ABSTRACT
A 34-year-old man presented with scanty hemoptysis, orange-colored expectoration, and mild dyspnea. He was in an enclosed building taking part in a military training exercise inhaling an orange-colored smoke from a smoke grenade ignition. His symptoms developed immediately after the initial exposure but he sought medical assistance 20 hours later because of their persistence. Fiberoptic bronchoscopy was performed revealing diffuse inflammatory tracheobronchial tree with streaky orange-pigmented secretions in the trachea and both main-stem bronchi. Acute tracheobronchitis was diagnosed and the patient was treated with nebulized bronchodilators and intravenous corticosteroids showing complete recovery. To our knowledge, this is the first well-documented report of inhalation injury induced by a smoke bomb explosion including potassium chlorate oxidizer and Sudan I and presenting with orange-pigmented sputum production. Smoke inhalation injury is associated with significant morbidity and mortality. The heterogeneity of the smoke and the large variety of the resulting symptoms may be the reason why a definition, specific diagnostic criteria, and therapeutic guidelines are still lacking.
Subject(s)
Bronchitis/etiology , Chlorates/adverse effects , Naphthols/adverse effects , Smoke Inhalation Injury/diagnosis , Sputum , Tracheitis/etiology , Adrenal Cortex Hormones/therapeutic use , Adult , Bombs , Bronchitis/drug therapy , Bronchodilator Agents/therapeutic use , Bronchoscopy , Humans , Male , Smoke Inhalation Injury/drug therapy , Tracheitis/drug therapyABSTRACT
Bronchoscopic drainage of a pyogenic lung abscess is an established therapeutic approach in selected patients in whom conventional antibiotic therapy fails. This intervention has also been undertaken in patients with abscess owing to underlying lung cancer and prior combined radiochemotherapy. However, this procedure has rarely been performed in cavitary lesions of advanced tumor origin before initiating any chemotherapy/radiotherapy scheme. Herein, we describe a case of a 68-year-old woman with lung adenocarcinoma stage IIIB, who underwent bronchoscopic drainage of necrotizing tumor lesion, thus improving her initial poor clinical condition and rendering other treatment modalities, such as radiotherapy, more effective and beneficial. Bronchoscopic drainage of a symptomatic cancerous lung abscess should be considered as an alternative and palliative treatment approach in patients with advanced inoperable non-small cell lung cancer.
Subject(s)
Adenocarcinoma/surgery , Lung Abscess/surgery , Lung Neoplasms/surgery , Lung/surgery , Adenocarcinoma/complications , Adenocarcinoma/pathology , Adenocarcinoma of Lung , Aged , Bronchoscopy , Drainage , Female , Humans , Lung/pathology , Lung Abscess/etiology , Lung Abscess/pathology , Lung Neoplasms/complications , Lung Neoplasms/pathology , NecrosisABSTRACT
Pemetrexed is indicated for locally advanced or metastatic non-squamous non-small-cell lung cancer as an initial treatment in combination with cisplatin or after prior chemotherapy as a single agent. It is generally a well-tolerated drug. The most common adverse reactions (incidence ≥ 20%) with single-agent use are fatigue, nausea, and anorexia. Additional common side effects when used in combination with cisplatin include vomiting, neutropenia, leukopenia, anemia, stomatitis/pharyngitis, thrombocytopenia, and constipation. Peripheral edema with associated erythema has rarely been described as an adverse effect. Herein, we report a patient with advanced non-small-cell lung cancer who experienced bilateral peripheral edema after pemetrexed administration. Discontinuation of pemetrexed and corticosteroids use completely resolved peripheral edema.
