Streptococcus intermedius: unusual presentation and complication of lung abscess

2021 ◽  
Vol 14 (11) ◽  
pp. e245675
Author(s):  
Nouraldeen Manasrah ◽  
Sushmita Nanja Reddy ◽  
Ali Al Sbihi ◽  
Wasif Hafeez
Keyword(s):  
Young Patients ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Rare Presentation ◽  
Streptococcus Intermedius ◽  
Direct Infiltration ◽  
Vertebral Bodies ◽  
The Right ◽  
Spread Of Infection ◽  
Contiguous Spread

We report a case of a 54-year-old immunocompetent male who had lung abscess secondary to Streptococcus intermedius that led to discitis by contiguous spread of infection. He initially presented with constant chest pain for 6 weeks that radiated to lower back, with no fever, chills or weight loss. He denied smoking cigarettes, alcohol use or any illicit drug. On investigation, a mass was identified on the posterior medial aspect of the right lower lobe with direct infiltration into right side of the T5–T6 vertebral bodies. Histopathology identified organising pneumonia with abscess. Tissue cultures showed S. intermedius, and were negative for other microorganisms. This case highlights a rare presentation of S. intermedius discitis by contiguous spread of infection from posterior right lower lobe lung abscess. S. intermedius usually occurs in older patients with pulmonary infections complicated with pleural effusion or lung abscess, but can present in young patients with no clear symptoms of lung infection, like our patient.

scholarly journals Pulmonary abscess as a complication of COVID-19 associated pneumonia: a clinical case

2022 ◽  
Vol 99 (12) ◽  
pp. 7-12
Author(s):  
T. I. Kalenchits ◽  
S. L. Kabak ◽  
S. V. Primak ◽  
N. M. Shirinaliev
Keyword(s):  
Clinical Laboratory ◽  
Lower Lobe ◽  
Pleural Empyema ◽  
Lung Abscess ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pulmonary Abscess ◽  
Causative Factors ◽  
The Right ◽  
Test Result

The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.

scholarly journals Non-Mucinous Lepidic Predominant Adenocarcinoma Presenting with Extensive Aerogenous Spread

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Yusuke Takanashi ◽  
Shogo Tajima ◽  
Masaru Tsukui ◽  
Kazuya Shinmura ◽  
Takamitsu Hayakawa ◽  
...  
Keyword(s):  
Cancer Progression ◽  
Histopathological Examination ◽  
Periodic Acid ◽  
Lower Lobe ◽  
Poor Response ◽  
Clara Cells ◽  
Invasive Adenocarcinoma ◽  
Rare Presentation ◽  
Periodic Acid Schiff ◽  
The Right

An extremely rare case of non-mucinous lepidic-predominant invasive adenocarcinoma (LPA) showing extensive aerogenous spread with a pneumonic presentation is reported. A 73-year-old woman was referred to our hospital because of an infiltrative shadow on chest xray. Chest computed tomography revealed extensive ground glass opacities in the right lower lobe, which was accompanied by infiltrative shadow with a pneumonic presentation. Invasive mucinous adenocarcinoma was presumed, and a partial resection of the right lower lobe was done. Histopathological examination revealed lepidic growth-predominant invasive adenocarcinoma with Clara type tumor cells, and there were innumerable aerogenous metastases also consisting of Clara cells. Because Alcian Blue and periodic acid-Schiff staining disclosed no mucus, the tumor was diagnosed as a non-mucinous LPA. The patient showed a poor response to 5 courses of pemetrexed, and she died one year after the diagnosis due to cancer progression. Nonmucinous LPA showed a rare presentation characterized by extensive aerogenous spread followed by a poor prognosis.

scholarly journals Bilateral Breast Lumps as a Presentation of Disseminated Squamous Cell Carcinoma of Lung

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13832
Author(s):  
Pramila Dharmshaktu ◽  
Ankur Jain ◽  
Naresh Gupta ◽  
Abhilasha Garg ◽  
Seema Kaushal
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lower Lobe ◽  
Malignant Cells ◽  
Rare Presentation ◽  
Ct Guided ◽  
The Past ◽  
Breast Lumps ◽  
The Right

