Massive Pleural Effusion as a Rare Manifestation in Severe Neonatal Sepsis

BACKGROUND: Neonatal sepsis can be severe and has mortality rate. The pleural effusion is a rare sign of severe sepsis in newborn and only few studies that reported it. CASE PRESENTATION: We report a case of newborn who referred to our hospital because of dependent mechanical ventilator and severe sepsis. We found a massive pleural effusion and did the pleural drainage. After the drainage, the baby was extubate and discharge well with no signs of respiratory distress. CONCLUSION: Massive pleural effusion might be considered as a cause of dependent ventilator in severe neonatal sepsis.

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Unilateral Agenesis of Lung, Kidney with Cardiac and Vertebral Defects a Rare Association

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i1.8898 ◽

2014 ◽

Vol 34 (1) ◽

pp. 77-79

Author(s):

B Maji ◽

N Ganguly ◽

A Ghosh

Keyword(s):

Pleural Effusion ◽

Respiratory Distress ◽

Ct Scan ◽

Final Diagnosis ◽

Fibre Optic ◽

Rare Association ◽

Massive Pleural Effusion ◽

Lung Agenesis ◽

Vertebral Defects

Unilateral lung agenesis initially misdiagnosed as unilateral massive pleural effusion with collapse of lung, and after several investigations, including ultrasonography or CT scan of thorax, fibre-optic bronchoscopy or bronchography, a final diagnosis of unilateral absence of lung is made. An anomaly scan may also reveal associated renal, cardiac and vertebral defects. Here we report a 7 months old female who presented with respiratory distress since birth and after a thorough investigation, she was found to have this rare association of pulmonary-renal-cardiacvertebral defect. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8898 J Nepal Paediatr Soc 2014;34(1):77-79

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Effect of Human Plasma-Derived Protein C and Murine Recombinant Protein C on Severe Neonatal Sepsis in Mice.

Blood ◽

10.1182/blood.v104.11.689.689 ◽

2004 ◽

Vol 104 (11) ◽

pp. 689-689

Author(s):

Eva-Maria Muchitsch ◽

Hans Peter Schwarz ◽

Katalin Varadi ◽

Charles Esmon ◽

Giuseppe Mancuso ◽

...

Keyword(s):

Severe Sepsis ◽

Mortality Rate ◽

Human Plasma ◽

Neonatal Sepsis ◽

Protein C ◽

Activated Protein C ◽

Risk Of Death ◽

Neonatal Mice ◽

Endogenous Protein ◽

Septic Condition

Abstract Neonatal sepsis is a leading cause of infant morbidity and mortality frequently associated with activation of the coagulation system. Reduced levels of protein C are found in the majority of patients with sepsis and are associated with an increased risk of death. Although activated protein C is indicated for the treatment of severe sepsis in adults, the risk of severe bleeding may limit its use in neonates. Because the likelihood of inducing bleeding with the zymogen form of protein C is reduced we assessed both human and murine protein C zymogen in a murine neonatal sepsis model. In this model neonatal mice were challenged with viable group B streptococci (GBS). The effect of this septic condition on endogenous protein C levels was evaluated and the effect of treatment with either recombinant murine protein C or human plasma-derived (non-activated) protein C (Ceprotin) investigated. During severe GBS sepsis murine endogenous protein C levels decreased over time in neonatal mice, resulting in a maximum decrease of −30 % at 16 hours after GBS challenge and returned towards baseline at 30 hours. Concomitantly, there was an increase in endogenous protein C activation up to 59 % at 6 hours after GBS challenge, returning to baseline levels at 16 hours. Blocking endogenous murine protein C with an anti-mouse monoclonal antibody increased the mortality rate significantly from 62 to 91 %. Treatment of neonatal septic mice (n=36) with 300 U/kg murine protein C subcutaneously 4 hours before GBS challenge decreased the mortality rate significantly in severe sepsis (LD90) to 64 % (p=0.002). Similarly pretreatment with human plasma-derived protein C (200 IU/kg) 4 hours before GBS challenge increased survival rate significantly in severe septic mice. Treatment with 200 IU/kg (Ceprotin) was even effective given 18 hours after GBS challenge, leading to a decrease in the mortality rate in severe sepsis from 87.5 to 48 %. Despite this species difference and the septic condition, human protein C zymogen was activated to activated protein C and detectable in the circulation of mice. This is the first preclinical study were a beneficial effect of a non-activated protein C could be shown in an animal model of severe neonatal sepsis.

