Seorang Penderita Siliko Tuberkulosis dengan Penyulit Pneumotoraks

Background: Silicosis is a lung disease caused by the work because of respirable crystalline silica. Often occurs in workers mining gold, iron, tin, granite, sandstone, slate, foundries, cement, ceramics and glass. The risk of silicosis develop into lung tuberculosis (TB) is higher than patients without silicosis. Another complication of silicosis is secondary spontaneous pneumothorax. Case : A man, 45 years old with a history of work as a bricklayer for 5 years with complaints shortness of breath since three days before admitted to the hospital, chest pain in the right hemithorax, and had chronic cough. Patients is on ATD therapy. From radiographic there is collapse lung, it was shown collapse line on the right hemithorax, and fibroinfiltrat with multiple cavities on both hemithorax. Patients then got chest tube insertion and evaluation for 3 weeks, but the lung has not expanded. From thoracoscopy, there is fibrotic band on the pleural space with conclution right trapped lung. From forcep biopsy on visceral pleura showed a widened alveolar epithelial layer coated with a pile of inflammatory lymphocytes and dust pigments. From broncoscopy, there is chronic lung inflamation. Spectrophotometric analysis from BAL specimens results showed a silica content of 4.25 ppm SiO2 from left BAL an 14.34 ppm SiO2 on the right BAL. Furthurmore, this patient got pleurodesis using betadine agent and continue the ATD. Evaluation the lung is fully expanded. Conclusion : This case illustrates the secondary spontaneous pneumothorax as a complication of silicotuberkulosis. No drug has proven effective for silicosis. Treatment is aimed to the disease complications that occur, in this case is secondary spontaneous pneumothorax and lung TB. Prevention at workplaces that have a risk of silicosis is very important.

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Profil hasil pemeriksaan foto toraks pada pasien pneumotoraks di Bagian / SMF Radiologi FK Unsrat RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2015 – Agustus 2016

e-CliniC ◽

10.35790/ecl.4.2.2016.14397 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Windy D.P. Masengi ◽

Elvie Loho ◽

Vonny Tubagus

Keyword(s):

Medical Records ◽

Spontaneous Pneumothorax ◽

Pleural Cavity ◽

Secondary Data ◽

Descriptive Study ◽

Age Group ◽

X Ray ◽

Secondary Spontaneous Pneumothorax ◽

Chest X Ray ◽

The Right

Abstract: Radiology examination especially chest x-ray can enforce various kinds of pulmonary diseases inter alia pneumothorax. Pneumothorax is defined as the presence of air in the pleural cavity. The causes of pneumothorax are very diverse ranging from idiopathic, infection, trauma, and iatrogenic. This study was aimed to obtain the profile of chest x-ray in patients with pneumothorax. This was a retrospective descriptive study by using secondary data from the medical records at the Department of Radiology Prof. Dr. R. D. Kandou Hospital Manado from January 2015 to August 2016. Samples were the medical records of patients that were radiologically diagnosed as pneumothorax. There were 41 patients that were diagnosed radiologically as pneumothorax. The majority of cases were male (90.2%), age group >50 years (36.6%), location of lesion in the right hemithorax (53.7%), and secondary spontaneous pneumothorax as the etiology (43,9 %). Conclusion: In this study, pneumothorax was more common among males, age group of ≥50 years, and secondary spontaneous pneumothorax as the etiology of pneumothorax.Keywords: pneumothorax, radiology, chest x-ray Abstrak: Pemeriksaan radiologi khususnya foto toraks dapat menegakkan berbagai macam diagnosis penyakit paru, salah satunya ialah pneumotoraks. Pneumotoraks adalah terdapatnya udara bebas didalam rongga pleura dengan penyebab yang sangat beragam mulai dari idiopatik, infeksi, trauma, maupun iatrogenik. Penelitian ini bertujuan untuk mengetahui profil hasil pemeriksaan foto toraks pada pasien pneumotoraks. Jenis penelitian ialah deskriptif retrospektif dengan pengambilan data di Bagian Radiologi RSUP Prof. Dr. R. D. Kandou Manado pada bulan Januari 2015 sampai dengan Agustus 2016. Sampel yaitu data rekam medik pasien yang didiagnosis pneumotoraks secara radiologis sebanyak 41 pasien. Yang tersering ditemukan ialah pasien laki-laki sebanyak 37 orang (90,2%), kelompok usia >50 tahun sebanyak 15 orang (36,6%), lokasi lesi hemitoraks deksra sebanyak 22 kasus (53,7%), serta etiologi pneumotoraks spontan sekunder sebanyak 18 kasus (43,9%). Simpulan: Pada penelitian ini didapatkan pneumotoraks paling banyak pada laki-laki, kelompok usia ≥50 tahun, dengan pneumotoraks spontan sekunder sebagai etiologi tersering. Kata kunci: pneumotoraks, radiologi, foto toraks

