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2.
J Investig Med High Impact Case Rep ; 10: 23247096221084852, 2022.
Article in English | MEDLINE | ID: covidwho-1817132

ABSTRACT

Coccidioidomycosis (CM) is a fungal disease that results from inhalation of spores of Coccidioides immitis and C posadasii. If symptomatic, disease primarily manifests as community-acquired pneumonia; however, additional pulmonary manifestations such as pleural effusion, empyema, and cavitation may occur. Diabetic patients have an increased risk of severe and cavitary CM. Cavitary disease may erode vasculature and pulmonary parenchyma leading to further complications. Furthermore, chronic cavities can become colonized as well and develop superimposed infections. This is a case of cavitary CM in uncontrolled diabetic nonadherent to treatment presenting with hemoptysis and mycetoma.


Subject(s)
Coccidioidomycosis , Lung Diseases, Fungal , Coccidioides , Coccidioidomycosis/complications , Coccidioidomycosis/diagnosis , Coccidioidomycosis/microbiology , Hemoptysis/etiology , Humans , Lung , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/diagnostic imaging
3.
Clin Imaging ; 83: 123-130, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1803768

ABSTRACT

Although COVID-19 coagulopathy typically manifests with thrombotic complications, hemorrhagic complications also occur and must be considered when making decisions about anticoagulation in these patients. Here, we report a case of massive hemoptysis occurring in a recently post-partum woman via Cesarean section with COVID-19 who was managed via bronchial artery embolization while on extracorporeal membrane oxygenation.


Subject(s)
COVID-19 , Embolization, Therapeutic , Extracorporeal Membrane Oxygenation , Bronchial Arteries/diagnostic imaging , Cesarean Section/adverse effects , Embolization, Therapeutic/adverse effects , Extracorporeal Membrane Oxygenation/adverse effects , Female , Hemoptysis/diagnostic imaging , Hemoptysis/etiology , Hemoptysis/therapy , Humans , Postpartum Period , Pregnancy , SARS-CoV-2
4.
Chest ; 161(4): e213-e217, 2022 04.
Article in English | MEDLINE | ID: covidwho-1763621

ABSTRACT

CASE PRESENTATION: A 58-year-old man presented to us with a 1-week history of high-grade fever and progressive dry cough. Four weeks before his presentation, he was diagnosed with COVID-19 infection and needed non-ICU hospital admission with no supplemental oxygen requirements for 6 days and was treated with a 5-day course of remdesivir and 3 weeks of dexamethasone. His steroid dose was commenced on dexamethasone 12 mg bid (four times the recommended dose) for 14 days and then gradually tapered over the remaining 7 days. His history was unremarkable, except for well-controlled asthma. He did not complain of any shortness of breath, weight loss, or loss of appetite. He was never a smoker and denied any alcohol use.


Subject(s)
COVID-19 , Hemoptysis , COVID-19/complications , Cough , Dexamethasone/therapeutic use , Dyspnea , Hemoptysis/diagnosis , Hemoptysis/etiology , Humans , Male , Middle Aged
5.
Chest ; 161(2): e97-e101, 2022 02.
Article in English | MEDLINE | ID: covidwho-1664781

ABSTRACT

CASE PRESENTATION: An 84-year-old man with an active smoking habit presented to the ED with dyspnea, hemoptysis, and thick phlegm that was difficult to clear. He reported no weight loss, no fever, and no chest pain or dysphonia. He denied both international travel and previous contact with confirmed cases of TB or SARS-CoV-2. He had no known occupational exposures. The patient's personal history included a resolved complete atrioventricular block that required a permanent pacemaker, moderate-to-severe COPD, rheumatoid arthritis (treated with oral prednisone, 2.5 mg/d) and B-chronic lymphocytic leukemia (treated with methotrexate and prophylactic oral supplements of ferrous sulfate). Moreover, he was in medical follow up because of a peptic ulcer, atrophic gastritis, and colonic diverticulosis. The patient also had a history of thoracic surgery after an episode of acute mediastinitis from an odontogenic infection, which required ICU management and temporal tracheostomy.


