ABSTRACT
Exogenous lipoid pneumonia is a rare entity with non-specific clinical presentation. Early diagnosis is key to prevent pulmonary fibrosis in cases of chronic exogenous lipoid pneumonia . Here, we present the diagnostic process in a 51-year-old female with chronic cough and yellow sputum, no fever nor signs of infection. The computerized axial tomography scan showed alveolar infiltrates in both lungs. We performed a bronchoalveolar lavage and collected a yellowish material, but no clear result were obtained from its analysis. Cryobiopsy of lung tissue was key for the diagnosis of exogenous lipoid pneumonia . This may be related to the chronic anorexia nervosa that the patient suffers, associated with purgative habits. After identifying the cause of the symptoms, the patient is recovering, changing her habits, and has no cough nor sputum.
Subject(s)
Anorexia Nervosa , Bronchopneumonia , Pneumonia, Lipid , Anorexia Nervosa/complications , Bronchoalveolar Lavage/adverse effects , Bronchoalveolar Lavage/methods , Female , Humans , Middle Aged , Pneumonia, Lipid/diagnosis , Pneumonia, Lipid/etiology , Pneumonia, Lipid/pathology , Tomography, X-Ray Computed/adverse effectsABSTRACT
La neumonía lipoidea exógena es una entidad infrecuente y con una presentación clínica inespecífica. Su diagnóstico temprano es clave para prevenir la fibrosis pulmonar que produce su cronificación. Presentamos el proceso diagnóstico de una paciente de 51 años, con clínica de tos con expectoración amarillenta, sin síntomas de infección ni fiebre, de larga evolución. En latomografía axial computarizada se observaron infiltrados pulmonares bilaterales de tipo alveolar. Se realizó un lavado broncoalveolar en el que se obtuvo un material amarillento de origen desconocido, que no permitió alcanzar ninguna conclusión clara. La criobiopsia pulmonar fue la prueba clave que llevó al diagnóstico de neumonía lipoidea exógena, en probable relación con la anorexia con hábito purgativo que la paciente sufría de forma crónica. Hallado el origen del problema, la paciente se encuentra actualmente en proceso de recuperación y cambio de hábitos, sin tos ni expectoración.(AU)
Exogenous lipoid pneumonia is a rare entity with non-specific clinical presentation. Early diagnosis is key to prevent pulmonary fibrosis in cases of chronic exogenous lipoid pneumonia . Here, we present the diagnostic process in a 51-year-old female with chronic cough and yellow sputum, no fever nor signs of infection. The computerized axial tomography scan showed alveolar infiltrates in both lungs. We per-formed a bronchoalveolar lavage and collected a yellowish material, but no clear result were obtained from its analysis. Cryobiopsy of lung tissue was key for the diagnosis ofexogenous lipoid pneumonia . This may be related to the chronic anorexia nervosa that the patient suffers, associated with purgative habits. After identifying the cause of the symptoms, the patient is recovering, changing her habits, and has no cough nor sputum.(AU)
Subject(s)
Humans , Male , Middle Aged , Inpatients , Physical Examination , Symptom Assessment , Cough , Tomography, Spiral Computed , Bronchoalveolar Lavage , Anorexia Nervosa/complications , Pneumonia, Lipid/diagnosis , Pneumonia, Lipid/etiology , Pneumonia , Health Systems , Spain , Patient CareABSTRACT
OBJECTIVE: To evaluate the clarity and efficacy of the information given to patients by doctors, in the hospital emergency ward (HEW) and the influence of accompanying people on such information. DESIGN: Descriptive transverse study. SETTING: HEW of the Hospital General of Segovia. PATIENTS AND OTHER PARTICIPANTS: 171 patients seen at the HEW between July and September of 1993. MEASUREMENTS AND MAIN RESULTS: An oral questionnaire consisting on 15 items including: age, sex and sociocultural profile of the patient, presence of a companion, knowledge the doctor's identity, oral information recived during the stay and oral and written recommendations at the time of discharge, was used. The report of discharge delivered to the patient was used for contrast. Only 20 patients (11.7%) knew the name of the doctor who attended them; a statistically significant difference (p > 0.01) was found in favour of those who were accompanied. In spite of the fact that 97.6% of the patients said that they had received a clear information and that 88.9% of them did referred to have no doubts, only 71.9% of them were able to repeat correctly the treatment recommended at the time of discharge. A 50% of the patients were able to read and understand the written report, while 19% of them did not understand it and another 20% considered it illegible. CONCLUSIONS: In order to guarantee the patient's compliance with recommendations given at the time of discharge of a HEW, it is necessary to improve oral and written information given to them, relying on the presence of a companion and checking their assimilation.
