ABSTRACT
Nocardia asiatica causing pyogranulomatous pleuropneumonia is reported for the first time in a dog coinfected with canine morbillivirus (CM), diagnosed based on epidemiological, clinical, haematological, images, microbiological, histopathological, polymerase chain reaction and hsp65 gene sequencing findings. The immunosuppression of CM probably favoured the opportunistic behaviour of N. asiatica. Despite the therapeutic measures, the animal died, mainly due to respiratory distress. The association of methods to improve early diagnosis, therapy procedures and prognosis of canine nocardiosis is discussed, as well as the close relationship between pets and their owners, which may favour the transmission of pathogens such as Nocardia from pets-to-humans, which poses an emerging public health issue.
Subject(s)
Coinfection/veterinary , Distemper Virus, Canine/isolation & purification , Distemper/complications , Nocardia Infections/veterinary , Nocardia/isolation & purification , Pleuropneumonia/veterinary , Animals , Brazil , Coinfection/diagnostic imaging , Distemper/diagnostic imaging , Dogs , Fatal Outcome , Female , Nocardia Infections/complications , Nocardia Infections/diagnosis , Pleuropneumonia/complications , Pleuropneumonia/diagnostic imagingABSTRACT
A 67-year-old woman was referred to our hospital because of gradually increasing dyspnoea on exertion for 6 months. Chest CT scan showed subpleural parenchymal fibrotic opacities with traction bronchiectasis in the bilateral upper lung fields. Serum rheumatoid factor and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) were positive. There was no evident reason to suspect connective tissue disease such as ANCA-associated vasculitis or rheumatoid arthritis. We performed a CT-guided percutaneous needle biopsy of the subpleural lesion that showed slight uptake on the fluorodeoxyglucose-positron emission tomography (FDG-PET) CT scan. This specimen showed subpleural fibrosis as evidenced by an abnormal increase of elastic tissue and minimal collagen deposition, which indicated pleuroparenchymal fibroelastosis (PPFE). Although PPFE can be associated with a variety of causes, its association with MPO-ANCA is unknown. A CT-guided transthoracic lung biopsy caused no adverse events and was useful in the diagnosis of PPFE in our patient.
Subject(s)
Antibodies, Antineutrophil Cytoplasmic/blood , Peroxidase/blood , Pleuropneumonia/diagnosis , Pulmonary Fibrosis/diagnosis , Radiography, Interventional/methods , Tomography, X-Ray Computed/methods , Aged , Biopsy, Needle , Diagnosis, Differential , Female , Humans , Image-Guided Biopsy/methods , Lung/diagnostic imaging , Lung/pathology , Pleura/diagnostic imaging , Pleura/pathology , Pleuropneumonia/blood , Pleuropneumonia/complications , Pulmonary Fibrosis/blood , Pulmonary Fibrosis/complicationsABSTRACT
An unusual case of pleural empyema related to Nocardia farcinica and Ureaplasma urealyticum, occurring after autologous haematopoietic stem cell transplantation in a 30-year-old patient with lymphoma, is reported. This case illustrates the role of repeated and comprehensive microbiological investigations and the contribution of molecular techniques in reaching the aetiological diagnosis.