Subject(s)
Bronchoscopy/methods , COVID-19/diagnosis , Ferrous Compounds , Lung Diseases , Multiple Chronic Conditions/therapy , Respiratory Aspiration , Aged, 80 and over , Biopsy/methods , Bronchoalveolar Lavage/methods , COVID-19/epidemiology , Diagnosis, Differential , Ferrous Compounds/administration & dosage , Ferrous Compounds/adverse effects , Hematinics/administration & dosage , Hematinics/adverse effects , Hemoptysis/diagnosis , Hemoptysis/etiology , Humans , Lung Diseases/chemically induced , Lung Diseases/diagnostic imaging , Lung Diseases/physiopathology , Lung Diseases/therapy , Male , Respiratory Aspiration/complications , Respiratory Aspiration/diagnosis , Respiratory Aspiration/physiopathology , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Withholding Treatment
6.
BMJ Case Rep ; 14(12)2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1596727

ABSTRACT

We present a case of new-onset haemoptysis and associated lung lesion on chest imaging in the setting of the COVID-19 pandemic. This was believed to be due to dental care avoidance after tooth fracture and long-term use of temporary dental filler, with subsequent aspiration and bronchial injury. Our patient underwent bronchoscopy due to persistent haemoptysis with findings of mild traumatic injury. She responded to conservative management with no pharmacologic intervention. With time, there was resolution of symptoms and radiographic improvement of the lung lesion. We include a brief discussion on the influence of the COVID-19 pandemic on healthcare avoidance, complications of tooth fracture and the differential diagnosis of a new solitary lung lesion on chest imaging.


Subject(s)
COVID-19 , Hemoptysis , Dental Care , Female , Hemoptysis/etiology , Humans , Lung , Pandemics , SARS-CoV-2
7.
Tuberk Toraks ; 69(4): 561-566, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1580007

ABSTRACT

The coronavirus disease 2019 (COVID-19) is characterized by respiratory infection which can show very different clinical pictures, somewhat changing medical paradigm. Hemoptysis defined as idiopathic can be seen as much as 15%. Currently, increasing hemoptysis cases are being reported in medical coronavirus literature. We here present a hemoptysis case that would be defined as idiopathic before the COVID-19 era. After the first clinical picture, the case turned into a life-threatening hemoptysis. We studied the case comprehensively as clinical, pathogenetical, therapeutic and clinical practical aspects. Thus, we hypothesized that especially in the pandemic era, all hemoptysis cases must be evaluated as a possible life threatening infectious disease with unpredictable prognosis.


Subject(s)
COVID-19 , Embolization, Therapeutic , Bronchial Arteries , Hemoptysis/diagnosis , Hemoptysis/etiology , Hemoptysis/therapy , Humans , SARS-CoV-2
9.
Chest ; 160(1): e39-e44, 2021 07.
Article in English | MEDLINE | ID: covidwho-1291398

ABSTRACT

CASE PRESENTATION: A 65-year-old man presented with shortness of breath, gradually worsening for the previous 2 weeks, associated with dry cough, sore throat, and diarrhea. He denied fever, chills, chest pain, abdominal pain, nausea, or vomiting. He did not have any sick contacts or travel history outside of Michigan. His medical history included hypertension, diabetes mellitus, chronic kidney disease, morbid obesity, paroxysmal atrial fibrillation, and tobacco use. He was taking amiodarone, carvedilol, furosemide, pregabalin, and insulin. The patient appeared to be in mild respiratory distress. He was afebrile and had saturation at 93% on 3 L of oxygen, heart rate of 105 beats/min, BP of 145/99 mm Hg, and respiratory rate of 18 breaths/min. On auscultation, there were crackles on bilateral lung bases and chronic bilateral leg swelling with hyperpigmented changes. His WBC count was 6.0 K/cumm (3.5 to 10.6 K/cumm) with absolute lymphocyte count 0.7 K/cumm (1.0 to 3.8 K/cumm); serum creatinine was 2.81 mg/dL (0.7 to 1.3 mg/dL). He had elevated inflammatory markers (serum ferritin, C-reactive protein, lactate dehydrogenase, D-dimer, and creatinine phosphokinase). Chest radiography showed bilateral pulmonary opacities that were suggestive of multifocal pneumonia (Fig 1). Nasopharyngeal swab for SARS-CoV-2 was positive. Therapy was started with ceftriaxone, doxycycline, hydroxychloroquine, and methylprednisolone 1 mg/kg IV for 3 days. By day 3 of hospitalization, he required endotracheal intubation, vasopressor support, and continuous renal replacement. Blood cultures were negative; respiratory cultures revealed only normal oral flora, so antibiotic therapy was discontinued. On day 10, WBC count increased to 28 K/cumm, and chest radiography showed persistent bilateral opacities with left lower lobe consolidation. Repeat respiratory cultures grew Pseudomonas aeruginosa (Table 1). Antibiotic therapy with IV meropenem was started. His condition steadily improved; eventually by day 20, he was off vasopressors and was extubated. However, on day 23, he experienced significant hemoptysis that required reintubation and vasopressor support.


