scholarly journals Empyema and lung abscess: An unusual presentation of pulmonary actinomycosis

2017 ◽  
Vol 4 (2) ◽  
pp. 60
Author(s):  
Matthew A. Robinson ◽  
Avinesh S. Bhar
Keyword(s):  
Chest Tube ◽  
Lower Lobe ◽  
Pulmonary Involvement ◽  
Lung Abscess ◽  
Tube Placement ◽  
Penicillin G ◽  
Computed Tomographic ◽  
History Of ◽  
Artery Disease ◽  
Disseminated Disease

Actinomyces spp. are an infrequent cause of pulmonary infections. Actinomyces spp. comprise part of the normal flora of the oral cavity and gastrointestinal tract. A. meyeri is especially known for pulmonary involvement and disseminated disease. The authors present a case of a polymicrobial pulmonary abscess containing A. meyeri. The patient was a 58-year-old man with a history of coronary artery disease, alcohol abuse and hypertension. He presented with progressive dyspnea and cough productive of grey-colored foul smelling sputum. Upon admission, a chest computed tomographic (CT) scan revealed a right-lower-lobe lung abscess, with an associated loculated empyema. The following day, the patient underwent a thoracostomy with chest tube placement. The chest tube drained several hundred milliliters of purulent pleural fluid, but a follow up chest CT showed little change in the size of the underlying empyema. A subsequent thoracotomy with decortication was performed, which evacuated 100 ml of thick purulent fluid. Fourteen days after admission, the patient was discharged on a 6- to 12-week course of intravenous penicillin G, followed by a 6-month course of oral penicillin V.

The Effect of Needle Gauge on the Risk of Pneumothorax and Chest Tube Placement After Percutaneous Computed Tomographic (CT)-Guided Lung Biopsy

2015 ◽  
Vol 38 (6) ◽  
pp. 1595-1602 ◽  
Author(s):  
Joshua D. Kuban ◽  
Alda L. Tam ◽  
Steven Y. Huang ◽  
Joe E. Ensor ◽  
Asher S. Philip ◽  
...  
Keyword(s):  
Chest Tube ◽  
Lung Biopsy ◽  
Tube Placement ◽  
Ct Guided ◽  
Chest Tube Placement ◽  
Computed Tomographic

scholarly journals 1303. A Rare Case of Legionella micdadei Lung Abscess in an Immunocompromised Patient

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S739-S740
Author(s):  
Fadi Samaan ◽  
Andriy Barchuk ◽  
Yasmin Bata ◽  
Rachael Biancuzzo ◽  
Elias Jabbour ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
White Cell Count ◽  
Lower Lobe ◽  
Immunocompromised Host ◽  
Lung Abscess ◽  
Cavitary Lesion ◽  
Amoxicillin Clavulanate ◽  
Artery Disease ◽  
Upper Abdominal ◽  
Legionella Micdadei

Abstract Background Legionella micdadei is the most common legionella species causing infection after L. pneumophila. It usually causes infection in immunocompromised hosts and leads to nodules with tendency to cavitate. It is difficult to culture which makes diagnosis challenging. We report a case or L. micdadei in an immunocompromised host with cavitary pneumonia. Methods Case Report. An 82 year-old female presented with upper abdominal pain for one day duration. She has history of hypertension, coronary artery disease, hyperlipidemia, heart failure, and hypothyroidism. She was diagnosed with hypersensitivity pneumonia 5 months prior, treated with prednisone (40 mg daily). The pain was not associated with nausea, vomiting or diarrhea. She was found with hypoxia despite she denied shortness of breath, cough, hemoptysis or chest pain. There was no fever, chills, headache, myalgia or upper respiratory symptoms. She was afebrile, tachycardic 134/min and hypoxic to 88% on room air. White cell count was 22x10(3) /mcL (90% neutrophils), hemoglobin was 10.4 g/dL, creatinine was 1.23 mg/dL and lactic acid was 3.6 mmol/L. Chest CT scan showed left lower lobe cavitary lesion with surrounding infiltrates (image 1). Quantiferon gold, serum galagtomannan, B-D-glucan, and vasculitis work-up were negative. Bronchoscopy showed a patent airway. Bronchial smears and cultures were negative for bacteria, fungi and mycobacteria. The patient was treated with ceftriaxone and metronidazole with de-escalation to amoxicillin/clavulanate. Bronchial culture was positive for legionella micdadei after discharge, azithromycin was added. Image 1. Cavitary lesion on thoracic CT Results Our patient was considered immunocompromised given steroid use, predisposing her for L. micdadei infection. L. micdadei is considered an opportunistic infection and was reported in hematologic malignancy population. It can cause an invasive lung disease with lung cavities. It needs special media for growth making it difficult to diagnose especially it is not detected by legionella urine antigen. Conclusion L. micdadei should be considered in the differential diagnosis for cavitary lung lesions in immunocompromised patients. Disclosures All Authors: No reported disclosures

A case of secondary syphilis with pulmonary involvement and review of the literature

2018 ◽  
Vol 29 (10) ◽  
pp. 1027-1032 ◽  
Author(s):  
Suttichai Visuttichaikit ◽  
Nuntra Suwantarat ◽  
Anucha Apisarnthanarak ◽  
Pansachee Damronglerd
Keyword(s):  
Treponema Pallidum ◽  
Clinical Signs ◽  
Systemic Infection ◽  
Final Diagnosis ◽  
Pulmonary Involvement ◽  
Needle Aspiration ◽  
Secondary Syphilis ◽  
Lung Abscess ◽  
Penicillin G ◽  
Amoxicillin Clavulanate