Subject(s)
Lymphoma, B-Cell/complications , Nocardia Infections/diagnosis , Pleuropneumonia/diagnosis , Polymerase Chain Reaction , Positron Emission Tomography Computed Tomography , Ureaplasma Infections/diagnosis , Ureaplasma urealyticum , Adult , DNA, Bacterial/analysis , Humans , Male , Molecular Typing , Nocardia , Nocardia Infections/complications , Nocardia Infections/diagnostic imaging , Nocardia Infections/microbiology , Pleuropneumonia/complications , Pleuropneumonia/microbiology , RNA, Ribosomal, 16S/analysis , Ureaplasma Infections/complications , Ureaplasma urealyticum/geneticsSubject(s)
Agammaglobulinemia/complications , Agammaglobulinemia/immunology , HIV Infections/complications , Immunocompromised Host , Mycoplasma Infections/complications , Mycoplasma Infections/diagnosis , Pregnancy Complications, Infectious/microbiology , Anti-Bacterial Agents/therapeutic use , CD4 Lymphocyte Count , Female , HIV Infections/immunology , HIV Infections/therapy , HIV-1 , Humans , Mycoplasma Infections/therapy , Mycoplasma hominis , Pleuropneumonia/complications , Pleuropneumonia/diagnosis , Pleuropneumonia/pathology , Pleuropneumonia/therapy , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/pathology , Pregnancy Complications, Infectious/therapy , Thoracotomy , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Infant , Pleuropneumonia/complications , Shock, Septic/complications , Streptococcus pneumoniae/pathogenicity , Drug Resistance, Multiple , Streptococcal Infections/complications , Anti-Bacterial Agents/therapeutic useABSTRACT
BACKGROUND: Suppurative-destructive diseases of the lung and pleura are prevalent kind of diseases occurring in children. They represent 9.1% of thoracic surgical diseases in this age. In such diseases, the pleural drainage is the most commonly used at present time. One of the methods is the transthoracic drainage by Seldinger. MATERIAL AND METHODS: Over the period of 13 years (2000-2012), 101 children with different forms of acute purulent destructive processes of the lung and pleura were treated in the Department of Pediatric Surgery of the University Hospital "St. George "- Plovdiv. We used percutaneous (transthoracic) drainage (Seldinger method) in the case of three children with lung abscess complicated pleuropneumonia with empyema. RESULTS: We achieved positive effect in treatment with all three children, without introducing additional operating procedures. CONCLUSION: There is still no consensus regarding the surgical treatment of various forms of acute suppurative-destructive diseases of the lungs and pleura (ASDDLP). Some authors attach great importance to the puncture method of treating ASDDLP, whilst they recommend the application of another treatment in case of failure.
Subject(s)
Drainage/methods , Lung Diseases/surgery , Lung/surgery , Pleura/surgery , Pleural Diseases/surgery , Thoracic Surgical Procedures/methods , Acute Disease , Child , Drainage/adverse effects , Empyema, Pleural/complications , Empyema, Pleural/surgery , Humans , Lung/pathology , Lung Abscess/complications , Lung Abscess/surgery , Lung Diseases/complications , Pleura/pathology , Pleural Diseases/complications , Pleuropneumonia/complications , Pleuropneumonia/surgery , Postoperative Complications/etiology , Thoracic Surgical Procedures/adverse effectsABSTRACT
BACKGROUND: Chest pain is a common complaint and reason for consultation in primary care. Traditional textbooks still assign pain localization a certain discriminative role in the differential diagnosis of chest pain. The aim of our study was to synthesize pain drawings from a large sample of chest pain patients and to examine whether pain localizations differ for different underlying etiologies. METHODS: We conducted a cross-sectional study including 1212 consecutive patients with chest pain recruited in 74 primary care offices in Germany. Primary care providers (PCPs) marked pain localization and radiation of each patient on a pictogram. After 6 months, an independent interdisciplinary reference panel reviewed clinical data of every patient, deciding on the etiology of chest pain at the time of patient recruitment. PCP drawings were entered in a specially designed computer program to produce merged pain charts for different etiologies. Dissimilarities between individual pain localizations and differences on the level of diagnostic groups were analyzed using the Hausdorff distance and the C-index. RESULTS: Pain location in patients with coronary heart disease (CHD) did not differ from the combined group of all other patients, including patients with chest wall syndrome (CWS), gastro-esophageal reflux disease (GERD) or psychogenic chest pain. There was also no difference in chest pain location between male and female CHD patients. CONCLUSIONS: Pain localization is not helpful in discriminating CHD from other common chest pain etiologies.
