An oesophageal spring

Oesophageal foreign bodies (OFBs) are a relatively common emergency in young children. OFBs are complicated by significant morbidity and mortality because their ingestion often occurs without witnesses, leading to a delay in diagnosis and treatment. We report an occult OFB in an 11-month-old infant who initially presented without any specific respiratory symptoms, mimicking a respiratory infection. Worsening of the patient’s cough, which did not show any improvement, despite treatment, and progressive onset of gastrointestinal manifestations (dysphagia, vomiting, and drooling) led to the diagnosis of an OFB (metallic spring). The complex and long-term clinical course of the patient highlights the need of promptly recognizing the presence of an occult OFB. This is because rapid diagnosis and treatment are essential for preventing severe and sometimes irreversible complications.

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Acquired tracheo-oesophageal fistula in a child with unrecognised tracheal foreign body

BMJ Case Reports ◽

10.1136/bcr-2020-240947 ◽

2021 ◽

Vol 14 (4) ◽

pp. e240947

Author(s):

Kanokpan Ruangnapa ◽

Wanaporn Anuntaseree ◽

Kantara Saelim ◽

Pharsai Prasertsan

Keyword(s):

Foreign Body ◽

Young Children ◽

Respiratory Symptoms ◽

Growth Failure ◽

Late Diagnosis ◽

Feeding Intolerance ◽

Recurrent Pneumonia ◽

High Index Of Suspicion ◽

Careful Investigation

We report the case of a 6-month-old girl who presented with recurrent pneumonia and growth failure. After full examination, she was diagnosed with long-standing, unrecognised tracheal foreign body, which was then successfully removed. However, her chronic respiratory symptoms did not improve, and she also had feeding intolerance. The persistence of symptoms indicated a second bronchoscopy and finally an acquired tracheo-oesophageal fistula was diagnosed. This case emphasises the challenges in diagnosis of an inhaled foreign body in young children. Late diagnosis of this condition can cause significant morbidities. A high index of suspicion and careful investigation are very important to prevent long-term complications.

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Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma

Canadian Respiratory Journal ◽

10.1155/2018/3095647 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Carlos Kofman ◽

Alejandro Teper

Keyword(s):

Risk Factors ◽

Fluticasone Propionate ◽

Young Children ◽

Respiratory Symptoms ◽

Term Treatment ◽

Recurrent Wheezing ◽

Inhaled Steroids ◽

Long Term Treatment ◽

Metered Dose

Background. In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma. Objective. To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Patients and Methods. Outpatient children (6 to 20 months old) with recurrent wheezing and risk factors for asthma were randomized to receive a 6-month treatment with metered-dose inhaler (MDI) of Fluticasone Propionate 125 mcg BID through an NVS or through a VHC. Parents recorded daily their child’s respiratory symptoms and rescue medication use. Results. 46 patients of 13.4 ± 5 months old were studied. During the study period, the NVS group (n=25) experienced 3.9 ± 2.4 obstructive exacerbations, and the VHC group (n=21) had 2.6 ± 1.6 (p=0.031). The NVS group had 17.4 ± 14% of days with respiratory symptoms, and the VHC group had 9.7 ± 7% (p=0.019). The NVS group spent 29.8 ± 22 days on albuterol while the VHC group spent 17.9 ± 11 days (p=0.022). Conclusion. Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.

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An Unusual Case of Foreign Body Aspiration: A Case Report

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v6i2.31593 ◽

2017 ◽

Vol 6 (2) ◽

pp. 47-49

Author(s):

Kuntal Roy ◽

Syed Khairul Amin ◽

Mumtahina Setu ◽

Tarannum Khondaker ◽

Nandita Sur Chowdhury

Keyword(s):

Case Report ◽

Foreign Body ◽

Young Children ◽

Clinical Examination ◽

Respiratory Symptoms ◽

Unusual Case ◽

Foreign Body Aspiration ◽

Delay In Diagnosis ◽

Medical College ◽

Careful History

Foreign body aspiration most commonly affects young children, with respiratory symptoms such as wheeze and cough after a choking episode. A careful history and clinical examination can identify those children that need additional investigation including bronchoscopy. However foreign body aspiration can mimic other conditions. The link between choking and subsequent symptoms may not be made by parents. We present a case with a delay in diagnosis, and discuss the appropriate management of suspected foreign body aspiration.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 47-49

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Chronical bronchitis

Kazan medical journal ◽

10.17816/kazmj64137 ◽

1980 ◽

Vol 61 (4) ◽

pp. 1-5

Author(s):

A. N. Kokosov ◽

N. I. Aleksandrova

Keyword(s):

Chronic Bronchitis ◽

Lung Diseases ◽

Clinical Course ◽

Diagnosis And Treatment

The modern views on the etiology and pathogenesis of chronic bronchitis, the most common form of chronic nonspecific lung diseases, are presented. On the basis of long-term observations and generalization of the latest literature data, the features of the clinical course of this disease are characterized. Methods of diagnosis and treatment are described.

