RESUMEN
Endobronchial Ultrasound (EBUS) with Transbronchial Needle Aspiration (TBNA) is performed with a very low complication rate. We present a unique case of massive life-threatening hemothorax from bronchial artery bleeding after EBUS-TBNA, presenting in a delayed fashion and requiring operative intervention. Although exceedingly rare, along with the unusual delayed timing of the presentation, practitioners should be aware of this complication. It may be helpful to perform EBUS with color doppler examination of the subcarinal space to identify and avoid bronchial arteries prior to TBNA of subcarinal lymph nodes.
Asunto(s)
Arterias Bronquiales , Hemotórax , Biopsia con Aguja Fina , Arterias Bronquiales/diagnóstico por imagen , Broncoscopía , Hemotórax/diagnóstico por imagen , Hemotórax/etiología , Humanos , MediastinoRESUMEN
To address the growing need for new antimicrobial agents, we explored whether inhibition of bacterial signaling machinery could inhibit bacterial growth. Because bacteria rely on two-component signaling systems to respond to environmental changes, and because these systems are both highly conserved and mediated by histidine kinases, inhibiting histidine kinases may provide broad spectrum antimicrobial activity. The histidine kinase ATP binding domain is conserved with the ATPase domain of eukaryotic Hsp90 molecular chaperones. To find a chemical scaffold for compounds that target histidine kinases, we leveraged this conservation. We screened ATP competitive Hsp90 inhibitors against CckA, an essential histidine kinase in Caulobacter crescentus that controls cell growth, and showed that the diaryl pyrazole is a promising scaffold for histidine kinase inhibition. We synthesized a panel of derivatives and found that they inhibit the histidine kinases C. crescentus CckA and Salmonella PhoQ but not C. crescentus DivJ; and they inhibit bacterial growth in both Gram-negative and Gram-positive bacterial strains.
