scholarly journals Pulmonary Koch in 4 Months Old: Congenital or Acquired?

2021 ◽  
Vol 11 (5) ◽  
pp. 206-209
Author(s):  
Priyasha Tripathi ◽  
Surendra Singh Raghuwanshi
Keyword(s):  
Respiratory Distress ◽  
Failure To Thrive ◽  
Female Child ◽  
Low Grade ◽  
Gastric Aspirate ◽  
Severe Respiratory Distress ◽  
Antitubercular Treatment ◽  
Open Case ◽  
Chest X Ray ◽  
Csf Examination

4 months old female child presented to us with complaints of fever, cough, cold, and poor weight gain. On examination the child had failure to thrive (weight 2.75kg, length 52cms, head circumference 35cms, weight for length <-3SD), cachexic look, severe respiratory distress (bilateral chest retractions and nasal flaring), hepatosplenomegaly, delayed milestones with low birth weight (2.07kg), continuous low grade fever. Mother was an open case of pulmonary Koch, taking antitubercular treatment since 6 months. Investigations revealed anemia, neutrophilia with reactive CRP, raised transaminases, pulmonary fibrosis and cavitary lesions in chest x-ray with normal CSF examination. Mantoux was reactive with gastric aspirate and cerebrospinal fluid negative for TB bacilli in GeneXpert. So the question arises, is it congenital or acquired? Key words: congenital TB, hepatosplenomegaly, respiratory distress, failure to thrive.

scholarly journals Duplication cyst of the esophagus: A rare congenital cause for vomiting and respiratory distress

2020 ◽  
Vol 6 (1) ◽  
pp. 13
Author(s):  
Saeed Al Hindi ◽  
Khaled Nazzal ◽  
Husain Al Aradi ◽  
Mohamed Mubarak
Keyword(s):  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neuromuscular Disorders ◽  
Failure To Thrive ◽  
Duplication Cyst ◽  
X Ray ◽  
Chest X Ray ◽  
Female Baby ◽  
Cystic Masses ◽  
Foreign Body Inhalation

A duplication cyst of the esophagus is the 2ndmost common congenital anomaly of the gastrointestinal tract. Although these benign cystic masses can be picked up routinely on a chest X-ray, patients may experience symptoms such as stridor or dysphagia corresponding to lesions within the neck or mediastinum. We present a rare case of a duplication cyst of esophagus in a 2-week-old female baby, which was surgically excised. Our aim in this case report is to raise awareness of this congenital disorder; especially when differential diagnoses such as acute respiratory distress syndrome (ARDS), failure to thrive, asthma, pneumonia, neuromuscular disorders and suspected foreign body inhalation have been ruled out in the pediatric patient.

Acute Pulmonary Edema after Polyethylene Glycol Intestinal Lavage in a Child

1993 ◽  
Vol 27 (9) ◽  
pp. 1044-1047 ◽  
Author(s):  
Christopher M. Paap ◽  
Robert Ehrlich
Keyword(s):  
Polyethylene Glycol ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Ventilatory Support ◽  
Gastrointestinal Symptoms ◽  
Acute Pulmonary Edema ◽  
Severe Respiratory Distress ◽  
X Ray ◽  
Chest X Ray ◽  
Outpatient Settings

OBJECTIVE: To report the case of an eight-year-old girl, without preexisting cardiac or renal disease, who developed acute pulmonary edema and severe respiratory distress after balanced electrolyte with polyethylene glycol (BE-PEG) intestinal lavage. CASE SUMMARY: During the nasogastric infusion of a one-liter dose of BE-PEG (OCL, Abbott), the patient experienced abdominal discomfort, gagging, vomiting, and coughing. After the nasogastric infusion, the patient again had emesis, developed tachypnea, intercostal retractions, and acute respiratory distress. She received oxygen and subsequently required intubation and ventilatory support. Physical examination revealed pulmonary congestion bilaterally but no signs of cardiac failure or sepsis. Chest X-ray revealed bilateral pulmonary edema. Ventilatory support was continued for 36 hours and the patient was extubated after two days. DISCUSSION: Enteral BE-PEG may have caused acute pulmonary edema secondary to aspiration or systemic fluid overload. Although the exact cause remains unknown, the close temporal onset of pulmonary edema after BE-PEG administration in an otherwise healthy child suggests a causal relationship. CONCLUSIONS: This case should alert clinicians to the potential for significant morbidity with BE-PEG solutions, particularly if used in outpatient settings. Patients who receive BE-PEG should be closely observed and monitored for potential aspiration, excessive infusion rates, and gastrointestinal symptoms to optimize efficacy and reduce morbidity.

scholarly journals Atypical presentation of congenital diaphragmatic hernia: case report

2019 ◽  
Vol 6 (5) ◽  
pp. 2228
Author(s):  
Sunita Arora ◽  
Gurpreet Kaur
Keyword(s):  
Respiratory Distress ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Period ◽  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Female Child ◽  
Severe Respiratory Distress ◽  
Radiographic Findings ◽  
Initial Symptoms

The Congenital diaphragmatic hernia generally presents with severe respiratory distress in the neonatal period and usually occurs once in every 2,000-3500 births. Late-presenting congenital diaphragmatic hernia (CDH) has been defined as CDH diagnosed after the neonatal period due to initial symptoms after the neonatal period or asymptomatic CDH found in the course of routine X-ray examination of the chest beyond the neonatal period. When late presentations occur, patients may be asymptomatic or may be critically ill with unusual respiratory and gastrointestinal symptoms. Case characteristics: 3yrs old female child presented with history of pain abdomen, abdominal distension, vomiting, respiratory distress and fever since 5days. Chest tube was inserted in view of left sided pleural effusion. Later on, diagnosed with diaphragmatic hernia. Outcome Child was operated, and diaphragmatic repair done and was discharged successfully after 38 days. Message: Congenital diaphragmatic hernia should be considered in the differential diagnosis of any child with unusual respiratory or gastrointestinal symptoms and abnormal chest radiographic findings.