Syphilis is a sexually transmitted systemic infection caused by Treponema pallidum. We report a case of a heterosexual, HIV-positive man who presented with secondary syphilis and a lung abscess. A bacterial lung abscess was suspected and a computed tomography-guided percutaneous needle aspiration of the lung abscess was performed. Direct pulmonary involvement by T. pallidum was suggested by a positive PCR result on the aspirated fluid specimen. The clinical signs of secondary syphilis improved, and the lung abscess was resolved after treatment with benzathine penicillin G and amoxicillin-clavulanate. The final diagnosis was secondary pulmonary syphilis. Few reports of secondary syphilis with pulmonary involvement have been reported to date.

scholarly journals Severe Pulmonary Infection in a 20-Month-Old Female

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yasmeen Mann ◽  
Paul Zeller ◽  
Kristen Carrillo-Kappus ◽  
Melissa Victor ◽  
Mary Moore
Keyword(s):  
Pleural Effusion ◽  
Chest Tube ◽  
Intraoperative Complications ◽  
Lower Lobe ◽  
Tube Placement ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Left Pleural Effusion ◽  
Bacterial Organism

Community-Acquired Pneumonia (CAP) is a common reason for hospitalization of a pediatric patient. We report a 20-month-old female admitted for suspected CAP. History included a week-long cough, fever, dyspnea, single occurrence of seizure-like activity, and a sick contact. Initial chest X-ray (CXR) showed left lower lobe pneumonia and parapneumonic effusion with a complex left pleural effusion. Ultrasound findings prompted the need for contrast-enhanced computed tomography (CT) of the chest. Contrast-enhanced CT of the chest confirmed a large pleural effusion with major atelectasis and mediastinal shift. The patient was treated with empiric antibiotics, video-assisted thoracoscopic surgical (VATS) decortication of empyema, and chest tube placement. Due to intraoperative complications, the VATS decortication was aborted and patient was transferred to the pediatric intensive care unit (PICU). A thoracentesis with culture failed to isolate a bacterial organism. Dexamethasone was started after repeat CXR showed persistent infiltrate. Subsequent contrast-enhanced CT of the chest showed a large collection of air and persistent consolidation. The patient received repeat VATS decortication and reinsertion of a chest tube. Repeat pleural fluid cultures failed to isolate a bacterial organism. Infectious disease (ID) consult recommended linezolid 140 mg Q8H for 4 weeks. Seven days after second VATS, a respiratory pathogen panel was positive for rhinovirus/enterovirus. With resolution of leukocytosis and clinical improvement, the patient was discharged with the chest tube in place and pediatric surgery outpatient follow-up. After three months, sequalae from both the infection and interventions presented .

scholarly journals A Rare Case of Spontaneous Empyema by Clostridium perfringens

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Sijan Basnet ◽  
Izza Mir ◽  
Elan Mohanty ◽  
Rashmi Dhital ◽  
Biswaraj Tharu ◽  
...  
Keyword(s):  
Clostridium Perfringens ◽  
Chest Tube ◽  
Rare Case ◽  
Pleural Cavity ◽  
Tube Placement ◽  
Shortness Of Breath ◽  
Nonproductive Cough ◽  
Chest Tube Placement ◽  
Swallowing Dysfunction ◽  
History Of

Empyema caused by clostridial infections is rare especially in the absence of invasive thoracic procedures. We present the case of an 81-year-old man without a history of preceding trauma who presented with shortness of breath and nonproductive cough and grew Clostridium perfringens only in the pleural cavity. He was predisposed to the infection due to his swallowing dysfunction. He was treated with penicillin and chest tube placement for drainage and subsequently improved.

scholarly journals Burkholderia cepacia: An unusual cause of pneumonia

2021 ◽  
Vol 6 (4) ◽  
pp. 249-252
Author(s):  
Arjun A S ◽  
Prasanna Kumar T ◽  
Manjunath H K
Keyword(s):  
Burkholderia Cepacia ◽  
Lower Lobe ◽  
Lung Abscess ◽  
High Grade Fever ◽  
Home Setting ◽  
Prescription Practices ◽  
Male Farmer ◽  
History Of ◽  
Chest X Ray ◽  
The Right

Burkholderia Cepacia is a gram negative organism, an uncommon cause of pneumonia. When isolated, it usually represents colonisation. In the presence of immunocompromising conditions, it can cause disease, ranging from mild illness to the highly fatal Cepacia syndrome. The organism is intrinsically resistant to many antibiotics. We report a 57 years old male farmer, who has diabetes mellitus and bronchial asthma, who presented with a acute history of high grade fever, pain abdomen and cough. He was diagnosed with a ruptured liver abscess, with the infection spreading to the right lower lobe. Laparotomy was performed. Pus culture grew Pseudomonas aeruginosa. He improved upon antibiotic therapy, only to return after one month with severe cough, chest X-ray revealing a lung abscess in the right lower lobe. Bronchoalveolar lavage culture grew Burkholderia cepacia, and sensitive antibiotics were initiated, however the patient succumbed to the illness. The implicated source of the organism was the nebulisation solution which he was using regularly. Emphasis should be laid on the need for improved aseptic practices while using medical solutions at either hospital or home setting. An index of suspicion may guide optimal antibiotic prescription practices in susceptible individuals.

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

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