scholarly journals Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis

2017 ◽  
Vol 56 (206) ◽  
Author(s):  
Deepshikha Gaire ◽  
Santosh Sharma ◽  
Kumar Poudel ◽  
Pankaj Pant
Keyword(s):  
Differential Diagnosis ◽  
Chest Pain ◽  
Pleural Effusion ◽  
Clinical Manifestations ◽  
Shortness Of Breath ◽  
X Ray ◽  
Fluid Analysis ◽  
Pain Abdomen ◽  
History Of ◽  
Specific Symptoms

Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. 48 yrs, female presented at TUTH emergency with fever on and off for 9 months, cough and shortness of breath for 3 months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia.  [PubMed]

Mesalamine-induced eosinophilic pleural effusion

2020 ◽  
Vol 13 (4) ◽  
pp. e233886 ◽  
Author(s):  
Abdullah Al-abcha ◽  
Fazal Raziq ◽  
Shouq Kherallah ◽  
Ahmad Alratroot
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Symptomatic Improvement ◽  
X Ray ◽  
Fluid Analysis ◽  
Ct Angiogram ◽  
History Of ◽  
Chest X Ray ◽  
Eosinophilic Pleural Effusion

A 45-year-old woman with a medical history of ulcerative colitis (UC) presented with difficulty in breathing. The patient was diagnosed with UC a month prior to presentation and was started on mesalamine suppository. Chest x-ray (CXR) on presentation showed bilateral pleural effusion, which was confirmed on CT angiogram of the chest. Diagnostic and therapeutic thoracentesis was performed and 0.7 L of pleural fluid was removed from the left side. The pleural fluid analysis was consistent with exudative pleural effusion with eosinophilia. Symptomatic improvement was noted after thoracentesis. Mesalamine was stopped and repeat CXR was obtained on the follow-up visit, which showed no pleural effusion. The Naranjo score was calculated to be 7, indicating that the eosinophilic pleural effusion was most probably secondary to adverse reaction from mesalamine.

scholarly journals Study of etiology of pleural effusion in Telangana population

2019 ◽  
Vol 6 (6) ◽  
pp. 1798
Author(s):  
Mohd Ifthekhar Mohiuddin ◽  
Parth N. Patel
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Clinical Manifestations ◽  
Pragmatic Approach ◽  
Gold Standard Method ◽  
X Ray ◽  
Fluid Analysis ◽  
Chest X Ray ◽  
Pedal Edema

Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology. Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals Differential Diagnosis between the Varieties of Vasculitis Forms

2018 ◽  
Vol 6 (2) ◽  
pp. 1-8
Author(s):  
Joana Hankollari ◽  
Marsida Duli ◽  
Qamil Dika ◽  
Xhenila Duli ◽  
Indrit Bimi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Blood Vessel ◽  
Specific Form ◽  
The Body ◽  
Imaging Studies ◽  
Patient Assessment ◽  
Diagnostic Difficulties ◽  
History Of ◽  
Specific Symptoms

Vasculitis is an inflammation of the blood vessels. It can affect any blood vessel in the body by manifesting a variety of systemic, non-specific symptoms that make difficult the diagnosis of this pathology and especially its specific form. In front of any patient suspected of being affected by vasculitis, some questions are asked: Is the vasculitis or other pathology that camouflages, whether it is primary or secondary vasculitis, in which vessels this pathology extends, how can the diagnosis be confirmed and how can it be determined the type of vasculitis?The purpose of this study is to inform about the protocols to be followed to perform differential diagnosis of vasculitis types.This study is a review based on the research of world studies and literature regarding the recommendations for performing differential diagnosis among the variety of vasculitis forms.Primary patient assessment involves taking the history of the medications it uses, risk factors for infectious pathology, history of cardiac valve pathologies, and autoimmune pathologies. Then laboratory and imaging studies are carried out, aiming at setting the diagnosis, determining the affected organ and the degree of disease activity. And recently we refer to algorithms to make differential diagnosis between the varieties of vasculitis forms.Despite the diagnostic difficulties of vasculitis, the variety of its forms, the separation of responsibilities among many specialities, there are protocols that need to be followed rigorously to arrive at a safe diagnosis as well as auxiliary algorithms to distinguish the type of vasculitis.

scholarly journals A case report: spontaneous postpartum rupture of unscarred uterus

2018 ◽  
Vol 7 (8) ◽  
pp. 3420
Author(s):  
Swati Singh ◽  
Ravinder Ahlawat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Emergency Laparotomy ◽  
Full Thickness ◽  
Uterine Incision ◽  
History Of ◽  
Rupture Of Uterus ◽  
Specific Symptoms

Rupture of uterus is characterized by a breach in the wall of the uterus involving its full thickness. An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to site and time of rupture. Authors report an unusual case of spontaneous rupture of unscarred uterus. A 32-year-old, pregnant woman, developed postpartum bleeding with no history of prior uterine incision. She was diagnosed as a case of rupture of uterus and emergency laparotomy was done. Early diagnosis and immediate surgical intervention may significantly improve the prognosis. Differential diagnosis of uterine rupture should always be kept in mind in all patients with or without risk factors.