scholarly journals Flexible Bronchoscopy in the Management of Congenital Lobar Emphysema in the Neonate

1998 ◽  
Vol 5 (3) ◽  
pp. 219-221 ◽  
Author(s):  
EZ Phillipos ◽  
K Libsekal
Keyword(s):  
Respiratory Distress ◽  
Flexible Bronchoscopy ◽  
Left Hemithorax ◽  
Severe Respiratory Distress ◽  
Emergency Relief ◽  
Congenital Lobar Emphysema ◽  
X Ray ◽  
Chest X Ray ◽  
Fraction Of Inspired Oxygen ◽  
Lobar Emphysema

This paper describes the case of a 3 kg neonate who had congenital lobar emphysema of the left upper lobe (LUL). He was in severe respiratory distress with a fraction of inspired oxygen of 0.8. Chest x-ray showed hyperlucent expanded left hemithorax and marked mediastinal shift. Following flexible bronchoscopy and introduction of ultrathin bronchoscope into the LUL bronchus, symptoms and chest x-ray improved markedly. Flexible bronchoscopy resulted in emergency relief of his initial respiratory distress, and left upper lobe lobectomy was performed electively three days later.

scholarly journals A rare cause of pediatric respiratory distress: pulmonary embolism

2020 ◽  
Vol 7 (4) ◽  
pp. 952
Author(s):  
Vinayaka H. S. ◽  
Dhananjaya Sarji Rudrappa ◽  
Shivashankara T. H.
Keyword(s):  
Pulmonary Embolism ◽  
Respiratory Distress ◽  
Pediatric Population ◽  
Rare Condition ◽  
Female Child ◽  
Sudden Onset ◽  
Acute Onset ◽  
Heparin Infusion ◽  
Chest X Ray ◽  
High Index Of Suspicion

Pediatric Pulmonary Embolism (PE) is a very rare condition as compared to adults. However, the incidence of pulmonary embolism in children is increasing as a result of accurate and timely diagnosis. Authors hereby reporting a 7-year-old female child who presented to us with acute onset respiratory distress and hypotensive shock, with no other significant illness in the past. The diagnosis of pulmonary embolism was made based on chest x ray, electrocardiogram and echocardiography. After ascertaining the diagnosis of PE, child was started on unfractionated heparin infusion along with other supportive measures. But the child went into refractory shock followed by asystole, could not be revived. Pulmonary embolism is a rare and potentially fatal, condition that often goes unrecognized among the pediatric population. There should be high index of suspicion on PE in a child who presented with sudden onset respiratory distress with other supportive radiological, 2d echo and lab findings.

scholarly journals Severe disease due to CCDC40 gene variants and the perils of late diagnosis in primary ciliary dyskinesia

2018 ◽  
pp. bcr-2018-224964 ◽  
Author(s):  
Hasan Ghandourah ◽  
Sharon D Dell
Keyword(s):  
Respiratory Distress ◽  
Primary Ciliary Dyskinesia ◽  
Neonatal Period ◽  
Severe Disease ◽  
Coiled Coil ◽  
Failure To Thrive ◽  
Gene Variants ◽  
Severe Respiratory Distress ◽  
Coiled Coil Domain ◽  
Ciliary Dyskinesia

Primary ciliary dyskinesia (PCD) can manifest in the neonatal period with severe respiratory distress. We describe a child with PCD who presented at term with severe neonatal respiratory distress, persistent right upper lobe collapse and failure to thrive who underwent lobectomy prior to the diagnosis of PCD at the age of 3 years. This case report illustrates the severe spectrum of lung disease associated with coiled-coil domain containing protein 40 (CCDC40) gene variants in patients with PCD.

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

2021 ◽  
Vol 35 (2) ◽  
pp. 93-94
Author(s):  
Jyotsna Bhushan ◽  
Shagufta Iqbal ◽  
Abhishek Chopra
Keyword(s):  
Respiratory Distress ◽  
Conservative Management ◽  
Preterm Neonate ◽  
Late Preterm ◽  
Intravenous Fluids ◽  
X Rays ◽  
Blood Gas ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

scholarly journals Bronchopulmonary dysplasia in extremely premature infant with congenital lobar emphysema: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bingchun Lin ◽  
Huitao Li ◽  
Chuanzhong Yang
Keyword(s):  
Premature Infant ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Gestational Age ◽  
Middle Lobe ◽  
Severe Respiratory Distress ◽  
Congenital Lobar Emphysema ◽  
X Ray ◽  
Chest X Ray ◽  
Lobar Emphysema

Abstract Background Congenital lobar emphysema (CLE) is a congenital pulmonary cystic disease, characterized by overinflation of the pulmonary lobe and compression of the surrounding areas. Most patients with symptoms need an urgent surgical intervention. Caution and alertness for CLE is required in cases of local emphysema on chest X-ray images of extremely premature infants with bronchopulmonary dysplasia (BPD). Case presentation Here, we report a case of premature infant with 27 + 4 weeks of gestational age who suddenly presented with severe respiratory distress at 60 days after birth. Chest X-ray and computed tomography (CT) indicated emphysema in the middle lobe of the right lung. The diagnosis of CLE was confirmed by histopathological examinations. Conclusions Although extremely premature infants have high-risk factors of bronchopulmonary dysplasia due to their small gestational age, alertness for CLE is necessary if local emphysema is present. Timely pulmonary CT scan and surgical interventions should be performed to avoid the delay of the diagnosis and treatment.

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