Subject(s)
Aspergillus niger/isolation & purification , COVID-19 , Hemoptysis , Invasive Pulmonary Aspergillosis , Pseudomonas aeruginosa/isolation & purification , SARS-CoV-2/isolation & purification , Superinfection , Voriconazole/administration & dosage , Aged , Antifungal Agents/administration & dosage , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/therapy , Clinical Deterioration , Critical Illness/therapy , Critical Pathways , Diagnosis, Differential , Hemoptysis/diagnosis , Hemoptysis/etiology , Hemoptysis/therapy , Humans , Invasive Pulmonary Aspergillosis/complications , Invasive Pulmonary Aspergillosis/diagnosis , Invasive Pulmonary Aspergillosis/physiopathology , Lung/diagnostic imaging , Lung/physiopathology , Male , Radiography, Thoracic/methods , Respiration, Artificial/methods , Superinfection/diagnosis , Superinfection/microbiology , Superinfection/physiopathology , Superinfection/therapy , Tomography, X-Ray Computed/methods , Treatment Outcome
10.
BMJ Case Rep ; 14(5)2021 May 20.
Article in English | MEDLINE | ID: covidwho-1238492

ABSTRACT

We present to you a case of life-threatening haemoptysis secondary to non-cystic fibrosis bronchiectasis complicated by bronchial artery pseudoaneurysms. We discuss this patient's emergency medical management using intravenous tranexamic acid, which resulted in successful resuscitation and eventual survival, and evaluate the need for urgent anaesthetic and interventional radiology input in such a case.


Subject(s)
Bronchiectasis , Embolization, Therapeutic , Bronchial Arteries/diagnostic imaging , Hemoptysis/etiology , Hemoptysis/therapy , Humans , Treatment Outcome
11.
BMJ Case Rep ; 14(4)2021 Apr 27.
Article in English | MEDLINE | ID: covidwho-1206019

ABSTRACT

A 65-year-old woman who presented with a constellation of symptoms, including cough with haemoptysis, fever, chills and hypoxia along with weight loss, was found to have diffuse alveolar haemorrhage. After a myriad of investigations returned normal, an open lung biopsy was performed, which revealed the diagnosis to be subacute eosinophilic pneumonia. This is one of its kind of rare presentations where eosinophilic pneumonia presents as diffuse alveolar haemorrhage and has been reported only five times prior to this.


Subject(s)
Lung Diseases , Pulmonary Eosinophilia , Aged , Female , Hemoptysis/etiology , Hemorrhage/etiology , Humans , Lung , Pulmonary Eosinophilia/complications , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/drug therapy
13.
BMC Cardiovasc Disord ; 20(1): 494, 2020 11 23.
Article in English | MEDLINE | ID: covidwho-1094026

ABSTRACT

BACKGROUND: Infective endocarditis has a relevant clinical impact due to its high morbidity and mortality rates. Right-sided endocarditis has lower complication rates than left-sided endocarditis. Common complications are multiple septic pulmonary embolisms, haemoptysis, and acute renal failure. Risk factors associated with right-sided infective endocarditis are commonly related to intravenous drug abuse, central venous catheters, or infections due to implantable cardiac devices. However, patients with congenital ventricular septal defects might be at high risk of endocarditis and haemodynamic complications. CASE PRESENTATION: In the following, we present the case of a 23-year-old man without a previous intravenous drug history with tricuspid valve Staphylococcus aureus endocarditis complicated by acute renal failure and haemoptysis caused by multiple pulmonary emboli. In most cases, right-sided endocarditis is associated with several common risk factors, such as intravenous drug abuse, a central venous catheter, or infections due to implantable cardiac devices. In this case, we found a small perimembranous ventricular septal defect corresponding to a type 2 Gerbode defect. This finding raised the suspicion of a congenital ventricular septal defect complicated by a postendocarditis aneurysmal transformation. CONCLUSIONS: Management of the complications of right-sided infective endocarditis requires a multidisciplinary approach. Echocardiographic approaches should include screening for ventricular septal defects in patients without common risk factors for tricuspid valve endocarditis. Patients with undiagnosed congenital ventricular septal defects are at high risk of infective endocarditis. Therefore, endocarditis prophylaxis after dental procedures and/or soft-tissue infections is highly recommended. An acquired ventricular septal defect is a very rare complication of infective endocarditis. Surgical management of small ventricular septal defects without haemodynamic significance is still controversial.