Development of new cold antibodies in a patient with a history of warm autoimmune haemolytic anaemia

2020 ◽  
Vol 13 (6) ◽  
pp. e232224 ◽  
Author(s):  
Meghan Anderson ◽  
Megan Winter ◽  
Vinicius Jorge ◽  
Claudia Dourado
Keyword(s):  
Chest Pain ◽  
Haemolytic Anaemia ◽  
Acute Treatment ◽  
Autoimmune Disorder ◽  
Shortness Of Breath ◽  
History Of ◽  
Mixed Pattern ◽  
Lost To Follow Up ◽  
Record Review

A 31-year-old male presented to our facility with complaints of shortness of breath and left-sided chest pain. On record review, it was revealed that he had been seen in 2014 for an almost identical presentation and had been found to have haemolytic anaemia with warm autoantibodies. Following his acute treatment during that hospital admission, he was lost to follow-up. During his subsequent admission, 5 years later, he was found to have a systemic autoimmune disorder with a superimposed acute bacterial infection leading to a second case of haemolytic anaemia and at this time with both cold and warm antibodies present. While his diagnosis was initially difficult to make due to both derangements in expected laboratory values and the mixed pattern of the haemolytic anaemia, he was promptly treated with intravenous immune globulin and steroids and was able to make a full recovery.

scholarly journals Just the Facts: Protected code blue – Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic

CJEM ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 431-434 ◽  
Author(s):  
Sarah McIsaac ◽  
Randy S. Wax ◽  
Brit Long ◽  
Christopher Hicks ◽  
Christian Vaillancourt ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Negative Pressure ◽  
Shortness Of Breath ◽  
Code Blue ◽  
Palpable Pulse ◽  
History Of

Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?

scholarly journals Idiopathic Chylopericardium in a Young Adult: Diagnosis and Management

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
João Pedro E. Sant’Ana ◽  
Amanda O. Vicente ◽  
Amanda S. Pereira ◽  
Pedro V. Bertozzi ◽  
Rodrigo A. S. Sardenberg
Keyword(s):  
Chest Pain ◽  
Pleural Effusion ◽  
Chest Ct ◽  
Pericardial Window ◽  
X Ray ◽  
Large Pericardial Effusion ◽  
Chest X Ray ◽  
Cardiac Silhouette ◽  
The Right ◽  
Precipitating Factor

Primary idiopathic chylopericardium (PIC) is an uncommon cardiologic disorder; it is defined as accumulation of lymph in the pericardial sac without any know precipitating factor. A 25-year-old presented with dyspnea and chest pain for over two months. The patient underwent a chest X-ray, which revealed an enlargement of cardiac silhouette and signs of cardiac tamponade. Chest CT was performed, revealing large pericardial effusion and small pleural effusion on the right hemithorax. The patient was referred to the ICU and underwent a pericardial window through VATS, which revealed 500 ml of a milky fluid.

scholarly journals Challenge in challenging times: a case report of ruptured isthmic ectopic pregnancy in an asymptomatic COVID-19 positive patient

2021 ◽  
Vol 10 (10) ◽  
pp. 3976
Author(s):  
Ankita Gahlot ◽  
Atri Raval ◽  
Bindoo Yadav ◽  
Swarnima Saxena
Keyword(s):  
Emergency Management ◽  
Ectopic Pregnancy ◽  
Positive Patient ◽  
Shortness Of Breath ◽  
Pain Abdomen ◽  
Obstetric Emergencies ◽  
History Of ◽  
Scarcity Of Resources ◽  
Optimal Medical Care ◽  
High Infectivity

Emergency surgical management of patients who are COVID-19 positive is extremely challenging for the treating doctors as there is a need to keep the balance between delivering optimal medical care to the patient, preventing spread to others and protecting ourselves. COVID-19 manifestations in pregnant women are similar to non-pregnant patients. The patient may be asymptomatic or may present with symptoms like cough, cold, fever and shortness of breath. In obstetric emergencies like ruptured ectopic pregnancy, when a patient presents in casualty with history of amenorrhea, pain abdomen and features of shock, main priority for the clinician is to stabilize them and treat the underlying cause so as to save their life. We report the emergency management of a hemodynamically unstable ruptured ectopic pregnancy at 9 weeks of gestation in a COVID-19 positive patient. It was stressful for the treating doctors because of high infectivity of the disease, scarcity of resources during the pandemic and precarious condition of the patient.

scholarly journals Umbilical Venous Catheterization in a Neonate Causing Pleural Effusion

2021 ◽  
Vol 36 (2) ◽  
pp. e242-e242
Author(s):  
Suresh Kotinatot ◽  
Devendra Jadhav ◽  
Ahmed Elajab ◽  
Munira Al Maazmi
Keyword(s):  
Pleural Effusion ◽  
Parenteral Nutrition ◽  
Respiratory Distress ◽  
Total Parenteral Nutrition ◽  
Rare Case ◽  
Rare Complication ◽  
Venous Catheter ◽  
X Ray ◽  
Fluid Analysis ◽  
Venous Catheterization

Pleural effusion is an extremely rare complication in neonates after umbilical venous catheterization that can present with respiratory distress, a neonatal emergency. It needs timely intervention to reduce respiratory distress. We report an interesting and rare case where a term newborn developed right-sided pleural effusion after umbilical venous catheter (UVC) insertion and starting on total parenteral nutrition (TPN). Pleural effusion was confirmed by X-ray and ultrasound and treated with intercostal drainage. The aspirated fluid was TPN, as evidenced by pleural fluid analysis. Pleural effusion resolved after removing the UVC.

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