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Re-expansion Pulmonary Edema after Drainage of Pleural Effusion in a Pediatric Patient with a Large Anterior Mediastinal Mass

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc/01/01/00001 ◽

2016 ◽

Vol 1 (1) ◽

Keyword(s):

Pleural Effusion ◽

Natural History ◽

Respiratory Distress ◽

Pulmonary Edema ◽

Clinical Case ◽

Mediastinal Mass ◽

Operative Management ◽

Anterior Mediastinal Mass ◽

Newly Diagnosed ◽

Case Presentation

Clinical case presentation of a 13 year old male with a newly diagnosed anterior mediastinal mass who developed rapid respiratory distress after drainage of a pleural effusion. We include a discussion of the incidence, natural history, and peri-operative management of children with re-expansion pulmonary edema.

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Actinomycosis presenting as an isolated pleural effusion in a patient with an HIV infection: a case report and literature review

AIDS Research and Therapy ◽

10.1186/s12981-021-00412-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jung Wan Park ◽

Yon Hee Kim ◽

Eunjung Lee ◽

Se Yoon Park ◽

Tae Hyong Kim

Keyword(s):

Pleural Effusion ◽

Hiv Infection ◽

Opportunistic Infections ◽

Pleural Biopsy ◽

Case Presentation ◽

Thoracic Actinomycosis ◽

Massive Pleural Effusion ◽

Progressive Dyspnea ◽

Diagnostic Approaches ◽

The Right

Abstract Background Thoracic actinomycosis is an uncommon, chronic, and progressive infection, especially in patients with HIV. We report a case of thoracic actinomycosis presenting as an isolated pleural effusion in a patient with an HIV infection. Case presentation A 68-year-old patient with progressive dyspnea and fever was admitted. On the right side, an ipsilateral massive pleural effusion was confirmed on the chest radiograph, and an HIV infection was newly diagnosed. A pleural biopsy was performed for the further differential diagnosis of potential opportunistic infections and malignancies. The pathology findings were consistent with actinomycosis. Conclusions Active diagnostic approaches such as a pleural biopsy should be considered for indeterminate pleural effusions in immunocompromised patients.

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Faculty Opinions recommendation of A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727274417.793538975 ◽

2017 ◽

Author(s):

Ary Serpa Neto

Keyword(s):

Emergency Department ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Protective Ventilation ◽

Lung Protective Ventilation ◽

Mechanical Ventilator ◽

Quasi Experimental ◽

The Impact

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Bowel necrosis in patient with severe case of COVID-19: a case report

BMC Surgery ◽

10.1186/s12893-021-01104-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel Ardian Soeselo ◽

Wirawan Hambali ◽

Sandy Theresia

Keyword(s):

Case Report ◽

Mortality Rate ◽

Critically Ill ◽

High Mortality ◽

Severe Case ◽

Bowel Necrosis ◽

Case Presentation ◽

Gastrointestinal Manifestations ◽

Emergent Laparotomy

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.

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Simultaneous enterovirus EV-D68 and CVA6 infections causing acute respiratory distress syndrome and hand, foot and mouth disease

Virology Journal ◽

10.1186/s12985-021-01560-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Ivanildo Pedro de Sousa ◽

Heloísa Ihle Giamberardino ◽

Sonia Mara Raboni ◽

Maria Carmo Debur ◽

Maria de Lourdes Aguiar Oliveira ◽

...

Keyword(s):

Respiratory Distress ◽

Clinical Symptoms ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Rt Pcr ◽

Double Infection ◽

Chinese Strain ◽

Case Presentation ◽

Foot And Mouth ◽

Shed Light

Abstract Background Although most enterovirus (EV) infections can be asymptomatic, these viral agents can cause serious conditions associated with central nervous system, respiratory disease and uncommon manifestations of hand, foot and mouth disease (HFMD). EV-coinfections have been rarely reported with development of complications and severe clinical outcome. An atypical case of a child presenting HFMD and severe acute respiratory syndrome, co-infected with EV-D68 and CVA6, is reported herein. Case presentation A 3-year-old boy was admitted in the emergency department unit showing fever, abdominal pain and tachycardia. Twenty-four hours after hospitalization the child developed severe clinical symptoms associated with HFMD and was discharged after recovery. Two days later, the child was readmitted with fever, cough and respiratory distress. RT-PCR and Sanger sequencing confirmed positivity for EV-D68 and CVA6 in oro and nasopharynges swabs and vesicles fluid, respectively. Phylogenetic analysis based on VP1 gene sequences suggested that CVA6 was closely related with HFMD viruses circulating in Turkey, while EV-D68 was genetically related to a Chinese strain. Conclusions To the best of our knowledge, this case is the first report of a double infection caused by CVA6 and EV-D68, which shed light on the pathogenesis of enterovirus infections. Further studies must be conducted to ascertain the role and clinical significance of EV co-infections, as well as a potential synergistic pathway between these viruses.

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