We present the case of a 65-year-old female who presented to our hospital with nodular swelling in her breast that first appeared in the right upper quadrant 10 months earlier, followed by involvement of the left upper quadrant along with nodular swelling in the right inguinal region for the past six months. She was also complaining of breathlessness on exertion and right-sided pleuritic chest pain for the past one year. Her chest X-ray showed well defined consolidation in the right lower lobe of the lung with pleural effusion. Further pleural tap showed malignant cells with squamous differentiation. Fine needle aspiration cytology (FNAC) from breast lumps was suggestive of malignant cells with morphology of cells likely to be squamous. CT-guided biopsy of the lung mass showed moderately differentiated squamous cell carcinoma of the lung. She succumbed to her illness following severe respiratory distress. Breast lump secondary to lung malignancy is very rare. Squamous cell carcinoma presenting as breast metastasis is a very rare presentation and reported in few cases. No previous case reporting bilateral breast lumps as a presentation of squamous cell carcinoma of the lung could be found in the literature.

Anatomical Variation in the Fissurization of Lung with Embryological and Clinical correlations- A Case Report

2021 ◽  
Vol 12 (4) ◽  
pp. 53-56
Author(s):  
Premavathy Dr. Dinesh
Keyword(s):  
Anatomical Variation ◽  
Left Lung ◽  
Lower Lobe ◽  
Pulmonary Medicine ◽  
Male Cadaver ◽  
Embryonic Life ◽  
The Right ◽  
Spread Of Infection ◽  
Fissure Formation ◽  
Oblique Fissure

Lungs are paired conical organs present in the thoracic cavity, which are responsible for gaseous exchange for oxygenation of blood. Both the lungs are divided into lobes by fissures. The right lung is divided into upper, middle and lower lobes by two fissures. The fissures are horizontal and oblique fissure whereas the left lung is divided into upper and lower lobes by oblique fissure. The left lung is divided into upper and lower lobe by oblique fissure. Both the lungs have ten bronchopulmonary segments (structurally separate and functionally independent units). Embryological evidence showed that the lungs developed from the endodermal counterpart of the foregut. Around 22 days of embryonic period, diverticulum are develop, then between 26-28 days lung buds develop. The right bronchial buds and left bronchial buds are branched into secondary and tertiary buds at 5th and 6th week of embryonic life consecutively. During routine anatomy dissection and demonstration in the Department of Anatomy, a 50 year old male cadaver showed anatomical variation in the right lung. The present study observed that the right lung showed partial horizontal fissure. The reason for partial or incomplete fissure formation is due to incomplete or absence of obliteration of prenatal fissure which indicates partial fusion of lobes, generally fissures separating the broncho-pulmonary segments in prenatal life. The reports says that incomplete fissures of the lung may lead to spread of infection like pneumonia to adjacent lobe and collapse in endobronchial lesions and gradation of the fissures of the lungs are very important for lung surgeries. The present study concludes that the knowledge of anatomical variation of lung is of utmost important in the field of pulmonary medicine.

scholarly journals Osteomyelitis in limb amputated by amniotic band sequence

2019 ◽  
Vol 12 (4) ◽  
pp. e228588
Author(s):  
Mohsin Raj Mantoo ◽  
Mayank Priyadarshi ◽  
Ankit Verma ◽  
Anu Thukral
Keyword(s):  
Coagulase Negative Staphylococcus ◽  
Amniotic Band ◽  
Knee Amputation ◽  
Systemic Sepsis ◽  
Intravenous Antibiotics ◽  
Band Sequence ◽  
The Right ◽  
Spread Of Infection ◽  
Amniotic Band Sequence ◽  
Contiguous Spread

A preterm (30+2 week) neonate with below-knee amputation (right lower limb), constriction rings and syndactyly, subsequent to amniotic band sequence, developed pus discharge from the right tibial stump. The neonate did not have clinical features of systemic sepsis. Blood culture was sterile. The pus culture, however, grew methicillin-resistant coagulase-negative Staphylococcus and bone scan was suggestive of osteomyelitis of right proximal tibial stump. Osteomyelitis was likely caused by the contiguous spread of infection from the exposed stump. Neonate was treated with intravenous antibiotics for 4 weeks and discharged on oral feeds.

