Functional Improvement ◽  
X Ray ◽  
Chest X Ray ◽  
Right Middle Lobe ◽  
The Right ◽  
End Stage

Emphysematous bullae are a complication of end-stage COPD. Patients with large bullae and poor respiratory function have limited treatment options. Surgical resection is a recognized treatment, but functional improvement after bullectomy is not satisfactory in patients with forced expiratory volume in 1 s (FEV1) < 35% predicted. When this 59-year-old male end-stage COPD patient was assessed, he was cachectic and lung function tests showed a FEV1 of 0.56 L (19% predicted) and a RV of 7 L (314% predicted), while 6MWT was 315 m and MRC dyspnea score was 4. Chest X-ray revealed a massive bulla of 10 cm in diameter in the right middle lobe. A fibrobronchoscopy was performed under local anesthesia and 2 Zephyr 4.0 valves were placed in the right middle lobe. Chest X-ray and CT scan performed 36 days later showed the complete resolution of the bulla. Seven months later, the patient demonstrated an improvement in FEV1 (+30%) and a decrease in RV from 314 to 262% predicted. This case report shows that the Zephyr valves may be successfully used to treat a large bulla in the right middle lobe in a patient with diffuse emphysema and severely impaired lung function.

scholarly journals Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lower Lobe ◽  
Middle Lobe ◽  
The Body ◽  
Single View ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

scholarly journals Alveolar adenoma: A rare lung tumor

2007 ◽  
Vol 135 (7-8) ◽  
pp. 461-464 ◽  
Author(s):  
Jelena Stojsic ◽  
Branislava Milenkovic ◽  
Jelena Radojicic ◽  
Malina Percinkovski
Keyword(s):  
Pulmonary Nodule ◽  
Solitary Pulmonary Nodule ◽  
Lung Tumor ◽  
Fibrous Tissue ◽  
Surgical Excision ◽  
Middle Lobe ◽  
Benign Lung Tumor ◽  
Right Middle Lobe ◽  
Malignant Alteration ◽  
The Right

Introduction Alveolar adenoma belongs to the group of benign epithelial tumors. Histogenesis of alveolar adenoma is a combination of proliferation of alveolar pneumocytes and fibrous tissue originating from septal mesenchyma. Case outline A sixty-nine-year old female patient was hospitalized for clinical examination and surgery of well defined and homogenous timorous lesion in the right middle lobe causing pleural pain. Bronchoscopic examination with biopsy did not resolve etiology of the disease. Tumorectomy was performed. Timorous nodule had a multicystic appearance and histologically, histochemically and immunohistochemically, an alveolar adenoma was estimated. Five years after surgery, the patient feels well, without respiratory symptoms and signs of recurrence or malignant alteration, respectively. Conclusion Alveolar adenoma is a rare benign lung tumor, most frequently presented as a solitary pulmonary nodule. After complete surgery, the tumor neither relapses nor malignantly alters. Surgical excision is curative. It is necessary to take into consideration alveolar adenoma, too, when a solitary pulmonary nodule is diagnosed.

scholarly journals A case of a 22-month-old boy with necrotizing pneumonia presenting with leukaemoid reaction misdiagnosed as leukaemia: A case report and review of the literature

2019 ◽  
Vol 31 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Shakilu Jumanne
Keyword(s):  
Leukocyte Count ◽  
Myeloproliferative Disorders ◽  
Middle Lobe ◽  
Total Leukocyte Count ◽  
Necrotizing Pneumonia ◽  
Diagnosis Of Cancer ◽  
Right Middle Lobe ◽  
Laboratory Investigations ◽  
The Right ◽  
Oncology Unit