Subject(s)
Chest Pain/physiopathology , Coronary Disease/diagnosis , Gastroesophageal Reflux/diagnosis , Psychophysiologic Disorders/diagnosis , Tietze's Syndrome/diagnosis , Chest Pain/etiology , Cohort Studies , Coronary Disease/complications , Cross-Sectional Studies , Diagnosis, Differential , Female , Gastroesophageal Reflux/complications , Humans , Hypertension/complications , Hypertension/diagnosis , Male , Physical Examination , Pleuropneumonia/complications , Pleuropneumonia/diagnosis , Primary Health Care , Psychophysiologic Disorders/complications , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnosis , Stomach Diseases/complications , Stomach Diseases/diagnosis , Thoracic Injuries/complications , Thoracic Injuries/diagnosis , Tietze's Syndrome/complicationsSubject(s)
Antimetabolites, Antineoplastic/therapeutic use , Ciprofloxacin/pharmacokinetics , Methotrexate/pharmacokinetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Antimetabolites, Antineoplastic/pharmacokinetics , Ciprofloxacin/adverse effects , Ciprofloxacin/therapeutic use , Drug Interactions , Humans , Kidney/metabolism , Kidney Tubular Necrosis, Acute/chemically induced , Kidney Tubular Necrosis, Acute/metabolism , Leucovorin/administration & dosage , Leucovorin/therapeutic use , Male , Membrane Transport Proteins/metabolism , Metabolic Clearance Rate , Methotrexate/therapeutic use , Pleuropneumonia/complications , Pleuropneumonia/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complicationsABSTRACT
Introducción: Streptococcus pneumoniae es un agente etiológico infrecuente del síndrome hemolítico urémico (SHU) con una mayor gravedad que el SHU clásico. Casos clínicos: Presentamos 2 pacientes con pleuroneumonía neumocócica que desarrollaron SHU. En un caso la evolución fue hacia la normalización de la función renal y en el otro, hacia la insuficiencia renal, que requirió trasplante renal. Conclusión: La enfermedad neumocócica invasiva puede ser causa de SHU grave. Un alto índice de sospecha es necesario para un diagnóstico precoz y un adecuado tratamiento (AU)
Introduction: Streptococcus pneumoniae is an infreqüent casual agent of hemolytic uremic syndrome (HUS) with more severity than classic HUS. Case report: We present two patients with pneumococcal pneumonia and empyema who developed HUS. One patient the renal function returned to normal and the other needed a renal transplantation. Conclusion: Pneumococcal invasive disease may be a cause of severe HUS, so a high index of suspicion is mandatory to prompt appropriate diagnosis and management (AU)
Subject(s)
Humans , Male , Infant , Hemolytic-Uremic Syndrome/complications , Hemolytic-Uremic Syndrome/diagnosis , Pneumonia, Pneumococcal/complications , Pleuropneumonia/complications , Pleuropneumonia/diagnosis , Streptococcus pneumoniae/isolation & purification , Kidney Transplantation/methods , Empyema/complications , Empyema/diagnosis , Thoracoscopy/methods , Renal Insufficiency/complications , Renal Insufficiency/diagnosis , Pneumococcal Infections/complications , Pneumococcal Infections/diagnosis , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Thoracic Surgery, Video-Assisted/methods , Proteinuria/blood , Proteinuria/complicationsSubject(s)
Fever of Unknown Origin/etiology , Horse Diseases/drug therapy , Horse Diseases/etiology , Pleuropneumonia/veterinary , Animals , Anti-Bacterial Agents/administration & dosage , Biopsy, Needle/veterinary , Cephalosporins/administration & dosage , Female , Horse Diseases/diagnostic imaging , Horses , Pleuropneumonia/complications , Pleuropneumonia/diagnostic imaging , Pleuropneumonia/drug therapy , Thoracic Cavity/diagnostic imaging , Thoracic Cavity/pathology , Treatment Outcome , UltrasonographyABSTRACT