Lung abscess due to aspirated vomitus

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Saad Farooq ◽  
◽  
Ebrahim Hasan Khan ◽  
Keyword(s):  
African American ◽  
Physical Examination ◽  
African American Male ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Chest Ct ◽  
Amoxicillin Clavulanate ◽  
The Right

Our patient was a 41-year-old African American male who came in with a cough, hemoptysis, and body aches for two days. He was vitally stable and physical examination did not reveal any abnormality. A Chest CT revealed a lung abscess at base of the right lower lobe. He was initially treated with ampicillin-sulbactam which was then converted to amoxicillin-clavulanate and he completely recovered on this regimen.Further history revealed that he was using marijuana and had an episode of vomiting which he aspirated and that was the likely cause of his lung abscess.

Chronic pulmonary thromboembolism due to intracardiac and pulmonary hydatidosis

2020 ◽  
Vol 28 (9) ◽  
pp. 610-612
Author(s):  
Ameya Kaskar ◽  
Varun Shetty ◽  
Devi Shetty
Keyword(s):  
Hydatid Disease ◽  
Pulmonary Thromboembolism ◽  
Circulatory Arrest ◽  
Wedge Resection ◽  
Pulmonary Arteries ◽  
Lower Lobe ◽  
Postoperative Recovery ◽  
Rare Presentation ◽  
Pulmonary Hydatid Disease ◽  
The Right

Hydatid disease remains a problem in endemic areas. The combination of both intracardiac and pulmonary hydatid disease in association with chronic pulmonary thromboembolism is a rare presentation. We report a case of a 14-year-old girl with hydatid disease of the lungs, right ventricle, and pulmonary arteries, presenting as chronic pulmonary thromboembolism. She underwent surgery for wedge resection of the pulmonary hydatid in the right lower lobe, removal of the right ventricular hydatid (under cardiopulmonary bypass), and pulmonary endarterectomy (under total circulatory arrest). Her postoperative recovery was uneventful.

PS02.163: A CASE OF SEPARATION SURGERY WITH DRAINAGE TUBE-LESS (DRESS) ESOPHAGOSTOMY FOR ADVANCED CANCER WITH A RESPIRATORY FISTULA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Yukinori Tanoue ◽  
Shinsuke Takeno ◽  
Fumiaki Kawano ◽  
Kousei Tashiro ◽  
Rouko Hamada ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Aspiration Pneumonia ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Drainage Tube ◽  
Lung Field ◽  
Definitive Chemoradiotherapy ◽  
The Right

Abstract Background Esophagorespiratory fistulas including esophagopulmonary fistulas occur in 5–10% patients with esophageal cancer with invasion to adjacent organs. With an esophagorespiratory fistula, saliva and food flow into the respiratory tract through the fistula and severe pneumonia or lung abscess can develop. Alternatively, whether chemoradiotherapy can be performed for patients with esophagorespiratory fistulas affects the further outcomes of treatment in these patients. An esophageal cancer patient with an esophagopulmonary fistula who underwent separation surgery with drainage tube-less (DRESS) esophagostomy and whose inflammation from the esophagorespiratory fistula could be effectively controlled, which facilitated the prompt administration of definitive chemoradiotherapy, is reported. Methods Case report: A 79-year-old man visited a clinic with a month-long history of dysphagia. Esophageal cancer at the middle thoracic esophagus was detected, and invasion of the left main bronchus and lower lobe of the right lung was seen on contrast-enhanced computed tomography (CT). Three weeks later, urgent CT showed a lung abscess in the lower lobe of the right lung that continued into the adjacent esophageal cancer, infiltrative shadows in the peripheral lung field, and a pleural effusion. Due to the esophagopulmonary fistula, the patient underwent emergency surgery that consisted of esophageal separation surgery and double bilateral esophagostomy on the right and left supraclavicular region and enterostomy (drainage tube-less esophageal separation surgery). Results Antibiotic drug therapy for pneumonia and lung abscess achieved a favorable outcome. Definitive chemoradiotherapy for the esophageal cancer was started from postoperative day 25. Radiotherapy could not be completed because of sepsis due to aspiration pneumonia, though the aspiration pneumonia improved with intensive treatment. At six-month follow-up, the patient had achieved relapse-free survival and is currently symptom-free. Conclusion Separation surgery with a drainage tube-less (DRESS) esophagostomy is the less invasive operative procedure, which allows prompt initiation of chemoradiotherapy. In many cases of esophageal surgeries, an external esophagostomy is made with a drainage tube, and drainage tubes sometimes cause trouble and affect the quality of life of patients after surgery. However, our drainage tube-less (DRESS) esophagostomy might improve patient's quality of life. In addition, evaluation of esophageal cancer by endoscopic examination through the esophagocutaneostomy can be easily performed. Disclosure All authors have declared no conflicts of interest.

