scholarly journals HEMATOGENOUS PULMONARY NODULES

2021 ◽  
Vol 9 (11) ◽  
pp. 40-43
Author(s):  
Kaoutar Imrani ◽  
◽  
Tlaite Oubaddi ◽  
L. Jroundi ◽  
F.Z. Laamrani ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Pulmonary Nodules ◽  
Venous Catheter ◽  
Chest Ct ◽  
Intravenous Drug Use ◽  
Septic Thrombophlebitis ◽  
Central Venous ◽  
History Of ◽  
Septic Pulmonary Embolism ◽  
Made In

Septic pulmonary embolism is an uncommon disorder that is most often seen in patients with predisposing situations (intravenous drug use, endocarditis, septic thrombophlebitis, central venous catheter infections…). The clinical signs are non-specific. CT scan is useful for diagnosis showing bilateral pulmonary nodules with some orienting signs. We report a case of a 43-year-old woman, with a history of hemodialysis via a tunneled jugular catheter, who presented with acute respiratory distress and fever, chest CT showed multiple bilateral nodules, some of which are excavated. Blood cultures showed a staphylococcus aureusbacteremia. The diagnosis of septic emboli was made in view of all the clinical, biological, and radiological elements.

scholarly journals Clinical and chest CT presentations from 27 patients with COVID-19 pneumonia in Mogadishu, Somalia: a descriptive study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Yahye Garad Mohamed ◽  
Mohamed Farah Yusuf Mohamud ◽  
M. Sabri Medişoğlu ◽  
Ihsan Yavuz Atamaca ◽  
Ibrahim Hussein Ali
Keyword(s):  
Sore Throat ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
First Case ◽  
Abnormal Chest ◽  
Lower Lung ◽  
History Of ◽  
Normal Chest ◽  
Bilateral Lung

Abstract Background Coronavirus disease 2019 (COVID-19) is an acute viral pneumonia that had recently been found in humans. The first case was discovered in Wuhan, Hubei province, China, in December 2019. In this article, we aimed to demonstrate the clinical and radiological characteristics of COVID-19 patients in Somalia from 20 March 2020 to 20 April 2020. Results Twenty-seven patients that had a positive RT-PCR test between 20 March 2020 and 20 April 2020 were retrospectively observed. This study included 19 (70.4%) males and 8 (29.6%) females, and the mean age and range were 43 years (SD ± 14.0) and 27–70 years, respectively. The majority (59.3%) of COVID-19-infected patients had no obvious history of exposure to infected patients. The participants of our study mostly presented with dry cough 24 (88.9%) patients, fever 19 (70.4%), myalgia 18 (66.6%), and sore throat 16 (59.3%). Twenty-five of 27 patients had abnormal chest CT, while 2 (7.4%) patients had normal chest CT. The most common patterns of abnormality seen on chest CT in patients with COVID-19 were ground-glass opacity (GGO) 74.1%, crazy paving pattern 18.5%, consolidation 14.8%, and mixed GCO 11.1%. Also, the most common predominant lesion distributions were bilateral lung involvement (88.9%), peripheral distribution (77.8%), and lower lung predominance (63%). Particularly, lung cavitation, discrete pulmonary nodules, pleural effusion, and underlying pulmonary fibrosis or emphysema had not been observed. Conclusion Dry cough, fever, myalgia, and sore throat were the most clinical presentations. GGO, crazy paving pattern, patchy consolidation, and mixed GCO were the typical chest CT manifestations.

scholarly journals Molecular epidemiology of catheter-related bloodstream infections caused by coagulase-negative staphylococci in haematological patients with neutropenia

2004 ◽  
Vol 132 (5) ◽  
pp. 921-925 ◽  
Author(s):  
M. MÜLLER-PREMRU ◽  
P. ČERNELČ
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Peripheral Vein ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Haematological Patients