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Spontaneous Pneumothorax as a Complication in Concomitant Diabetic Ketoacidosis and Pulmonary Tuberculosis: A Case Report

Case Reports in Acute Medicine ◽

10.1159/000513324 ◽

2021 ◽

pp. 7-12

Author(s):

Filbert Riady Adlar ◽

Willy Anthony

Keyword(s):

Pulmonary Tuberculosis ◽

Diabetic Ketoacidosis ◽

Spontaneous Pneumothorax ◽

Gas Analysis ◽

Prior History ◽

Pulmonary Tb ◽

Drainage Fluid ◽

Secondary Spontaneous Pneumothorax ◽

Arterial Blood ◽

The Right

Secondary spontaneous pneumothorax (SSP) can occur as a complication of several underlying diseases such as pulmonary tuberculosis (TB) or, rarely, diabetic ketoacidosis (DKA). As diabetes mellitus (DM) is significantly prevalent in tuberculosis patients, it is possible to have both TB and DKA concurrently. However, there has not been any documentation of SSP as a complication in concomitant DKA and pulmonary TB. In this report, we described a 30-year-old female who presented to the emergency department with a chief complaint of shortness of breath that had intensified since a day before. She was diagnosed with pulmonary TB 1 week before and had started on her anti-tuberculosis drugs regimen. Prior history of DM was not known. Physical examination showed a slight decrease in consciousness, tachycardia, tachypnea, Kussmaul breathing, decreased lung sounds in the right hemithorax and hyperresonant on percussion. Laboratory results showed leukocytosis and hyperglycemia, ketones were positive on urinalysis and arterial blood gas analysis indicated metabolic acidosis. Chest X-ray revealed pneumothorax in the right hemithorax. She was diagnosed with pneumothorax of the right hemithorax, DKA, sepsis and pulmonary TB. Treatment involved prompt placement of chest tube drainage, fluid rehydration, intravenous insulin, antibiotic, sodium bicarbonate and anti-tuberculosis drugs. Her condition improved after 9 days of uneventful hospitalization. We discussed how concomitant presence of both DKA and pulmonary TB can increase the likelihood of developing secondary spontaneous pneumothorax.

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Secondary spontaneous pneumothorax: a time to re‐evaluate management

Respirology Case Reports ◽

10.1002/rcr2.749 ◽

2021 ◽

Vol 9 (8) ◽

Author(s):

Arturo Cortes‐Telles ◽

Diana Lizbeth Ortíz‐Farias ◽

Felipe Perez‐Hernandez ◽

Dulce Rodriguez‐Morejon

Keyword(s):

Spontaneous Pneumothorax ◽

Secondary Spontaneous Pneumothorax

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Bedside tracer gas technique accurately predicts outcome in aspiration of spontaneous pneumothorax

Thorax ◽

10.1136/thx.56.8.617 ◽

2001 ◽

Vol 56 (8) ◽

pp. 617-621

Author(s):

D G Kiely ◽

S Ansari ◽

W A Davey ◽

V Mahadevan ◽

G J Taylor ◽

...

Keyword(s):