Se define pleuroneumonía a las neumonías que presentan compromiso inflamatorio pleural, asociado o no a derrame pleural. Su tratamiento se basa en el empleo juicioso y precoz de antibióticos y/o drenaje pleural, y/o fibrinolíticos; y/o debridación por videotoracoscopía; y/o decorticación por toracotomÍa. El objetivo de nuestro trabajo fue determinar el comportamiento de las pleuroneumonías en HCRV, en pacientes menores de 15 años, caracterizando la clínica, su evolución, tratamientos efectuados y la efectividad de éstos; mediante un estudio descriptivo, retrospectivo de las fichas clínicas con diagnóstico de egreso de Pleuroneumonía en el HCRV, entre enero del 2000 y diciembre del 2005. Se registraron 75 casos de Pleuroneumonía en un número de 6 a 16 casos por año; en edades entre 6 meses y 14 años 10 meses; con predominio del grupo etario Lactantes. Uno de cada cuatro pacientes requirió algún tipo de intervención quirúrgica. Se concluye que las pleuroneumonías si bien son infrecuentes, significan una alta morbilidad para los pacientes y su manejo requiere de protocolos que permitan un actuar oportuno y seguro.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Pleuropneumonia/diagnosis , Pleuropneumonia/epidemiology , Pleuropneumonia/therapy , Age and Sex Distribution , Chile/epidemiology , Epidemiology, Descriptive , Length of Stay , Pleuropneumonia/surgery , Pleuropneumonia/complications , Retrospective StudiesSubject(s)
Coombs Test , Hemolytic-Uremic Syndrome/diagnosis , Pleuropneumonia/diagnosis , Child, Preschool , Diagnosis, Differential , Female , Hemolytic-Uremic Syndrome/complications , Hemolytic-Uremic Syndrome/immunology , Humans , Infant , Male , Pleuropneumonia/complications , Pleuropneumonia/immunology , Pneumonia, Pneumococcal/complications , Pneumonia, Pneumococcal/diagnosisABSTRACT
Intractable hiccups in transplanted patients may be caused by various medical conditions including infections. We report a case of a 44-year-old man who suffered from intractable hiccups after cadaveric kidney transplantation. We identified 3 different hiccup periods with different causes: 1) steroid and anesthetics use, 2) severe ulcerose herpetic and mycotic esophagitis, and 3) pleuropneumonia caused by nosocomial methicillin-resistant Staphylococcus epidermidis and pulmonary abscess requiring thoracic surgery.
Subject(s)
Hiccup/etiology , Kidney Transplantation/adverse effects , Adult , Anesthetics/administration & dosage , Anesthetics/adverse effects , Cadaver , Esophagitis/complications , Esophagitis/etiology , Humans , Male , Methicillin Resistance , Pleuropneumonia/complications , Pleuropneumonia/microbiology , Pneumonia, Staphylococcal/complications , Pneumonia, Staphylococcal/microbiology , Staphylococcus aureus/drug effects , Steroids/administration & dosage , Steroids/adverse effectsABSTRACT
The article discusses diagnostic difficulties in patients with acute abdominal pain. The author adduces data on the frequency of late diagnostics of pleuropneumonia and diaphragmatic pleuritis in patients with abdominal syndrome before admission, and in the admission department of an urgent aid hospital. The analysis of the causes of delayed diagnosis of lung and pleura diseases is exemplified with 2 clinical observations. The article also covers ways of prevention of diagnostic errors in patients with abdominal pain.
Subject(s)
Abdominal Pain/diagnosis , Pleurisy/diagnosis , Pleuropneumonia/diagnosis , Abdominal Pain/etiology , Acute Disease , Adult , Diagnosis, Differential , Diagnostic Errors , Fatal Outcome , Female , Humans , Male , Middle Aged , Pleurisy/complications , Pleuropneumonia/complications , SyndromeABSTRACT
Hyperimmunoglobulin-E syndrome (HIES) is a rare immunodeficiency disorder that is characterized by elevated serum concentration of IgE, eosinophilia and severe, recurrent bacterial and fungal infections. Poor regulation of immune system is evident, with decreased production of cytokines, especially interferon. Production of specific antibodies to capsular polysaccharide antigens is decreased Skeletal malformations have been reported in these patients. They can be caused by excessive production of interleukin-4, which may lead to pathologic bony tissue resorption. Due to immune system deficiency and malformations of skeletal and connective tissue, HIES is a multisystem disorder. We present a patient with recurrent bacterial infections since the early age. At the age of two years he presented with severe destructive staphylococcal pneumonia with pleural effusion, pneumatocela formation and pneumothorax. The patient also had a dysmorphic face and skeletal malformations that were most evident at the head. The diagnosis of HIES was made on the basis of elevated serum concentrations of IgE, hypereosinophily, and decreased leukocyte function in vivo and in vitro. Family history of our patient showed an autosomal-dominant inheritance pattern of HIES.