Catheter-related bloodstream infection (CRBSI) caused by coagulase-negative staphylococci (CNS) is common in haematological patients with febrile neutropenia. As the clinical signs of CRBSI are usually scarce and it is difficult to differentiate from blood culture contamination, we tried to confirm CRBSI by molecular typing of CNS isolated from paired blood cultures (one from a peripheral vein and another from the central venous catheter hub). Blood cultures were positive in 59 (36%) out of 163 patients. CNS were isolated in 24 (40%) patients; in 14 from paired blood cultures (28 isolates) and in 10 from a single blood culture. CNS from paired blood cultures were identified as Staphylococcus epidermidis. Antimicrobial susceptibility was determined and bacteria were typed by pulsed-field gel electrophoresis (PFGE) of bacterial genomic DNA. In 13 patients, the antibiotic susceptibility of isolates was identical. The PFGE patterns from paired blood cultures were identical or closely related in 10 patients, thus confirming the presence of CRBSI. In the remaining four patients they were unrelated, and suggested a mixed infection or contamination. Since CNS isolates from three patients had identical PFGE patterns, they were probably nosocomially spread amongst them.

scholarly journals Home Parenteral Nutrition in Patients with Intestinal Failure: Possible Undetected Complications

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 581 ◽  
Author(s):  
Lidia Santarpia ◽  
Giulio Viceconte ◽  
Maria Foggia ◽  
Lucia Alfonsi ◽  
Grazia Tosone ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Intestinal Failure ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Home Parenteral Nutrition ◽  
Central Venous ◽  
Radiological Features ◽  
Oncological Patients ◽  
Septic Pulmonary Embolism ◽  
Lung Infections

Background: Septic pulmonary embolism (SPE) may be a frequently undetected complication of central venous catheter (CVC)-related bloodstream infections (CRBSIs). Materials and Methods: The incidence of SPE was evaluated in a cohort of non-oncological patients on home parenteral nutrition (HPN) who were hospitalized for a CRBSI from January 2013 to December 2017. The main clinical, microbiological, and radiological features and the therapeutic approach were also described. Results: Twenty-three infections over 51,563 days of HPN therapy were observed, corresponding to an infection rate of 0.45/1000. In 10 out of the 23 cases (43.5%), pulmonary lesions compatible with SPE were identified. Conclusion: Our results demonstrated that a CRBSI can produce asymptomatic SPE with lung infiltrates in 43.5% of the cases, suggesting the need to check for secondary lung infections to choose the most appropriate antimicrobial therapy.

scholarly journals FDG embolism mimicking lung metastasis

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Amin Haghighat Jahromi ◽  
◽  
Carl K Hoh ◽  
Keyword(s):  
Central Venous Catheter ◽  
Lung Metastasis ◽  
Intravenous Administration ◽  
Patient Management ◽  
Venous Catheter ◽  
Central Venous ◽  
History Of ◽  
Platelet Aggregates ◽  
18F Fdg ◽  
Repeat Imaging

2-[18F]-FDG embolism artifact is a PET pitfall that may cause misinterpretation as lung metastasis. This rare phenomenon results from clumping of the radiotracer with platelet aggregates during intravenous administration. It should be considered, especially if there is no corroborating anatomic correlate for focal pulmonary FDG activity and if the radiotracer is administered through a central venous catheter. Herein, we present images of a 3-year-old girl with history of abdominal neuroblastoma and lung metastasis, showing FDG embolism artifact, subsequently resolved in the repeat imaging. Our case reinforces the importance of knowing this artifact as misinterpretation can have a significant effect on patient management.

Brachial Arteriovenous Fistula as a Complication of Placement of a Peripherally Inserted Central Venous Catheter: A Case Report and Review of the Literature

2006 ◽  
Vol 72 (9) ◽  
pp. 833-836 ◽  
Author(s):  
Hoang S. Tran ◽  
Brian J. Burrows ◽  
William A. Zang ◽  
David C. Han
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Duplex Ultrasound ◽  
Venous Catheter ◽  
Central Venous ◽  
Arterial Tree ◽  
Line Placement ◽  
Term Administration ◽  
History Of ◽  
Picc Line

Peripherally inserted central venous catheter (PICC) lines have become a frequently used method of intravenous access for long-term administration of antibiotics, chemotherapy, and parenteral nutrition. Catheter-related complications involving the arterial tree are rare. We report a case of a 25-year-old woman with a history of difficult PICC line placement that presented with an arteriovenous fistula in the left arm. Duplex ultrasound confirmed the diagnosis of a brachial artery-to-brachial vein arteriovenous fistula (AVF), and the patient underwent surgical repair. To our knowledge, this is the first reported case of an AVF resulting from PICC line placement. Correction of AVF is indicated to alleviate symptoms as well as to prevent future complications.

