scholarly journals Leptospirosis: An Unusual Cause of ARDS

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Marc Clavel ◽  
Gwenaelle Lhéritier ◽  
Nicolas Weinbreck ◽  
Antoine Guerlin ◽  
Anthony Dugard ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Lung Biopsy ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Open Lung Biopsy ◽  
Alveolar Haemorrhage ◽  
Massive Hemoptysis ◽  
Open Lung ◽  
Wild Rat ◽  
Severe Leptospirosis

Severe leptospirosis usually associates shock, jaundice, renal failure, and thrombocytopenia. Massive hemoptysis due to diffuse alveolar haemorrhage may rarely occur leading to an acute respiratory failure and multiple organ failure. We present the case of an acute respiratory distress syndrome caused by a severe leptospirosis. The severity of the respiratory failure contrasted with the absence of significant liver or renal dysfunction. Bedside open lung biopsy was only consistent with a postinfectious BOOP. The diagnosis was retrospective when the niece of the patient presented with similar inaugural symptoms ten days later after being scratched by a wild rat which was considered by our patient as a pet.

Impact of open lung biopsy on refractory acute respiratory failure]]>

2006 ◽  
Vol 32 (5) ◽  
Author(s):  
Carmen S. V. Barbas ◽  
Vera L. Capelozzi ◽  
Cristiane Hoelz ◽  
Ricardo B. Magaldi ◽  
Rog�rio Souza ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
Open Lung

Diffuse alveolar haemorrhage in the setting of eosinophilic pneumonia

2021 ◽  
Vol 14 (4) ◽  
pp. e241672
Author(s):  
Adam T Ladzinski ◽  
Aditya Mehta ◽  
Brian J Dykstra ◽  
Sarah M Sharghi
Keyword(s):  
Weight Loss ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
Eosinophilic Pneumonia ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Open Lung

A 65-year-old woman who presented with a constellation of symptoms, including cough with haemoptysis, fever, chills and hypoxia along with weight loss, was found to have diffuse alveolar haemorrhage. After a myriad of investigations returned normal, an open lung biopsy was performed, which revealed the diagnosis to be subacute eosinophilic pneumonia. This is one of its kind of rare presentations where eosinophilic pneumonia presents as diffuse alveolar haemorrhage and has been reported only five times prior to this.

Open lung biopsy in pediatric patients with respiratory failure after abdominal transplantation

2005 ◽  
Vol 9 (2) ◽  
pp. 197-200 ◽  
Author(s):  
Christopher Vendryes ◽  
Gwenn E. McLaughlin ◽  
Rita L. Romaguera ◽  
Juan Sola ◽  
Tomoaki Kato
Keyword(s):  
Respiratory Failure ◽  
Lung Biopsy ◽  
Pediatric Patients ◽  
Open Lung Biopsy ◽  
Open Lung

scholarly journals The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Abdullah Almotairi ◽  
Sharmistha Biswas ◽  
Jason Shahin
Keyword(s):  
Respiratory Failure ◽  
Steroid Therapy ◽  
Lung Biopsy ◽  
Retrospective Cohort ◽  
Diagnostic Yield ◽  
Open Lung Biopsy ◽  
Systemic Steroid ◽  
Open Lung ◽  
Systemic Steroid Therapy ◽  
Hypoxic Respiratory Failure

Background. The aim of this study was to assess the utility of open lung biopsy in patients with hypoxic respiratory failure of unknown etiology admitted to an ICU and to examine the use of steroid therapy in this patient population.Methods. A retrospective cohort study was performed of all consecutive patients admitted to three tertiary care, university-affiliated, ICUs during the period from January 2000 to January 2012 with the principal diagnosis of hypoxic respiratory failure and who underwent an open lung biopsy.Results. Open lung biopsy resulted in a diagnostic yield of 68% and in a 67% change of management in patients. A multivariable analysis of clinical variables associated with acute hospital mortality demonstrated that postbiopsy systemic steroid therapy (OR 0.24, 95% C.I 0.06–0.96) was significantly associated with improved survival. Complications arising from the biopsy occurred in 30% of patients.Conclusion. Open lung biopsy had significant diagnostic yield and led to major changes in management and aided in end-of-life decision-making in the ICU. Systemic steroid therapy was associated with improved survival. The risk-benefit ratio of open lung biopsy is still unclear, especially given the availability of newer diagnostic tests and possible empirical therapy with steroids.

Open-lung Biopsy in Patients with Acute Respiratory Distress Syndrome 

1998 ◽  
Vol 88 (4) ◽  
pp. 935-944 ◽  
Author(s):  
Laurent Papazian ◽  
Pascal Thomas ◽  
Fabienne Bregeon ◽  
Louise Garbe ◽  
Christine Zandotti ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Biopsy ◽  
Distress Syndrome ◽  
Ventilatory Support ◽  
Open Lung Biopsy ◽  
Chest Roentgenogram ◽  
Open Lung ◽  
Cytomegalovirus Pneumonia

Background It has been suggested that fibrosis present during the fibroproliferative phase of acute respiratory distress syndrome (ARDS) can be treated by corticosteroids. However, neither clinical nor microbiologic criteria permit differentiation of this fibroproliferative phase from a nosocomial pneumonia. The aim of this observational case series was to evaluate the safety and utility of open-lung biopsy (OLB) performed in patients receiving ventilatory support who had persistent ARDS despite negative bacterial cultures. Methods During a 4-yr period, 37 OLBs were performed in 36 of 197 patients receiving ventilatory support who had ARDS. The severity of ARDS was assessed by a lung injury score of 3.1 +/- 0.4 (mean +/- SD) and a median ratio of the partial pressure of oxygen (PaO2) to the fraction of inspired oxygen (FiO2) of 118 mmHg. Histologic examination; bacterial, fungal, and acid-fast staining; and cultures of the tissue sample were performed. Results Fibrosis was present in only 41% of the lung specimens obtained by OLB. Only six patients received corticosteroids (17%). In 9 of the 15 patients with fibrosis, cytomegalovirus pneumonia precluded the use of corticosteroids. Histologic cytomegalovirus pneumonia was diagnosed in 18 cases. Histologic bacterial or mycobacterial pneumonia was diagnosed in five cases. No significant change in arterial blood gases was noted as linked to the biopsy procedure except an increase of the PaO2/FiO2 ratio. One pneumothorax was diagnosed on a chest roentgenogram 12 h after OLB. Only one patient required blood transfusion during the 48-h period after OLB (for an hemothorax). Five patients had moderate air leaks from operative chest tubes for 2-10 days. Conclusions Open lung biopsy appeared to be a useful and acceptably safe diagnostic technique in patients with ARDS. It permitted the diagnosis of unexpected cytomegalovirus pneumonia.

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