Subject(s)
Job Syndrome/complications , Pleuropneumonia/complications , Staphylococcal Infections/complications , Child, Preschool , Humans , Job Syndrome/diagnosis , MaleABSTRACT
A 7-year-old Thoroughbred gelding was admitted to Equine Hospital, Korea Racing Association for evaluation and treatment of colic. Based on the size and duration of the large colonic and cecal impaction, a routine ventral midline celiotomy and large colon enterotomy were performed to relieve the impaction. Six days following surgery the gelding exhibited signs of lethargy, fever, inappetence and diarrhea. Eleven days following surgery, the jugular veins showed a marked thrombophlebitis. On the sixteenth day of hospitalization the gelding died suddenly. Upon physical examination, the horse was febrile, tachycardic and tachypnoeic. Thoracic excursion appeared to be increased; however, no abnormal lung sounds were detected. No cough or nasal discharge was present. Hematology revealed neutrophilic leukocytosis. Serum biochemistry was normal but plasma fibrinogen increased. In necropsy, fibrinopurulent fluid was present in the thoracic cavity. There were firm adhesions between visceral pleura and thoracic wall. White, mixed and red thrombi were formed in both jugular veins from the insertion point of IV catheter. Histopathological examination showed fibrinopurulent inflammation and vascular thrombosis in the lung. The pleura showed edematous thickening and severe congestion. The clinicopathological and pathological findings suggest that septic thrombi associated with septic thrombophlebitis metastasized into the pulmonary circulation and were entrapped in the pulmonary parenchyma and provoked pleuropneumonia.
Subject(s)
Colic/surgery , Horse Diseases/pathology , Pleuropneumonia/veterinary , Postoperative Complications/veterinary , Thrombophlebitis/veterinary , Animals , Fatal Outcome , Histocytochemistry , Horses , Male , Pleuropneumonia/complications , Pleuropneumonia/pathology , Postoperative Complications/pathology , Sepsis/complications , Sepsis/pathology , Sepsis/veterinary , Thrombophlebitis/complications , Thrombophlebitis/pathologyABSTRACT
A 7-year-old Thoroughbred gelding was admitted to Equine Hospital, Korea Racing Association for evaluation and treatment of colic. Based on the size and duration of the large colonic and cecal impaction, a routine ventral midline celiotomy and large colon enterotomy were performed to relieve the impaction. Six days following surgery the gelding exhibited signs of lethargy, fever, inappetence and diarrhea. Eleven days following surgery, the jugular veins showed a marked thrombophlebitis. On the sixteenth day of hospitalization the gelding died suddenly. Upon physical examination, the horse was febrile, tachycardic and tachypnoeic. Thoracic excursion appeared to be increased; however, no abnormal lung sounds were detected. No cough or nasal discharge was present. Hematology revealed neutrophilic leukocytosis. Serum biochemistry was normal but plasma fibrinogen increased. In necropsy, fibrinopurulent fluid was present in the thoracic cavity. There were firm adhesions between visceral pleura and thoracic wall. White, mixed and red thrombi were formed in both jugular veins from the insertion point of IV catheter. Histopathological examination showed fibrinopurulent inflammation and vascular thrombosis in the lung. The pleura showed edematous thickening and severe congestion. The clinicopathological and pathological findings suggest that septic thrombi associated with septic thrombophlebitis metastasized into the pulmonary circulation and were entrapped in the pulmonary parenchyma and provoked pleuropneumonia.
Subject(s)
Animals , Male , Colic/surgery , Fatal Outcome , Histocytochemistry , Horse Diseases/pathology , Horses , Pleuropneumonia/complications , Postoperative Complications/pathology , Sepsis/complications , Thrombophlebitis/complicationsABSTRACT
The paper describes one acute toxic hepatitis event in a woman of 60 with pleuropneumonia and exudative pleurisy. She had been treated with ethacizinum in small dose. To solve the problem, antioxidant and drug with hepato protective action should be prescribed along with ethacizinum.