Symptoms Of Productive Cough Research Articles

Tubercular tracheobronchial amyloidosis: a rare complication presenting as an endobronchial mass — a case report

BackgroundPulmonary amyloidosis often occurs as a part of systemic AL (amyloid light chain) amyloidosis. Localized tracheobronchial amyloidosis is a very rare entity. Most often, it is asymptomatic, or if symptomatic, it usually presents with vague symptoms such as cough, dyspnoea, hoarseness, wheezing, haemoptysis, and rarely respiratory failure. It is commonly misdiagnosed as asthma, tuberculosis, COPD, malignancy, or pneumonia.Case presentationWe are presenting a case of an elderly male, aged 64 years, who presented with symptoms of productive cough, dyspnoea, wheezing, and significant weight loss over a period of 6 months. Investigations such as bronchoscopy, histopathology, and imaging studies showed an endobronchial mass and left-sided pleural effusion.ConclusionsEndobronchial amyloidosis generally has a nodular appearance which can imitate an endobronchial tumour. The quality of life is decreased in these patients, and the life expectancy is approximately 8–10 years. Therefore, the early diagnosis of this disease is essential.

Pulmonary Paragonimiasis: A Case Series.

case reports; eosinophilia; paragonimiasis; pleural effusion.

Perfil clínico e epidemiológico de pacientes pediátricos diagnosticados com COVID-19 em um hospital público de referência na Amazônia brasileira

INTRODUCTION: The disease caused by SARS-CoV-2 called COVID-19 has high transmissibility and broad clinical spectrum. OBJECTIVE: To describe the epidemiological profile and clinical manifestations of children infected with the SARS-CoV-2 virus in a referral pediatric hospital. METHODS: This is a descriptive retrospective study, approved by the Research Ethics Council. RESULTS: 139 medical records of children diagnosed with COVID-19 were analyzed. By correlating the clinical outcome of the disease with its classification, the result was that 13% of patients who died had the severe form of COVID-19. 20% of children with mild clinical form and 19% of moderate clinical form were discharged home. When analyzing each of the symptoms with the clinical outcome, there was a statistically significant relationship between myalgia and dry cough symptoms and the discharge home outcome. And when the complications were analyzed: acute respiratory distress syndrome, multiple organ dysfunction and sepsis, they presented significant statistics with the clinical outcome of death and with the severe and critical clinical forms. When symptoms and complications were related to the clinical classification, they found a significant association between symptoms of productive cough and sore throat and the clinical forms: mild and moderate. CONCLUSION: It is necessary to encourage research in order to characterize the various clinical manifestations of this pathology, which may have different forms of presentation and spread knowledge about it, to establish measures for early diagnosis and adequate treatment, with restoration of health. of affected children.

PNEUMATOCELE FORMATION DUE TO SARS-COV2: A CASE REPORT

PNEUMATOCELE FORMATION DUE TO SARS-COV2: A CASE REPORT

Inhaled therapy for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is characterised by progressive symptoms of productive cough, breathlessness, wheeze and exacerbations. Airway obstruction is detected by quality assured spirometry, and is defined as a Forced Expired Volume in one second / Forced Vital Capacity ratio <0.7. Inhaled therapy is the most effective treatment solution, with bronchodilators and inhaled steroids helping to improve symptoms, quality of life and lung function, while reducing risk of exacerbations. Bronchodilators are available as both monotherapy and as dual combination therapy. Inhaled steroids can be added to inhaled long-acting bronchodilators, but are not without significant complications, including pneumonia. Therefore, careful assessment of the phenotype of a patient with chronic obstructive pulmonary disease must be given before commencing any therapy that contains inhaled steroid and other treatments, such as flu vaccination, smoking cessation and pulmonary rehabilitation should be given due consideration.

Inhaled therapy for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is characterised by progressive symptoms of productive cough, breathlessness, wheeze and exacerbations. Airway obstruction is detected by quality assured spirometry, and is defined as a Forced Expired Volume in one second / Forced Vital Capacity ratio <0.7. Inhaled therapy is the most effective treatment solution, with bronchodilators and inhaled steroids helping to improve symptoms, quality of life and lung function, while reducing risk of exacerbations. Bronchodilators are available as both monotherapy and as dual combination therapy. Inhaled steroids can be added to inhaled long-acting bronchodilators, but are not without significant complications, including pneumonia. Therefore, careful assessment of the phenotype of a patient with chronic obstructive pulmonary disease must be given before commencing any therapy that contains inhaled steroid and other treatments, such as flu vaccination, smoking cessation and pulmonary rehabilitation should be given due consideration.