Subject(s)
Acute Kidney Injury/etiology , Coronary Circulation , Endocarditis, Bacterial/microbiology , Heart Septal Defects, Ventricular/physiopathology , Hemodynamics , Hemoptysis/etiology , Staphylococcal Infections/microbiology , Acute Kidney Injury/microbiology , Acute Kidney Injury/physiopathology , Anti-Bacterial Agents/therapeutic use , Conservative Treatment , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Heart Septal Defects, Ventricular/complications , Heart Septal Defects, Ventricular/diagnostic imaging , Hemoptysis/microbiology , Hemoptysis/physiopathology , Humans , Male , Risk Factors , Staphylococcal Infections/complications , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Treatment Outcome , Young Adult
14.
Intern Med ; 60(5): 803-805, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1031094

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a novel infectious disease affecting the general population worldwide. A fever and cough are the common clinical presentations of COVID-19. In most of these patients, computed tomography (CT) shows bilateral peripheral ground-glass opacities. We herein report a case of hemoptysis and lung bulla in the convalescent phase of COVID-19. Based on the clinical observations, alveolar destruction was likely associated with hemoptysis and bulla formation. Therefore, we suggest the follow-up of COVID-19 patients whose clinical parameters indicate alveolar damage, even after their symptoms improve.


Subject(s)
Blister/etiology , COVID-19/complications , COVID-19/pathology , Hemoptysis/etiology , Lung/pathology , Blister/diagnostic imaging , Blister/pathology , COVID-19/diagnostic imaging , Cough/virology , Fever/virology , Hemoptysis/diagnostic imaging , Hemoptysis/pathology , Humans , Lung/diagnostic imaging , Male , Middle Aged , Pulmonary Alveoli/diagnostic imaging , Pulmonary Alveoli/pathology , SARS-CoV-2 , Tomography, X-Ray Computed
15.
Chest ; 159(1): e35-e38, 2021 01.
Article in English | MEDLINE | ID: covidwho-1002398

ABSTRACT

CASE PRESENTATION: A 28-year-old man presented with shortness of breath, chest pain, and scant hemoptysis. Three weeks previously, he was admitted for coronavirus disease 2019 pneumonia that had been diagnosed by nasal swab polymerase chain reaction. Chest CT imaging demonstrated bilateral ground-glass opacities without evidence of VTE. He was treated with hydroxychloroquine, up to 7 L/min oxygen, and self-proning. After 8 days of hospitalization, he was discharged on 4 L/min oxygen. After discharge, his symptoms and hypoxia resolved.


Subject(s)
COVID-19/complications , Chest Pain/etiology , Dyspnea/etiology , Hemoptysis/etiology , Adult , Chest Pain/therapy , Dyspnea/therapy , Hemoptysis/therapy , Humans , Male
16.
Med Klin Intensivmed Notfmed ; 115(Suppl 3): 146-151, 2020 Dec.
Article in German | MEDLINE | ID: covidwho-973452

ABSTRACT

The present case describes the diagnostic and therapy of the pulmorenal syndrome of a 40-year-old patient who presented in our clinic due to increasing respiratory insufficiency and hemoptysis with confirmed COVID-19 disease.


