scholarly journals The First Reported Case of Hemoptysis After Silicone Gel Breast Implants

Author(s):  
Guang Ying Zhuo ◽  
Pei Yong Zhang ◽  
Tao Xiang

Abstract Background: Hemoptysis after silicone breast prosthesis surgery has not been reported so far, and the mechanism is unclear. Case presentation: A 25-year-old young woman presented hemoptysis after silicone breast prosthesis replacement surgery. CTA revealed diffuse interstitial, alveolar, and terminal bronchial exudate changes in absent of pulmonary embolism. Noninvasive ventilator assisted breathing, combined with atomized inhalation of budesonide 2ml every 8h and intravenous infusion of hydrocortisone 100mg every 12h. Chest CT improved significantly 3 days later, and discharged 10 days later. Conclusions: Diffuse alveolar hemorrhage might be the cause of hemoptysis after silicone breast augmentation, and glucocorticoid treatment is very effective. However, if pulmonary imaging suggested diffuse pulmonary hemorrhage, BAL and lung biopsy should be performed to confirm the clinical diagnosis before treatment.

2019 ◽  
Vol 2 (1) ◽  

Introduction: The unicompartmental Oxford prosthesis has been used as a goodalternative for medial unicompartmental osteoarthritis because it is associated with earlyrehabilitation and a low rate of intraoperative complications. This case describes a rarecomplication during the procedure. Case Presentation: We present an intraoperative fracture of the medial condyle in a 70-year-old woman that was treated with 6.5 mm cannulated screws with a compressiontechnique. The patient remained in a non-weight bearing protocol for 6 weeks andreached a full range of mobility at 3 months. Complete radiological consolidation and agood functional outcome were observed. Conclusion: Intraoperative fractures benefit from a stable osteosynthesis that allows freerange of mobility and does not delay postoperative rehabilitation.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
H. J. Wang ◽  
G. Z. Chen ◽  
C. J. Zhou ◽  
Y. FU ◽  
L. N. YAO

Abstract Background Pulmonary hemorrhage is an important complication of leptospirosis. Once acute respiratory distress syndrome (ARDS) occurs as a secondary condition, treatment is extremely difficult and the mortality rate is very high. Case presentation The patient was a 49-year-old. He was admitted to the hospital because he had experienced a fever and cough for 4 days. Hemorrhage, respiratory failure, ARDS and other symptoms appeared soon after admission. Due to severe pulmonary hemorrhage secondary to ARDS, mechanical ventilation was performed through tracheal intubation. During intubation, the patient suffered cardiac arrest, and the patient’s condition worsened. He was confirmed to have leptospirosis through second-generation sequencing of the alveolar lavage fluid. Finally, we successfully treated the patient with penicillin as an anti-infective medication and venous-venous extracorporeal membrane oxygenation (v-vECMO). To the best of our knowledge, this report is the first to describe the successful application of ECMO in mainland China. Conclusions Leptospirosis can induce serious but transient ARDS with a better prognosis than other causes of ARDS. Our patient was successfully treated with V-vECMO.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Daniel Lachant ◽  
Paritosh Prasad

Background.Legionella micdadeiis a Gram negative bacterium that can stain weakly acid fast. It was first described in 1979 after immunosuppressed patients developed pneumonia at a Pittsburgh VA, initially given the name Pittsburgh Pneumonia Agent. It is the second most commonLegionellaspecies causing infection afterpneumophila, and typically infects immunocompromised hosts. It is not easy to be cultured which makes diagnosing difficult.Case Presentation. A 31-year-old female with ulcerative colitis, primary sclerosing cholangitis, and cirrhosis presented with fever, chills, shortness of breath, dry cough, and chest pain for five days after being started on immunosuppression for autoimmune hepatitis two months earlier. The first chest CT showed small bilateral cavitary nodules. The nodules continued to grow on subsequent imaging despite what was thought to be appropriate therapy. A transthoracic biopsy was performed which grewLegionella micdadeiand the patient improved after being treated with levofloxacin.Conclusion.Legionella micdadeiis an atypical pathogen known to cause pneumonia in immunosuppressed patients. This case highlights a typical presentation of an atypical infection not commonly thought about and should be considered when nodules are growing despite being on broad antimicrobial therapy.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Junichi Ochi ◽  
Minoru Ohkouchi ◽  
Yoshikazu Tsukada ◽  
Shinichiro Tominaga ◽  
Satoshi Takayama ◽  
...  

Amiodarone-induced pulmonary toxicity is a critical and potentially fatal side effect of amiodarone. Our study was designed to reveal its clinical features, including KL-6, as an interstitial marker. The medical records of eight patients (five men and three women) with amiodarone-induced pulmonary toxicity, who had been referred to our hospital, were examined. The mean age at the initiation of amiodarone was 48 years (range, 54-87 years) and mean duration of medication prior to the development of pulmonary toxicity was 18 months (range, 7-33 months). Serum KL-6 was elevated in six of the eight patients with a range of 525-2915 U/mL. Chest computed tomography (CT) findings showed non-segmental consolidation and/or ground glass opacity. Foamy macrophages were found in bronchoalveolar lavage (BAL) fluids of all examined patients and in transbronchial lung biopsy (TBLB) specimens in half of the examined patients. We concluded that serum KL-6, chest CT findings, and foamy macrophages in BAL fluids and TBLB specimens will be helpful for the diagnosis of amiodarone-induced pulmonary toxicity.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michiru Sawahata ◽  
Noritaka Sakamoto ◽  
Hideaki Yamasawa ◽  
Yuki Iijima ◽  
Hirotoshi Kawata ◽  
...  