Induction of Malignant Hyperthermia in Susceptible Swine by 3,4-Methylenedioxymethamphetamine (“Ecstasy”)

2003 ◽  
Vol 99 (5) ◽  
pp. 1132-1136 ◽  
Author(s):  
Marko Fiege ◽  
Frank Wappler ◽  
Ralf Weisshorn ◽  
Mark U. Gerbershagen ◽  
Melanie Menge ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Malignant Hyperthermia ◽  
Clinical Signs ◽  
Body Core Temperature ◽  
Muscle Rigidity ◽  
Central Venous ◽  
Dantrolene Sodium ◽  
Venous Pco2 ◽  
History Of ◽  
Body Core

Background 3,4-Methylenedioxymethamphetamine (MDMA, "ecstasy") can mediate acute toxic effects such as muscle rigidity, metabolic acidosis, and hyperthermia. Because of close clinical similarities, an association between MDMA intoxication and malignant hyperthermia (MH) was suggested. The aim of this study was to investigate whether MDMA is a trigger of MH in susceptible swine. Methods MH-nontriggering general anesthesia was performed in six MH-susceptible (MHS) and six MH-normal swine. The animals were exposed to MDMA in cumulative doses of 0.5, 1, 2, 4, 8, and 12 mg/kg. The clinical occurrence of MH was defined by achievement of two of three conditions: central venous Pco2 >/=75 mmHg, central venous pH </= 7.20, and increase of body core temperature >/= 2.0 degrees C. Once MH occurred, a standardized therapy with dantrolene, sodium bicarbonate, and hyperventilation with 100% oxygen was initialized. Results Administration of 8 mg/kg MDMA triggered MH in all MHS swine. The MH-normal swine also developed clinical signs of hypermetabolism, but even after administration of 12 mg/kg MDMA, changes were moderate compared with the MHS swine. Dantrolene therapy of MDMA-induced MH crisis in the MHS swine partially counteracted the clinical signs of MH immediately. Conclusions MDMA induces MH in genetically susceptible swine in relevant doses. Therefore, MHS patients should avoid use of MDMA or related drugs. Patients with a personal or family history of MDMA-induced hyperthermia should be tested for a diagnosis of MH susceptibility. Dantrolene is effective in therapy of MDMA-induced porcine MH.

scholarly journals The natural history of asymptomatic central venous catheter–related thrombosis in critically ill children

Blood ◽  
2019 ◽  
Vol 133 (8) ◽  
pp. 857-866 ◽  
Author(s):  
Sophie Jones ◽  
Warwick Butt ◽  
Paul Monagle ◽  
Timothy Cain ◽  
Fiona Newall
Keyword(s):  
Natural History ◽  
Central Venous Catheter ◽  
Critically Ill ◽  
Venous Catheter ◽  
Critically Ill Children ◽  
Postthrombotic Syndrome ◽  
Central Venous ◽  
History Of ◽  
Clinically Significant

