Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Medicine (Baltimore) ; 100(20): e25973, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011084

RESUMO

INTRODUCTION: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is less commonly used in nonmalignant diseases. In particular, its application in mediastinal cystic lesions has been reported less frequently. EBUS-TBNA is a reassuringly safe procedure with an overall complication rate less than 2%, and serious adverse event rate of 0.14% to 0.16%. The most common complications are infections (mediastinal cyst infection most seen). PATIENT CONCERNS: A 28-year-old male presented to the hospital with mediastinal cyst that was incidentally discovered by computed tomography. There was no past history of the patient reviewed. DIAGNOSIS: The cyst was identified as a round, anechoic structure by EBUS and serous fluid was aspirated. The carcino-embryonic antigen, mycobacterium tuberculosis DNA and cultures in the fluid were negative. Cytology analysis showed lots of lymphocytes and no malignant cells. The diagnosis of lymphangioma was confirmed based on the computed tomography and EBUS presentation, the nature of the aspirated fluid and the large number of mature lymphocytes within the cystic fluid. INTERVENTIONS: Twenty-six hours after EBUS-TBNA, the patient complained of a fever with the highest temperature of 39°C, accompanied by a right-side chest pain, no other symptoms of were reported. The following examinations confirmed the diagnosis of pneumonia, pleurisy, mediastinitis and mediastinal cyst infection, while cultures from cyst and right pleural effusion were both negative. The patient was treated with Teicoplanin+Imipenem/cilastatin, and ultrasound guided transcutaneous catheterization drainage of mediastinal cyst and pleural effusion were performed. OUTCOMES: Seven days after the treatments, the patient's symptoms resolved, the complete blood count, C-reactive protein, erythrocyte sedimentation rate were lowered. The size of the cyst was slightly reduced on 17 June compared to that before EBUS-TBNA. Although the surgical resection of the cyst was recommended, the patient declined. After extracted the two drainage tubes, the patient was discharged on June 22. The patient was followed up by telephone 6 months after discharge and he remained asymptomatic. CONCLUSIONS: EBUS-TBNA is a useful diagnostic and therapeutic tool for the management of mediastinal cysts. However, considering the possibility of serious complications, the clinical procedure should be carried out scrupulously with appropriate patient selection and strict aseptic principles.


Assuntos
Broncoscopia/efeitos adversos , Cisto Mediastínico/cirurgia , Mediastinite/etiologia , Pleurisia/etiologia , Pneumonia/etiologia , Infecção da Ferida Cirúrgica/etiologia , Adulto , Antibacterianos/uso terapêutico , Broncoscopia/métodos , Terapia Combinada , Drenagem , Quimioterapia Combinada , Endossonografia , Humanos , Achados Incidentais , Masculino , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/microbiologia , Mediastinite/diagnóstico , Mediastinite/terapia , Pleurisia/diagnóstico , Pleurisia/terapia , Pneumonia/diagnóstico , Pneumonia/terapia , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
3.
Pediatr Emerg Care ; 32(12): 868-871, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27902675

RESUMO

A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. The patient underwent surgical decompression and attempted removal of the cystic structure revealing that the cyst originated from the epicardium. His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst. Emergency department physicians must maintain a broad differential in patients with symptoms of acute abdomen to prevent complications from serious cardiac or pulmonary diseases that present with symptoms of referred abdominal pain.


Assuntos
Abdome Agudo/etiologia , Abdome Agudo/microbiologia , Descompressão Cirúrgica/métodos , Infecções por Bactérias Gram-Positivas/diagnóstico , Cisto Mediastínico/congênito , Cisto Mediastínico/diagnóstico por imagem , Abdome Agudo/diagnóstico , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Pré-Escolar , Diagnóstico Diferencial , Ecocardiografia , Serviço Hospitalar de Emergência , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Masculino , Cisto Mediastínico/microbiologia , Cisto Mediastínico/cirurgia , Propionibacterium acnes/isolamento & purificação , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
Tex Heart Inst J ; 41(4): 401-6, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25120393

RESUMO

Nontyphoidal Salmonella, especially Salmonella enterica, is a rare cause of endocarditis and pericarditis that carries a high mortality rate. Proposed predisposing conditions include immunodeficiency states, congenital heart defects, and cardiac valve diseases. We present 2 cases of cardiovascular salmonellosis. The first case is that of a 73-year-old woman with mechanical mitral and bioprosthetic aortic valves who died from sequelae of nontyphoidal Salmonella mitral valve vegetation, aortic valve abscess, and sepsis. The second case is that of a 62-year-old man with a recent systemic lupus erythematosus exacerbation treated with oral steroids, who presented with obstructive features of tamponade and sepsis secondary to a large S. enteritidis purulent pericardial cyst. He recovered after emergent pericardial drainage and antibiotic therapy. Identifying patients at risk of cardiovascular salmonellosis is important for early diagnosis and treatment to minimize sequelae and death. We reviewed the literature to identify the predisposing risk factors of nontyphoidal Salmonella cardiac infection.


