Necrotizing Pneumonia: A Rare Outcome of a Rare Complication.

Necrotizing pneumonia is a rare complication of community-acquired pneumonia, characterized by lung parenchymal destruction in affected areas. It has been sporadically documented over the years, mostly with insidious progression and a higher incidence among individuals with risk factors. Its diagnosis relies on clinical, analytical, and imaging data, and the treatment encompasses medical and surgical measures. The persistently high morbidity and mortality result from delayed diagnosis and the intricate therapeutic approach. In this report, the authors describe an unusual case of necrotizing pneumonia in a patient without risk factors.

An Unexpected Complication: Obstructive Shock Secondary to Venous Air Embolism.

Air embolism is a rare but possibly life-threatening situation. Gas embolism can be arterial, occurring as a complication of a lung biopsy, arterial catheterization, or extracorporeal circulation in the context of cardiopulmonary bypass, or venous, as in cases of venous catheter manipulation (especially with a central venous catheter in a spontaneously breathing patient), pressurized venous infusions, or in a neurosurgical context. Various clinical manifestations are described in the literature, ranging from asymptomatic cases to obstructive shock. Clinical manifestations may include chest pain, dyspnea, nausea and vomiting, altered consciousness, focal neurological deficits, seizures, vertigo, and amaurosis. Physical examination findings may include hypotension and "mill wheel murmur" on chest auscultation. Early diagnosis and treatment are essential to improve the outcome of these patients. Approach and management include placing the patient in the left lateral decubitus and/or Trendelenburg position and on high-flow oxygen. Hyperbaric oxygen therapy is the definitive treatment for arterial gas embolism, which may reduce air emboli size, improve tissue oxygenation, and reduce ischemic lesion. Here, we report the case of a 62-year-old female patient with obesity, hypertension, dyslipidemia, and recovering from coronavirus disease 2019 (COVID-19) with obstructive shock due to venous gas embolism.

Infectious Pyomyositis With Intramuscular Abscess in a Healthy Adult.

Pyomyositis is an uncommon bacterial infection of the skeletal muscle, with most cases presenting with an intramuscular abscess. Although it is more frequent in tropical regions, it can also occur in temperate regions, essentially in adult males with comorbidities. We report a case of an adult male with an intramuscular abscess and demonstrate the importance of meticulous clinical examination and imaging examinations in obtaining a diagnosis for pathologies with nonspecific clinical manifestations.