Abstract Asymptomatic central venous catheter (CVC)–related thrombosis in children varies in incidence from 5% to 69%. The rate of acute and long-term complications, such as postthrombotic syndrome (PTS), from asymptomatic CVC-related thrombosis is unknown. This article reports the outcomes of a prospective study of 189 children in pediatric intensive care that aimed to determine the frequency of asymptomatic CVC-related thrombosis during hospital admission, and the incidence of residual CVC-related thrombosis and clinically significant PTS 2 years later. Risk factors associated with CVC-related thrombosis were also identified. This study is distinct from previous work as children identified to have asymptomatic CVC-related thrombosis were not treated (clinical team kept blinded) and the entire cohort was followed for 2 years to determine the natural history of asymptomatic thrombosis. Ultrasounds of 146 children determined a 21.9% incidence of acute CVC-related thrombosis. Two children were symptomatic. No radiological thrombosis extension or clinical embolization occurred in the 126 children assessed at follow-up. Using 2 recognized PTS scales, clinically significant PTS was reported in 2 children (1 symptomatic, 1 asymptomatic CVC-related thrombosis), however, neither had functional impairment. Cardiac arrest was a risk factor for CVC-related thrombosis during admission and femoral CVC placement was predictive of residual thrombosis 2 years later. This study challenges the notion that critically ill children with asymptomatic CVC-related thrombosis require anticoagulant treatment, as the results demonstrate that the incidence of acute or long-term complications is low. A larger confirmatory study of nontreatment of CVC-related thrombosis in critically ill children is justified.

scholarly journals Bloodstream infection due to Enterobacter ludwigii, correlating with massive aggregation on the surface of a central venous catheter

Infection ◽  
2020 ◽  
Vol 48 (6) ◽  
pp. 955-958
Author(s):  
Lysett Wagner ◽  
Frank Bloos ◽  
Slavena Vylkova
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Infectious Agent ◽  
Venous Catheter ◽  
Enterobacter Cloacae ◽  
Molecular Testing ◽  
Blood Components ◽  
Central Venous ◽  
History Of ◽  
Enterobacter Ludwigii

AbstractWe report a case of catheter associated bloodstream infection due to Enterobacter ludwigii with a massive aggregation on the outside surface of a central venous catheter (CVC). The 57 years old patient with a history of spondylodiscitis and Staphylococcus aureus-associated endocarditis was admitted to the intensive care unit for acute cerebral infarction. The patient developed signs of infections and the CVC was removed 11 days after placement. The infectious agent was identified by standard diagnostics to the genus level as belonging to the Enterobacter cloacae complex, and additional molecular testing determined the species as E. ludwigii. The catheter was selected for a study aiming to identify the influence of blood components on the formation of central venous catheter-associated biofilms. In this course a massive biofilm was recognized and is presented here.

scholarly journals Epidemiology of fungal infections and risk factors in newborn patients

2013 ◽  
Vol 4 (1S) ◽  
pp. 5-17
Author(s):  
Paolo Manzoni
Keyword(s):  
Laboratory Tests ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Venous Catheter ◽  
Extremely Low Birth Weight ◽  
Diagnostic Process ◽  
Fungal Colonization ◽  
Specific Risk ◽  
Rule Out ◽  
Made In

The incidence of fungal infections among newborn babies is increasing, owing mainly to the in­creased ability to care and make survive immature infants at higher specific risk for fungal infections. The risk is higher in infants with very low and extremely low birth weight, in babies receiving total parenteral nutrition, in neonates with limited barrier effect in the gut, or with central venous catheter or other devices where fungal biofilms can originate. Also neonates receiving broad spectrum antibiotics, born through caesarian section or non-breastfed can feature an increased, specific risk. Most fungal infections in neonatology occur in premature children, are of nosocomial origin, and are due to Candida species. Colonization is a preliminary step, and some factors must be considered for the diagnosis and grading process: the iso­lation site, the number of colonized sites, the intensity of colonization, and the Candida subspecies. The most complicated patients are at greater risk of fungal infections, and prophylaxis or pre-emptive therapy should often be considered. A consistent decisional tree in neonatology is yet to be defined, but some efforts have been made in order to identify characteristics that should guide the prophylaxis or treatment choices. A negative blood culture and the absence of symptoms aren’t enough to rule out the diagnosis of fungal infections in newborn babies. Similarly, laboratory tests have been validated only for adults. The clinical judgement is of utmost importance in the diagnostic process, and should take into account the presence of clinical signs of infection, of a severe clinical deterioration, as well as changes in some laboratory tests, and also the presence and characteristics of a pre-existing fungal colonization.

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