073 Alemtuzumab induced allergic inflammatory syndrome (ALIAS) with eosinophilic acalculous cholecystitis: a report of two cases

2018 ◽  
Vol 89 (6) ◽  
pp. A30.1-A30 ◽  
Author(s):  
Ariadna Fontes-Villalba ◽  
John DE Parratt
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Signs ◽  
Young Patients ◽  
Lower Lobe ◽  
Acalculous Cholecystitis ◽  
X Ray ◽  
Blood Tests ◽  
Chest X Ray ◽  
The Right ◽  
Inflammatory Syndrome

IntroductionAlemtuzumab, a humanised monoclonal antibody directed at CD52, is a highly active treatment for multiple sclerosis (MS) that induces rapid depetion of circulating lymphocytes. Infusion-associated reactions and autoimmune disorders are established adverse effects. We describe two cases of alemtuzumab associated allergic inflammatory syndrome involving the lungs and gallbladder in two young patients after their first course of Alemtuzumab.Case 1 A 26 year old female with relapsing-remitting MS (RRMS) received her first course of alemtuzumab. On the fourth day of treatment, she developed bronchospasm, chest pain and an interstitial infiltrate in the right lower lobe on chest X-ray. She had right upper quadrant pain and a positive Murphy’s sign and ‘gallbladder sludge’ on ultrasound. Blood tests showed lymphopenia and eosinophilia. The patient was diagnosed with acalculous cholecystitis. Antibiotic therapy was initiated but laparoscopic cholecystectomy was required. The pathology demonstrated eosinophilic cholecystitis.Case 2 A 29 year old man with RRMS was switched to alemtuzumab due to positive JCV antibody status. He had an episode of hemoptysis on the fifth day of the infusion. Two days later, haemoptysis was accompanied by chest tightness. Physical examination revealed a palpable liver and positive Murphy sign. Blood tests were remarkable for abnormal liver enzymes. Signs of interstitial changes in the right lower lobe were observed on a chest X-ray. The patient was diagnosed with acalculous cholecystitis and antibiotic therapy was initiated. The infiltrate resolved and the clinical signs quickly improved.ConclusionThe characteristics of this condition are acute onset (within days of alemtuzumab) and non-infective inflammation of the lung (right lower lobe in these cases) and gallbladder. The pathology in one case indicates this is likely to be a drug related, allergic phenomenon with extensive eosinophilic infiltration of the gallbladder.

scholarly journals Burkholderia cepacia: An unusual cause of pneumonia

2021 ◽  
Vol 6 (4) ◽  
pp. 249-252
Author(s):  
Arjun A S ◽  
Prasanna Kumar T ◽  
Manjunath H K
Keyword(s):  
Burkholderia Cepacia ◽  
Lower Lobe ◽  
Lung Abscess ◽  
High Grade Fever ◽  
Home Setting ◽  
Prescription Practices ◽  
Male Farmer ◽  
History Of ◽  
Chest X Ray ◽  
The Right

Burkholderia Cepacia is a gram negative organism, an uncommon cause of pneumonia. When isolated, it usually represents colonisation. In the presence of immunocompromising conditions, it can cause disease, ranging from mild illness to the highly fatal Cepacia syndrome. The organism is intrinsically resistant to many antibiotics. We report a 57 years old male farmer, who has diabetes mellitus and bronchial asthma, who presented with a acute history of high grade fever, pain abdomen and cough. He was diagnosed with a ruptured liver abscess, with the infection spreading to the right lower lobe. Laparotomy was performed. Pus culture grew Pseudomonas aeruginosa. He improved upon antibiotic therapy, only to return after one month with severe cough, chest X-ray revealing a lung abscess in the right lower lobe. Bronchoalveolar lavage culture grew Burkholderia cepacia, and sensitive antibiotics were initiated, however the patient succumbed to the illness. The implicated source of the organism was the nebulisation solution which he was using regularly. Emphasis should be laid on the need for improved aseptic practices while using medical solutions at either hospital or home setting. An index of suspicion may guide optimal antibiotic prescription practices in susceptible individuals.

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