Subject(s)
Hernia, Diaphragmatic/etiology , Hernia, Diaphragmatic/surgery , Rib Fractures/etiology , Rib Fractures/surgery , Sneezing , Thoracic Wall/surgery , Aged , Hernia, Diaphragmatic/diagnosis , Humans , Male , Rib Fractures/diagnosis , Rupture, Spontaneous , Suture Techniques , Thoracic Wall/pathology , Thoracotomy , Tomography, X-Ray ComputedABSTRACT
UNLABELLED: HISTORY AND PRESENTATION AT ADMISSION: An 82-year-old male patient presented with a 3 week history of exercise-induced dyspnea, productive cough and left sided chest pain. INVESTIGATIONS: Computertomography of the chest revealed an occluding endobronchial tumor in the left main bronchus with enlarged mediastinal lymph nodes, mediastinal shift and post-stenotic peribronchitis. TREATMENT AND COURSE: The tumor was removed completely with an optical forceps in rigid bronchoscopy. Histologically an endobronchial sialadenoma papilliferum was diagnosed. CONCLUSIONS: Benign tumors of the lower airways are rare. They cannot be distinguished reliably from malignant tumors by their endoscopic and radiologic appearance. Sialadenoma papilliferum is an extremely rare benign salivary gland tumor which is characterized by coexisting glandular and (pseudo) papillar formations. It occurs mainly in the oral cavity. The relapse rate is 10-15%. In single cases a malignant transformation may appear.
Subject(s)
Adenoma/diagnosis , Bronchial Neoplasms/diagnosis , Precancerous Conditions/diagnosis , Adenoma/pathology , Adenoma/surgery , Aged, 80 and over , Airway Obstruction/diagnosis , Airway Obstruction/pathology , Airway Obstruction/surgery , Bronchi/pathology , Bronchi/surgery , Bronchial Neoplasms/pathology , Bronchial Neoplasms/surgery , Bronchoscopy , Chest Pain/etiology , Diagnosis, Differential , Dyspnea/etiology , Follow-Up Studies , Humans , Male , Narrow Band Imaging , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Precancerous Conditions/pathology , Precancerous Conditions/surgery , Tomography, X-Ray ComputedABSTRACT
Broncho-pulmonary salmonelloses are rare manifestations of extraintestinal focal infections in adults caused by different subspecies of Salmonella. They may appear without previous gastroenteritic symptoms especially in patients older than 60 years, as well as in patients who are immunocompromised or suffer from chronic pulmonary diseases. The transmission route is hematogenous or via aspiration of contaminated gastric fluid. Complications are acute respiratory distress syndrome, lung abscesses and pleural empyemas. Complicated und lethal courses have been described frequently. Therefore, antibiotic therapy should be initiated in every case with sufficient duration of treatment and in accordance to antibiotic resistance. Recommended antibiotics are third generation cephalosporins, trimethoprim-sulfamethoxazole, ampicillin or fluoro-quinolones. In this review 4 different clinical courses of broncho-pulmonary salmonellosis caused by Salmonella enterica subsp. enterica serovar Brandenburg, Salmonella groups B (O4), C (O6) and O11 to O67 are presented and discussed in the context of the current literature.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Bronchial Diseases/diagnosis , Bronchial Diseases/drug therapy , Lung Diseases/diagnosis , Lung Diseases/drug therapy , Salmonella Infections/diagnosis , Salmonella Infections/drug therapy , Aged , Bronchial Diseases/microbiology , Female , Humans , Lung Diseases/microbiology , Male , Middle Aged , Salmonella Infections/microbiology , Treatment OutcomeABSTRACT
A 76-year-old female patient with chronic obstructive pulmonary disease presented with dyspnea, fever and productive coughing. The chest X-ray revealed upper lobe pneumonia. Intravenous antibiotic therapy with moxifloxacine was initiated but soon afterwards the patient developed septic shock with hypotension, acute respiratory and renal failure. Pressure-controlled ventilation, continuous veno-venous hemodialysis and administration of catecholamines were initiated but the patient died 22 h after hospitalization due to multiple organ dysfunction syndrome. Microbiology of blood cultures revealed Pasteurella multocida which was probably transmitted through close contact with the pet dog.