Chest Radiograph ◽

Spontaneous Pneumothorax ◽

Significant Risk ◽

Admission Rate ◽

Primary Spontaneous Pneumothorax ◽

Tracer Gas ◽

Secondary Spontaneous Pneumothorax ◽

Poor Predictor ◽

Bedside Test ◽

Simple Bedside

BACKGROUNDThere is no technique in general use that reliably predicts the outcome of manual aspiration of spontaneous pneumothorax. We have hypothesised that the absence of a pleural leak at the time of aspiration will identify a group of patients in whom immediate discharge is unlikely to be complicated by early lung re-collapse and have tested this hypothesis by using a simple bedside tracer gas technique.METHODSEighty four episodes of primary spontaneous pneumothorax and 35 episodes of secondary spontaneous pneumothorax were studied prospectively. Patients breathed air containing a tracer (propellant gas from a pressurised metered dose inhaler) while the pneumothorax was aspirated percutaneously. Tracer gas in the aspirate was detected at the bedside using a portable flame ioniser and episodes were categorised as tracer gas positive (>1 part per million of tracer gas) or negative. The presence of tracer gas was taken to imply a persistent pleural leak. Failure of manual aspiration and the need for a further intervention was based on chest radiographic appearances showing either failure of the lung to re-expand or re-collapse following initial re-expansion.RESULTSA negative tracer gas test alone implied that manual aspiration would be successful in the treatment of 93% of episodes of primary spontaneous pneumothorax (p<0.001) and in 86% of episodes of secondary spontaneous pneumothorax (p=0.01). A positive test implied that manual aspiration would either fail to re-expand the lung or that early re-collapse would occur despite initial re-expansion in 66% of episodes of primary spontaneous pneumothorax and 71% of episodes of secondary spontaneous pneumothorax. Lung re-inflation on the chest radiograph taken immediately after aspiration was a poor predictor of successful aspiration, with lung re-collapse occurring in 34% of episodes by the following day such that a further intervention was required.CONCLUSIONSNational guidelines currently recommend immediate discharge of patients with primary spontaneous pneumothorax based primarily on the outcome of the post-aspiration chest radiograph which we have shown to be a poor predictor of early lung re-collapse. Using a simple bedside test in combination with the post-aspiration chest radiograph, we can predict with high accuracy the success of aspiration in achieving sustained lung re-inflation, thereby identifying patients with primary spontaneous pneumothorax who can be safely and immediately discharged home and those who should be observed overnight because of a significant risk of re-collapse, with an estimated re-admission rate of 1%.

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Surgical treatment for secondary spontaneous pneumothorax: a risk factor analysis

Surgery Today ◽

10.1007/s00595-020-02206-0 ◽

2021 ◽

Author(s):

Norikazu Kawai ◽

Takeshi Kawaguchi ◽

Motoaki Yasukawa ◽

Takashi Tojo ◽

Noriyoshi Sawabata ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Surgical Treatment ◽

Spontaneous Pneumothorax ◽

Risk Factor Analysis ◽

Secondary Spontaneous Pneumothorax

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Comparison of video-assisted thoracoscopic talcage for recurrent primary versus persistent secondary spontaneous pneumothorax

CrossRef Listing of Deleted DOIs ◽

10.1183/09031936.97.10020412 ◽

1997 ◽

Vol 10 (2) ◽

pp. 412-416 ◽

Cited By ~ 25

Author(s):

M. Noppen ◽

M. Meysman ◽

J. d'Haese ◽

I. Monsieur ◽

W. Verhaeghe ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Secondary Spontaneous Pneumothorax ◽

Video Assisted

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Pleurodesis After Bronchial Occlusion for Inoperable Secondary Spontaneous Pneumothorax

Journal of Bronchology & Interventional Pulmonology ◽

10.1097/lbr.0000000000000785 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Hirotaka Kida ◽

Hiromi Muraoka ◽

Kei Morikawa ◽

Takeo Inoue ◽

Masamichi Mineshita

Keyword(s):

Spontaneous Pneumothorax ◽

Secondary Spontaneous Pneumothorax

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Effects of Antibiotic Therapy on Pseudomonas aeruginosa-Induced Lung Injury in a Rat Model

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.43.10.2389 ◽

1999 ◽

Vol 43 (10) ◽

pp. 2389-2394 ◽

Cited By ~ 7

Author(s):

Erika J. Ernst ◽

Satoru Hashimoto ◽

Joseph Guglielmo ◽

Teiji Sawa ◽

Jean-Francois Pittet ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Acute Lung Injury ◽

Lung Injury ◽

Rat Model ◽

In Vivo Model ◽

Antibiotic Administration ◽

Lung Water ◽

Alveolar Epithelial ◽

The Right

ABSTRACT The effect of antibiotics on the acute lung injury induced by virulent Pseudomonas aeruginosa PA103 was quantitatively analyzed in a rat model. Lung injury was induced by the instillation of PA103 directly into the right lower lobes of the lungs of anesthetized rats. The alveolar epithelial injury, extravascular lung water, and total plasma equivalents were measured as separate, independent parameters of acute lung injury. Four hours after the instillation of PA103, all the parameters were increased linearly depending on the dose of P. aeruginosa. Next, we examined the effects of intravenously administered antibiotics on the parameters of acute lung injury in d-galactosamine-sensitized rats. One hour after the rats received 107 CFU of PA103, an intravenous bolus injection of aztreonam (60 mg/kg) or imipenem-cilastatin (30 mg/kg) was administered. Despite an MIC indicating resistance, imipenem-cilastatin improved all the measurements of lung injury; in contrast, aztreonam, which had an MIC indicating sensitivity, did not improve any of the lung injury parameters. The antibiotics did not generate different quantities of plasma endotoxin; therefore, endotoxin did not appear to explain the differences in lung injury. This in vivo model is useful to quantitatively compare the efficacies of parenteral antibiotic administration on Pseudomonas airspace infections.

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