PLEURAL-BASED LUNG MASS WITH AN UNUSUAL PRESENTATION

SESSION TITLE: Disorders of the Pleura 2 SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/09/2018 01:15 pm - 02:15 pm INTRODUCTION: Primary tumors of the pleura are rare. Majority of the tumors are benign. About 10–20% of the cases reported in the literature are malignant. We present a case of a patient with non specific symptoms and radiological findings consistent with a mass of pleural origin. CASE PRESENTATION: 44 year old African American male, presented with symptoms of productive cough, fever and left sided pleuritic chest pain since the last two months. He was recently incarcerated and released two weeks prior to presentation. He was a former smoker of 20 pack years. PPD and HIV test done within the last one year were normal. On physical examination, he had a fever of 102.2F, heart rate of 127/min, and respiratory rate 22/min. Chest auscultation revealed bilateral expiratory wheezing. Labs showed a normal complete blood count and metabolic panel. TB Gold quantiferon was less than 0.01 IU/ml. Respiratory virus panel was positive for rhinovirus. Initial Chest X ray showed a relatively well demarcated round mass in the left mid-lung with minimal displacement of the carina to the right. CT Chest confirmed the presence of a 12.0 x 14.6 x 13.1 cm pleural based lung mass with atelectasis of the left upper lobe and mass effect on the left hilar structures. Patient underwent a CT guided biopsy of the mass. Pathology revealed atypical cells with a low to moderate degree of pleomorphism. Immunohistochemistry revealed expression of CD 34 and diffuse nuclear expression of STAT6. Patient underwent surgical resection of the mass with partial pleurectomy. Intraoperative findings revealed large chest wall mass attached to the anterior parietal pleura. Post-operative course was unremarkable. Surgical pathology confirmed the presence of a malignant solitary fibrous tumor. DISCUSSION: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms of mesenchymal origin believed to arise from sub mesothelial connective tissue. SFTP is common in the fifth and sixth decades of life compared with SFTs arising intra-abdominally or in soft tissue. There is no sexual predilection. Evidence of a genetic predisposition or a relationship to exposure to asbestos or tobacco have not been demonstrated. The most common presenting symptoms are non-specific and include cough, chest pain and dyspnea. Paraneoplastic syndromes may be occur and present with clubbing, pulmonary osteoarthropathy secondary to secretion of hyaluronic acid, and refractory hypoglycemia due to secretion of insulin like growth factor II. Our patient presented with symptoms of an upper respiratory tract viral infection and non specific symptoms consistent with SFTP .Surgical resection is the mainstay of treatment in both benign and malignant variants. CONCLUSIONS: SFTP are rare. They may present with non specific symptoms.The prognosis for patients with SFTP is generally favorable with a 5-year overall survival rate ranging from 79 to 100%. Reference #1: 1. Solitary fibrous tumors of the pleura.Cardillo G1, Lococo F, Carleo F, Martelli M.Curr Opin Pulm Med. 2012 Jul;18(4):339-46. https://doi.org/10.1097/MCP.0b013e328352f696 Reference #2: Solitary fibrous tumor of the pleura.Robinson LA.Cancer Control. 2006 Oct;13(4):264-9 DISCLOSURES: No relevant relationships by MUHAMMAD ADEEL, source=Web Response no disclosure on file for Ashish Arora; No relevant relationships by Bilal Bangash, source=Web Response No relevant relationships by Jeff Kwon, source=Web Response No relevant relationships by Safal Shetty, source=Web Response

PneumocystisPneumonia Presenting as an Enlarging Solitary Pulmonary Nodule

Pneumocystis pneumonia is a life threatening infection that usually presents with diffuse bilateral ground-glass infiltrates in immunocompromised patients. We report a case of a single nodular granulomatous Pneumocystis pneumonia in a male with diffuse large B-cell lymphoma after R-CHOP therapy. He presented with symptoms of productive cough, dyspnea, and right-sided pleuritic chest pain that failed to resolve despite treatment with multiple antibiotics. Chest X-ray revealed right lower lobe atelectasis and CT of chest showed development of 2 cm nodular opacity with ground-glass opacities. Patient underwent bronchoscopy and biopsy that revealed granulomatous inflammation in a background of organizing pneumonia pattern with negative cultures. Respiratory symptoms resolved but the solitary nodular opacity increased in size prompting a surgical wedge resection which revealed granulomatous Pneumocystis pneumonia infection. This case is the third documented report of Pneumocystis pneumonia infection within a solitary pulmonary nodule in an individual with hematologic neoplasm. Although Pneumocystis pneumonia most commonly occurs in patients with HIV/acquired immunodeficiency syndrome and with diffuse infiltrates, the diagnosis should not be overlooked when only a solitary nodule is present.