Abstract Background The number of reports on sarcoidosis complicated by hypersensitivity pneumonitis (HP) is limited, and most describe cases complicated by chronic bird-related HP. Here, we present for the first time a case with Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related HP. Case presentation A 62-year-old man with a past medical history of sarcoidosis was admitted to our department, and chest computed tomography showed diffuse ground-glass opacities, which appeared as he rapidly increased the number of pigeons he kept for a competition. Random transbronchial lung biopsy revealed well-formed non-caseating epithelioid granulomas, which contained positively stained substances on immunohistochemistry using the PAB antibody, a specific monoclonal antibody against P. acnes lipoteichoic acid. Poorly formed non-caseating granulomas without positively stained substances were also detected. Conclusion We describe the successful identification of this exceptionally rare case of sarcoidosis complicated by acute bird-related HP in which two morphologically and immunohistologically different types of granulomas were present in the same lung.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Robert Ta ◽  
Romulo Celli ◽  
A. Brian West

The case of a 16-year-old African-American girl with systemic lupus erythematosus, who developed diffuse alveolar hemorrhage with fatal consequences, is described. Diffuse alveolar hemorrhage is a rare but serious complication of systemic lupus. It occurs in three distinct but overlapping phenotypes, acute capillaritis, bland pulmonary hemorrhage, and diffuse alveolar damage, each of which is associated with a different group of underlying conditions. Diffuse alveolar hemorrhage is a medical emergency: choice of treatment depends on early diagnosis and determination of the underlying etiology. Acute infection, superimposed on diffuse alveolar hemorrhage in the setting of immune compromise, is often a terminal event, as in this case.


2019 ◽  
Vol 14 ◽  
Author(s):  
Yuki Yabuuchi ◽  
Hitomi Goto ◽  
Mizu Nonaka ◽  
Hiroaki Tachi ◽  
Tatsuya Akiyama ◽  
...  

Background: Excessive inhalation of aluminium powder occasionally results in upper lobe predominant lung fibrosis, which is similar to idiopathic pleuroparenchymal fibroelastosis (IPPFE) and has been suggested to be secondary PPFE. Case presentation: A 67-year-old man who had worked in an aluminum-processing factory for 50 years visited our hospital complaining of exertional dyspnea. Chest computed tomography (CT) showed bilateral dense sub-pleural consolidation in the upper and middle lung fields, which was consistent with IPPFE; however, the possibility of secondary PPFE associated with aluminosis was not ruled out. Considering the patient’s critical condition, trans-bronchial lung biopsy (TBLB) rather than surgical lung biopsy was performed, with elemental analysis of the biopsied specimen. Unfortunately, the specimen obtained by TBLB did not contain alveolar tissue; therefore, pathological diagnosis of PPFE was not possible. However, radiographic findings were highly suggestive of PPFE. On elemental analysis, excessive amounts of aluminum were detected in the bronchiolar walls, establishing a diagnosis of airway aluminosis with likely secondary PPFE resulting from aluminium exposure. Conclusions: TBLB with elemental analysis might be useful in differentiating idiopathic PPFE from secondary causes in dust inhalation related disease, such as aluminosis. This case indicated that inhalation of aluminium might cause secondary PPFE, with attention needing to be paid to avoid further exposure.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mia C. Lundgren ◽  
Jerry A. Molitor ◽  
Benjamin Spilseth ◽  
Oyedele Adeyi

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease, characterized by autoantibody production and immune complex formation, that has the potential to affect virtually any organ. Pleuropulmonary involvement occurs in 50–70% and commonly manifests as pleuritis and pleural effusion. Diffuse alveolar hemorrhage (DAH) is a rare manifestation of SLE. Most cases of DAH occur in young adults with an underlying autoimmune disease such as systemic vasculitis or Goodpasture syndrome. SLE is typically lower on the list of initial differential diagnoses of DAH due to its rarity compared to other etiologies. We present a case of a patient with dyspnea on exertion, dry coughs, lower extremity edema, and intermittent periorbital edema who ultimately succumbed to respiratory failure secondary to DAH in the setting of SLE. The diagnosis of SLE was suspected clinically and confirmed at autopsy due to her rapid clinical deterioration. DAH requires prompt intervention, and management is guided by the underlying disease process. SLE is a potentially treatable disease; therefore, timely diagnosis is important in order to exclude other noninfectious causes of DAH (reviewed in this report) and to initiate appropriate therapy.


2020 ◽  
Author(s):  
Tianyu Wang ◽  
Haibin Liu ◽  
Caiquan Liang ◽  
Hang Zhang ◽  
Jianchun Liao ◽  
...  

Abstract Background: Retropharyngeal abscesses are rarely reported in adults and occur mostly in patients with immunocompromise or as a foreign body complication. Admittedly, the treatment of retropharyngeal abscesses frequently involves surgical drainage to achieve the best results. However, when retropharyngeal abscesses occurred in a highly suspected patient with COVID-19, the managements and treatments should be caution in order to prevent the spread of the virus. Case presentation: On Feb. 13, a 40-year-old male with retropharyngeal abscesses turned to our department complaining dyspnea and dysphagia. In addition, his chest CT scan shows a suspected COVID-19 infection, thus making out Multiple Disciplinary Team (MDT) determine to perform percutaneous drainage and catheterization through left anterior cervical approach under the guidance of B-ultrasound. Finally, the patient recovered and was discharged from the hospital on Feb. 27 after 14 days of isolation. There was no recurrence after half a year follow-up. Conclusions: By presenting this case, we aim at raising awareness of different surgical drainage methods and summarizing our experience in the management of retropharyngeal abscesses during the outbreak of COVID-19.


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