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Methods for rapid diagnosis of meningitis etiology in adults

Biomarkers in Medicine ◽

10.2217/bmm-2019-0333 ◽

2020 ◽

Cited By ~ 1

Author(s):

Victoria Poplin ◽

David R Boulware ◽

Nathan C Bahr

Keyword(s):

Cerebrospinal Fluid ◽

Multiplex Pcr ◽

Fungal Pathogens ◽

Holistic Approach ◽

Rapid Diagnosis ◽

Lateral Flow ◽

Significant Morbidity ◽

Delay In Diagnosis ◽

Fungal Meningitis ◽

Poor Outcomes

Infectious meningitis can be caused by viral, bacterial or fungal pathogens. Despite widely available treatments, many types of infectious meningitis are still associated with significant morbidity and mortality. Delay in diagnosis contributes to poor outcomes. Cerebrospinal fluid cultures have been used traditionally but are time intensive and sensitivity is decreased by empiric treatment prior to culture. More rapid techniques such as the cryptococcal lateral flow assay (IMMY), GeneXpert MTB/Rif Ultra (Cepheid) and FilmArray multiplex-PCR (Biofire) are three examples that have drastically changed meningitis diagnostics. This review will discuss a holistic approach to diagnosing bacterial, mycobacterial, viral and fungal meningitis.

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Aspiration of Aluminum Beverage Can Tab: Case Report and Literature Review

Case Reports in Otolaryngology ◽

10.1155/2017/1010975 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Alhasan N. Elghouche ◽

Brian C. Lobo ◽

Jonathan Y. Ting

Keyword(s):

Case Report ◽

Foreign Bodies ◽

Clinical Course ◽

Primary Objective ◽

Radiographic Evaluation ◽

Significant Delay ◽

Endoscopic Evaluation ◽

Patient History ◽

Delay In Diagnosis ◽

First Case

We describe the case of a 16-year-old male who aspirated a beverage can tab resulting in significant functional impairment. Since the introduction of beverage can opening tabs (“pop-tops” or “pull-tabs”) nearly 50 years ago, five cases of their aspiration have been reported in the literature and this is the first case to report tracheal lodgment. We describe the clinical course for this patient including the inadequacy of radiographic evaluation and a significant delay in diagnosis. We highlight unique features of small aluminum foreign bodies that require consideration and mention a potential change in epidemiology associated with evolving product design. Our primary objective is increased awareness among otolaryngologists that radiography is unreliable for diagnosis or localization of small aluminum foreign bodies. The patient history must therefore be incorporated with other imaging modalities and/or endoscopic evaluation. Also, given the marked prevalence of aluminum beverage cans, we suspect that the inadvertent aspiration of can tabs is more common than indicated by the paucity of published reports.

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Critical Manifestations of Pneumoscrotum

Current Urology ◽

10.1159/000442855 ◽

2015 ◽

Vol 9 (2) ◽

pp. 62-66 ◽

Cited By ~ 7

Author(s):

Gautam Dagur ◽

Min Y. Lee ◽

Kelly Warren ◽

Reese Imhof ◽

Sardar A. Khan

Keyword(s):

Treatment Option ◽

Historical Perspective ◽

Treatment Options ◽

Rapid Diagnosis ◽

Morbidity And Mortality ◽

Diagnosis And Treatment ◽

Significant Morbidity ◽

Treatment Results ◽

Physical Finding ◽

Secondary Objective

Introduction: Pneumoscrotum is a critical, physical finding that may indicate significant morbidity and mortality. Accumulation of gas in the scrotum can be primary or secondary. Objective: This paper discusses rapid diagnosis and treatment options. Material and Methods: PubMed searches for pneumoscrotum, etiology, diagnosis, and treatment. Results: We review the historical perspective, classification, etiology, diagnosis, and treatment options of pneumoscrotum, as well as the presentation of pneumoscrotum in neonates/infants. Conclusion: It is crucial to diagnose the etiology pneumoscrotum and designing a treatment option based off that.

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