Benign Metastasizing Leiomyoma After Uterine Artery Embolization

Abstract SESSION TYPE: Miscellaneous Case Report Posters IPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Uterine artery Embolization (UAE) is a minimally invasive treatment for uterine fibroids and is an alternative to hysterectomy. Particles of polyvinyl alcohol are injected under fluoroscopy into the uterine artery to block vascularization to the fibroids. Common adverse effects include fever, nausea, cramping abdominal pain, and vaginal discharge of necrotic tissue and blood. Other complications such as uterine injury, infection and even sepsis are rare. Several case reports described patients developing pulmonary emboli following this procedure including 2 fatalities. We report a patient with a benign course of multiple leiomyomata in the lungs discovered 8 years after UAE.CASE PRESENTATION: 44 year old female with history of uterine fibroids status post UAE 8 years ago presented with symptoms of productive cough and shortness of breath. Chest X-ray showed multiple well circumscribed bilateral pulmonary nodules. On tomography (CT) scan the largest nodule was 2.8 x 2.6 cm. There was also some airspace disease noted in the right upper lobe. Patient was treated with antibiotics for community acquired pneumonia and her symptoms resolved. She underwent bronchoscopy with transbronchial biopsy which was non-diagnostic. Percutaneous CT guided biopsy of one of the peripheral nodules showed smooth muscle cells of uterine origin. Cells appeared to be well differentiated which is consistent with leiomyoma. Patient was monitored with biannual CT scans and the nodules remained stable on two follow-up scans. She remains asymptomatic. Patient was encouraged to undergo hysterectomy to prevent any further leiomyomatous metastases.DISCUSSION: UAE remains a popular and minimally invasive alternative to hysterectomy. Leiomyomatous tissue can be dislodged during this procedure and embolize in the pulmonary vasculature. Implantation into the parenchyma can lead to subsequent nodule formation. Benign metastasizing leiomyoma has been described after uterine manipulation. We report a patient who developed benign metastasizing leiomyoma discovered 8 years after UAE. Our patient has had a benign course and the pulmonary nodules have been stable in size for over one year.CONCLUSIONS: Benign metastasizing leiomyoma may occur after UAE. It appears to have a benign course and patients may not be symptomatic. Consideration of imaging after this procedure may be appropriate.1) Hamoda H, Tait P, Edmonds DK. Fatal Pulmonary Embolus After Uterine Artery Fibroid Embolisation. Cardiovasc Intervent Radiol 2009; 32:1080-1082.2) Poujade O, Genin AS, Dhouha M, Luton D. A Benign Metastasizing Leiomyoma Involving a Nodule in the Pulmonary Artery: Case and Literature Review. Eur J of Gynaecol Oncol 2010; 31:329-32.DISCLOSURE: Eric Anderson: Consultant fee, speaker bureau, advisory committee, etc.: Honoraria for educational lectures from superDimensionThe following authors have nothing to disclose: Dmitriy Kogan, Cristina Reichner, Mary Fishman, Gloria Bowles-JohnsonNo Product/Research Disclosure InformationGeorgetown University, Washington, DC.

A case of pulmonary arteritis with stenosis of the main pulmonary arteries with positive myeloperoxidase‐antineutrophil cytoplasmic autoantibodies

A 53-year-old woman was referred to our hospital with the main symptoms of productive cough, fever and exertional dyspnoea. Chest X-ray revealed enlargement of the left hilar shadow and cavitary infiltration in the right upper lobe. 99mTechnetium-macroaggregated albumin (99mTc-MAA) perfusion scintigram showed complete hypoperfusion through the entire right lung. A pulmonary angiogram revealed stenotic lesions in the right and left main pulmonary arteries. Right cardiac catheterization showed an elevated right ventricular systolic pressure. There was no evidence of systemic arterial lesions nor vasculitis. The patient was positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic autoantibodies (ANCA) (168 EU). The Mycobacterium avium complex sputum culture was positive. The pulmonary stenotic lesions were surgically resected. The resected pulmonary arterial lesions were pathologically diagnosed as non-specific vasculitis. The cavitary lesion disappeared 6 months after the surgery. Two years after the surgery, although the MPO-ANCA level had decreased to 12 EU, stenosis of the pulmonary arteries reappeared. It is suggested that the patient became positive for MPO-ANCA in association with the Mycobacterium avium complex infection, and that the presence of MPO-ANCA may not be related to the development of pulmonary stenosis of the main pulmonary arteries.