scholarly journals An Infectious Cause of Esophagobronchial Fistula

2021 ◽  
Vol 3 (3) ◽  
pp. 21-23
Author(s):  
Abdul Basit Ibne Momen ◽  
Rafa Faaria ◽  
Farhana Khan ◽  
Sadia Saber ◽  
Md Tarek Alam

An infected cause of esophagobronchial fistula between left bronchus and esophagus is mentioned who is a 32 year old male with a history of smoking and I/V drug abuse. The scientific reasons for suspecting an esophagogastric-bronchial fistula in an adult are discussed, as well as a description of the different etiologies of this condition. Intra thoracic malignancy, injuries, and infections are the most frequent causes of esophageal-bronchial fistula. These fistulas are caused by the rupturing of caseous peribronchial lymph nodes into adjacent structures such as the esophagus and bronchi. It's difficult to determine what the right course of action is. Such cases are surgically treated, while others can only be treated conservatively. Diagnosing bronchoesophageal fisula is usually challenging and often delayed, since there have not been many cases found. Any patient who presents with cough after deglutition should be suspected of having an esophagobronchial fistula, and tubercular origin should also be considered, particularly in an endemic region, since early diagnosis and treatment with anti-tubercular therapy typically results in resolution.

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Sushan Homagain ◽  
Suraj Shrestha ◽  
Sushil Sah ◽  
Gopal Sedain

Primary Calvarial Tuberculosis, a rare entity of skull is even rarer after second decade of life in a healthy person without evidence of tuberculosis elsewhere in the body. Most of the cases are often misdiagnosed as osteomyelitis/syphilis/bony metastasis. We report a case of primary skull tuberculosis in 26-year-old male with complains of headache and swelling in the right frontal region with no history of previous tuberculosis. The patient was operated and the histopathological examination of excised tissue was suggestive of tubercular pathology. The patient is doing well after anti-tubercular therapy. Being a rare disease, tubercular osteomyelitis of skull bones is often missed and misdiagnosed due to lack of clinical suspicion and slow growth of mycobacterium cultures. Histopathological examination of biopsy material and demonstration of acid-fast bacilli in the pus are helpful for diagnosis and early management of the disease.


PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 303-304
Author(s):  
Donald B. Hawkins ◽  
Emily J. Kahlstrom ◽  
Eithne F. MacLaughlin ◽  
Monique F. Margetis

Foreign bodies in the airway often present problems for physicians who treat children. The following case report illustrates some of these problems. CASE REPORT A 6-year-old boy was admitted to the Pediatric Respiratory Disease Service of the Los Angeles County-University of Southern California Medical Center with a complaint of persistent nonproductive cough since awakening the morning of the previous day. He also had a history of discharge from his right nostril for eight months, at times foul-smelling. During this time, he had seen doctors on three occasions; twice antibiotics had been prescribed for sinus infection. He was in no distress, and demonstrated no respiratory difficulty.


2017 ◽  
Vol 10 (2) ◽  
pp. 553-557 ◽  
Author(s):  
Taichi Ozeki ◽  
Michiko Asano ◽  
Nobukazu Fujimoto ◽  
Jun Nishimura ◽  
Kenji Takada ◽  
...  

A 73-year-old man was referred to our hospital after a 2-week history of bloody sputum and cough. Computed tomography (CT) images of the chest showed a mass grouped with mediastinal lymph nodes, and bronchoscopy showed a projecting mass in the right main bronchus. After a transbronchial biopsy, the patient was diagnosed with squamous cell carcinoma (T4N2M0 stage IIIB). The patient was treated with systemic chemotherapy, consisting of cisplatin (40 mg/m2, days 1 and 8) and docetaxel (30 mg/m2, days 1 and 8), and concurrent thoracic irradiation at a daily dose of 2 Gy. On day 35 of treatment, the patient complained of a sore throat and cough. A CT of the chest showed punctate low-attenuation foci between the esophagus and bronchus. Gastrointestinal endoscopy and bronchoscopy demonstrated a fistula in the middle intrathoracic esophagus and the left main bronchus. The patient’s symptoms gradually improved, and the fistula was closed after the suspension of chemoradiotherapy. Radiotherapy was resumed and completed on day 82. However, on day 108, he developed a fever and cough, and a tumor with fistula was revealed in the right main bronchus. He had an esophageal stent inserted, but he later died of sudden hemoptysis.


Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.


VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.


Commonwealth ◽  
2017 ◽  
Vol 19 (1) ◽  
Author(s):  
John Arway

The challenges of including factual information in public policy and political discussions are many. The difficulties of including scientific facts in these debates can often be frustrating for scientists, politicians and policymakers alike. At times it seems that discussions involve different languages or dialects such that it becomes a challenge to even understand one another’s position. Oftentimes difference of opinion leads to laws and regulations that are tilted to the left or the right. The collaborative balancing to insure public and natural resource interests are protected ends up being accomplished through extensive litigation in the courts. In this article, the author discusses the history of environmental balancing during the past three decades from the perspective of a field biologist who has used the strength of our policies, laws and regulations to fight for the protection of our Commonwealth’s aquatic resources. For the past 7 years, the author has taken over the reins of “the most powerful environmental agency in Pennsylvania” and charted a course using science to properly represent natural resource interests in public policy and political deliberations.


2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.


1996 ◽  
Vol 35 (4I) ◽  
pp. 399-417 ◽  
Author(s):  
John W. Mellor

The right to the flow of income from water is vigorously pursued, protected, and fought over in any arid part of the world. Pakistan is of course no exception. Reform of irrigation institutions necessarily changes the rights to water, whether it be those of farmers, government, or government functionaries. Those perceived rights may be explicit and broadly accepted, or simply takings that are not even considered legitimate. Nevertheless they will be fought over. Pakistan has a long history of proposals for irrigation reform, little or none being implemented, except as isolated pilot projects. Thus, to propose major changes in irrigation institutions must be clearly shown to have major benefits to justify the hard battles that must be fought and the goodwill of those who might win those battles for reform. Proponents of irrigation institution reform have always argued the necessity of the reforms and the large gains to be achieved. Perhaps, however, those arguments have not been convincing. This paper will briefly outline the failed attempts at irrigation reform to provide an element of reality to the discussion. It will then proceed to make the case of the urgency of reform in a somewhat different manner to the past. Finally, current major reform proposals will be presented. This paper approaches justification of irrigation reform by focusing on the agricultural growth rate. It does so because that is the critical variable influencing poverty rates and is a significant determinant of over-all economic growth rates. The paper decomposes growth rates and suggests a residual effect of deterioration of the irrigation system that is large and calls for policy and institutional reform. The data are notional, suggesting the usefulness of the approach and paves the way for more detailed empirical analysis and enquiry for the future.


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