BackgroundNecrotizing pneumonia and hyperleukocytosis, to the extent of that seen in leukaemia, is a rarely reported presentation. The commonest trigger of such a presentation is an inflammatory process caused by an overwhelming infection which leads to bone marrow irritation. However, the misdiagnosis of this clinical entity as leukaemia should be avoided at all costs so as to avoid the anxiety associated with a diagnosis of cancer, both to the patients and their families.Case presentationHere, we report the case of a 22-month-old boy who was referred to our Pediatric Oncology Unit (POU). Owing to a high total leukocyte count (TLC) of 98,000 cells/µl, there was a strong suspicion of leukaemia. The boy had been reviewed at another hospital where he presented with fever and cough refractory to the commencement of tuberculosis medications as a result of chest radiography findings. Laboratory investigations performed on admission in the POU were negative for leukaemia and other myeloproliferative disorders. A chest computer tomography (CT) scan was performed to delineate opacification in the right middle lobe. This revealed multiple necrotic and emphysematous foci in line with a diagnosis of necrotizing pneumonia. Subsequently, the patient responded well to a course of piperacillin- tazobactam. The TLC normalized and the cough and fever resolved over a period of 2 weeks. ConclusionHere, we describe a particularly rare case of leukaemoid reaction with a massive leukocyte count. Such patients can be easily misdiagnosed as having leukaemia or other myeloproliferative disorders, especially in settings with limited diagnostic availability. Such misdiagnosis can cause undue stress on the patient and their families. Thus, it is important that patients presenting with these symptoms should undergo a thorough review of history, physical examination and a structured workup.

scholarly journals Lobar torsion after thoracoscopic esophagectomy, and prevention method to detect its incidence during the operation

2016 ◽  
Author(s):  
Yutaka Miyawaki ◽  
Yasuaki Nakajima ◽  
Yutaka Tokairin ◽  
Kenro Kawada ◽  
Taichi Ogo ◽  
...  
Keyword(s):  
Pulmonary Resection ◽  
Middle Lobe ◽  
Thoracoscopic Esophagectomy ◽  
Fatal Complication ◽  
Case Presentation ◽  
Urgent Surgery ◽  
Right Middle Lobe ◽  
Prevention Method ◽  
Pulmonary Torsion ◽  
The Right

Abstract Introduction: Lobar torsion is a rare but fatal complication, with such cases being mostly treated with pulmonary resection. Only a few cases of pulmonary torsion following esophagectomy have thus far been reported, and all cases occurred subsequent to transthoracic esophagectomy. Case presentation: We herein present the case of a patient with the right middle lobe torsion after thoracoscopic esophagectomy in a 64-year-old male.As the patient exhibited a hemodynamically unstable condition immediately after surgery and bronchoscopy and computed tomography revealed right middle lobe torsion, urgent surgery was performed.As torsion of right middle lobe was confirmed during a second operation, repositioning for torsion was performed. Fortunately, right middle lobe was aerated and exhibited a good complexion immediately after repositioning; therefore, pneumonectomy was not performed. Conclusion: Because it is difficult to observe the process of reinflation of a collapsed lung under direct vision in order to prevent lobar torsion when performing thoracoscopic esophagectomy, it is imperative to confirm the patency of the proximal bronchi during the operation using bronchoscopy.

scholarly journals Hydropneumothorax Revealing a Pneumoblastoma in Children

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karima El Fakiri ◽  
Ghizlane Draiss ◽  
Noureddine Rada ◽  
Mohammed Bouskraoui ◽  
Abderrachid Hamdaoui ◽  
...  
Keyword(s):  
Outer Segment ◽  
Middle Lobe ◽  
High Grade ◽  
Cystic Lesions ◽  
Type Ii ◽  
Pathological Study ◽  
X Ray ◽  
Thoracic Drainage ◽  
Chest X Ray ◽  
The Right

Pneumoblastoma is a rare primary childhood tumor. We report the observation of an infant aged 2 years and 8 months who presented with dry cough and dyspnea. The physical examination found mixed pleural effusion syndrome on the right. The chest X-ray revealed a right pneumothorax. Biology has shown leukocytosis at 16,000/mm3. The CT scan revealed parenchymal air cystic lesions affecting the outer segment of the middle lobe mimicking a pulmonary malformation. Thoracic drainage brought back 100 ml of the fluid. Two months later, when a pyopneumothorax appeared, a medium lobectomy was performed. Pathological study specimen showed a high-grade type II pneumoblastoma The extension assessment identified a secondary hepatic location. Chemotherapy has been indicated. This observation illustrates the diagnosis challenge of pneumoblastoma in children.

scholarly journals LEAVE NO LOBE UNSCOPED: A CASE OF MYCOBACTERIUM TB OF THE RIGHT MIDDLE LOBE

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A635
Author(s):  
Dawn Maldonado ◽  
Michael Megally ◽  
Terence McGarry
Keyword(s):  
Middle Lobe ◽  
Right Middle Lobe ◽  
The Right
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