Overlooked diagnosis of infected paratracheal air cysts in patients with respiratory symptoms: Case report.

RATIONALE: Infected paratracheal air cysts as the focus of respiratory symptoms can be overlooked in practice because of nonspecific symptoms and physician's scant knowledge for this entity. We report 2 cases of infected paratracheal air cyst diagnosed at chest computed tomography (CT) and bronchoscopy/endobronchial ultrasound. PATIENT CONCERN: Two patients visited our hospital with respiratory symptoms, including cough, sputum, and fever. DIAGNOSES: Chest CT showed paratracheal cystic lesions with air-fluid level in the thoracic inlet. In the first patient, endobronchial ultrasound revealed a right paratracheal hypoechoic mass corresponding to the lesion on CT scan. In the second patient, bronchoscopy revealed purulent discharge from a dimpling at posterolateral wall of trachea, which was the opening of communication between the trachea and infected paratracheal air cyst. INTERVENTIONS: Both patients received antibiotic treatment. OUTCOME: After medical treatment, the patients' symptoms were improved. Follow-up chest CT scans showed air-filled paratracheal air cysts without internal fluid or rim enhancement. LESSONS: A physician should pay attention to paratracheal air cyst in patients with respiratory symptoms when their lungs are clear on CT scan.

Does sex of client affect counselors' evaluation?

This study examined whether clients' positive or negative self-disclosure and sex affected counselors' evaluation of the clients. 80 counselors (30 certified, 45 master's and five doctoral trainees; six men and 74 women), after viewing a video-taped counseling interview in which the client self-disclosed either largely positive or negative contents responded to the Clinical Impression Scale which contained 8 clinical characteristics of clients (assertiveness, overall coping skills, anxiety, attitude toward counseling, motivation to change, self-esteem, insight, and depression). When the client self-disclosed largely negative content about self, counselors evaluated male client more negatively, i.e., less assertive, poor coping skills, higher anxiety, more negative attitude toward counseling, less eager to change, lower self-esteem, less insight, and higher depression) than female client. However, when the client self-disclosed largely positive content, there was no statistically significant sex difference between the two groups. The implications are discussed.