ABSTRACT
An elderly patient with progressive dementia presented with nonspecific symptoms of fatigue, skin discoloration, shortness of breath, and altered mental status. She quickly developed respiratory failure requiring emergent endotracheal intubation. Initial laboratory results revealed methemoglobinemia levels greater than 30% with blood appearing black in hue. The etiology of her acute symptoms and the inciting substance of the disease was an ongoing discussion with the patient's family, which ultimately revealed accidental ingestion of lava lamp fluid as the cause. Although rare, methemoglobinemia is a medical emergency requiring prompt diagnosis and treatment. When a thorough history fails to reveal a possible source, alternative origins should be investigated, such as household products.
ABSTRACT
INTRODUCTION: Unilateral absence of the pulmonary artery (UAPA) or pulmonary artery agenesis is a rare congenital disorder presenting with a wide spectrum of symptoms. The clinical presentation is variable and many patients can be asymptomatic for many years and even throughout their lives. CASE PRESENTATION: We report the case of a 53-year-old African-American woman who was diagnosed with right pulmonary artery agenesis after presenting with uncontrolled asthma and recurrent bronchopulmonary infections. CONCLUSION: In an unexplained case of recurrent respiratory infections and shortness of breath, the possibility of a rare congenital anomaly like UAPA should be considered and an appropriate evaluation should be done.
ABSTRACT
Swyer-James Macleod syndrome is a rare disorder that leads to recurrent respiratory infections. The fibrosis and obstruction of the terminal and respiratory bronchioles, likely caused by respiratory infections in early childhood, prevents normal development of the alveolar bud. Organisms that have been associated with this syndrome include adenovirus, measles, bordetella pertussis, mycobacterium spp, influenza A and mycoplasma. The syndrome is an acquired cause of unilateral emphysema. The diagnosis of the syndrome can be made in infancy or early childhood, but in asymptomatic individuals can be delayed until adulthood and rarely in the elderly. Chest radiographs and computed tomographic (CT) scan can confirm the diagnosis and exclude other possibilities. A case of Swyer- James Macleod syndrome diagnosed at age 63 in a patient with recurrent respiratory infections and a history of childhood pertussis is presented.