Subject(s)
Acute Kidney Injury , COVID-19 , Glomerulonephritis , Granulomatosis with Polyangiitis , Acute Kidney Injury/diagnosis , Acute Kidney Injury/therapy , Adult , Hemoptysis/etiology , Humans , SARS-CoV-2
17.
Chest ; 158(5): e215-e219, 2020 11.
Article in English | MEDLINE | ID: covidwho-891959

ABSTRACT

Diffuse alveolar hemorrhage (DAH) is a severe and potentially life-threatening disease manifestation. In addition to autoimmune diseases such as antineutrophil cytoplasmic antibody-associated vasculitis and anti-glomerular basement membrane syndrome, pulmonary viral infections are known to be culprits of DAH. Health-care providers worldwide in the coronavirus disease 2019 pandemic have been confronted with an unprecedented number of viral lung infections, with great variance in symptoms and severity. Hemoptysis, the key symptom of DAH, is a rare complication. We present two cases of immunocompromised patients with rapidly developing hypoxemic respiratory failure and evidence of DAH in the context of severe acute respiratory syndrome coronavirus 2 infection.


Subject(s)
Coronavirus Infections/complications , Hemorrhage/etiology , Immunocompromised Host , Lung Diseases/etiology , Pneumonia, Viral/complications , Aged , Aortitis/complications , Aortitis/drug therapy , Aortitis/immunology , Autoimmune Diseases/complications , Autoimmune Diseases/drug therapy , Autoimmune Diseases/immunology , Betacoronavirus , COVID-19 , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/immunology , Carcinoma, Transitional Cell/therapy , Chemoradiotherapy , Coronavirus Infections/immunology , Coronavirus Infections/physiopathology , Cross Infection , Glucocorticoids/therapeutic use , Hemoptysis/etiology , Humans , Hypereosinophilic Syndrome/complications , Hypereosinophilic Syndrome/drug therapy , Hypereosinophilic Syndrome/immunology , Hypoxia/physiopathology , Immunosuppressive Agents/therapeutic use , Male , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/physiopathology , Prednisolone/therapeutic use , Respiratory Insufficiency/physiopathology , SARS-CoV-2 , Urinary Bladder Neoplasms/complications , Urinary Bladder Neoplasms/therapy
19.
Ann Thorac Surg ; 111(3): e183-e184, 2021 03.
Article in English | MEDLINE | ID: covidwho-797517

ABSTRACT

Patients with severe coronavirus disease 2019 from infection with severe acute respiratory syndrome coronavirus 2 mount a profound inflammatory response and are predisposed to thrombotic complications. Pulmonary vein thrombosis is a rare disease process resulting in pulmonary congestion, infarction, and potential mortality. This report describes a patient with coronavirus disease 2019 requiring venovenous extracorporeal membrane oxygenation for hypoxic respiratory failure who developed hemorrhagic infarction of the right lower lobe. During emergency exploration the patient was found to have a right inferior vein thrombosis and marked lobar hemorrhage mandating lobectomy.


Subject(s)
COVID-19/complications , Hemoptysis/surgery , Infarction/surgery , Lung/blood supply , Pneumonectomy/methods , Adult , COVID-19/epidemiology , Hemoptysis/etiology , Humans , Infarction/etiology , Lung/surgery , Male , Pandemics
20.
BMC Pulm Med ; 20(1): 244, 2020 Sep 14.
Article in English | MEDLINE | ID: covidwho-757052

ABSTRACT

BACKGROUND: Since the beginning of SARS-CoV-2 outbreak in China, severe acute respiratory syndrome has been widely descripted. Hemoptysis has rarely been observed in SARS-CoV-2 infection. We report here a case of severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection and managed in a referral center. CASE PRESENTATION: A 58-year-old man was admitted to our intensive care unit for severe hemoptysis with history of post-tuberculosis bronchiectasis. At ICU admission the patient had fever and severe acute respiratory failure requiring high flow oxygen therapy. Respiratory tract sampling was positive for SARS-CoV-2. Multi-detector computed tomography angiography pointed out localized bronchiectasis on the left lower lobe and enlarged left bronchial and phrenic arteries; bronchial arteriography with distal embolization was performed with favorable outcome and no bleeding recurrence. CONCLUSIONS: To our knowledge, this is the first case of acute exacerbation of bronchiectasis related to SARS-CoV-2 infection and complicated by severe hemoptysis. Whether the virus may play a role in the dysregulation of airway haemostasis, and contribute to episodes of hemoptysis in patients with chronic pulmonary diseases and predisposing factors might be investigated.


Subject(s)
Bronchiectasis/complications , Coronavirus Infections/complications , Hemoptysis/etiology , Pneumonia, Viral/complications , Tuberculosis, Pulmonary/complications , COVID-19 , Humans , Male , Middle Aged , Pandemics , Severity of Illness Index
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