Assuntos
Tamponamento Cardíaco/microbiologia , Endocardite Bacteriana/microbiologia , Cisto Mediastínico/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções por Salmonella/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/imunologia , Tamponamento Cardíaco/terapia , Drenagem , Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/imunologia , Endocardite Bacteriana/terapia , Evolução Fatal , Feminino , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/instrumentação , Humanos , Hospedeiro Imunocomprometido , Imageamento por Ressonância Magnética , Masculino , Cisto Mediastínico/diagnóstico , Cisto Mediastínico/imunologia , Cisto Mediastínico/terapia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/imunologia , Infecções Relacionadas à Prótese/terapia , Fatores de Risco , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/imunologia , Infecções por Salmonella/terapia , Sepse/microbiologia , Resultado do Tratamento , Infecções Urinárias/microbiologia , Adulto Jovem
6.
Thorac Cardiovasc Surg ; 60(3): 239-41, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21409750

RESUMO

Bronchogenic cysts are an uncommon congenital malformation deriving from the primitive foregut. They are mainly unilocular, and respiratory distress is the most common presentation in pediatric patients. We describe the case of a 12-year-old girl with a huge infected mediastinal bronchogenic cyst which was resected via an axillary muscle-sparing thoracotomy.


Assuntos
Cisto Broncogênico/microbiologia , Cisto Mediastínico/microbiologia , Infecções Respiratórias/microbiologia , Antibacterianos/uso terapêutico , Cisto Broncogênico/diagnóstico , Cisto Broncogênico/terapia , Broncoscopia , Criança , Feminino , Humanos , Cisto Mediastínico/diagnóstico , Cisto Mediastínico/terapia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/terapia , Toracotomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
7.
Ann Card Anaesth ; 11(2): 116-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18603752

RESUMO

Patient with a mediastinal mass may be diagnosed incidentally or following evaluation for the symptoms due to compressive effects on the adjoining structures. Pericardial cysts account to 6% of mediastinal masses. Echocardiography, computerised tomography and magnetic resonance imaging aid in accurate diagnosis and localization of these cysts. Anaesthesia for patients with these cysts may occasionally turn out to be catastrophic during induction or in postoperative period. Surgery is the preferred choice of treatment in these patients.


Assuntos
Cisto Mediastínico/diagnóstico , Cisto Mediastínico/microbiologia , Tuberculose/diagnóstico , Adolescente , Anestesia/métodos , Ecocardiografia , Humanos , Imageamento por Ressonância Magnética , Masculino , Cisto Mediastínico/cirurgia , Tomografia Computadorizada por Raios X , Tuberculose/cirurgia
8.
Pediatr Infect Dis J ; 25(7): 649-51, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16804440

RESUMO

Airway obstruction associated with Pott's disease is rare. We present a case of severe airway obstruction caused by an extensive paravertebral mediastinal abscess in a 3-year-old boy with tuberculosis of the thoracic spine.


Assuntos
Obstrução das Vias Respiratórias/complicações , Tuberculose da Coluna Vertebral/complicações , Pré-Escolar , Humanos , Masculino , Cisto Mediastínico/microbiologia , Cisto Mediastínico/cirurgia
10.
Eur J Cardiothorac Surg ; 22(4): 599-601, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12297179

RESUMO

Hydatid disease remains a serious health problem for the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. Hydatid cysts are usually located in the liver, lung, and brain. Mediastinal hydatid disease is very rare that have been only anecdotally in the literature. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. Between 1985 and 2002, 11 cases with primary mediastinal hydatid cyst were treated surgically at our clinic. Median age was 28.4 and ranged from 19 to 46 years. Symptoms included chest pain in nine patients (82%), and cough in six patients (54%). The cyst was located in the anterior mediastinum in four patients (36%), in the posterior mediastinum in five patients (45%) and in the middle mediastinum in two patients (18%). All cysts were intact except one cyst that ruptured into right intrapleural space. Surgical approach was right thoracotomy in five patients (45%), left thoracotomy in three patients (27%), and median sternotomy in three patients (27%). Total pericystectomy was chosen as the surgical procedure in all patients except four (36%), who had cystectomy and local curettage for cyst located vital structures. There were no complications and mortality postoperatively. Primary hydatid cysts of the mediastinum are distinct clinical entity that must be considered when caring for a patient with a mediastinal mass in endemic regions. Because of surrounding vital structures the cyst should be treated without delay.


Assuntos
Equinococose/cirurgia , Echinococcus , Cisto Mediastínico/microbiologia , Adulto , Animais , Broncoscopia , Equinococose/diagnóstico , Equinococose/diagnóstico por imagem , Ecocardiografia , Esofagoscopia , Feminino , Humanos , Cisto Mediastínico/cirurgia , Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Toracotomia , Tomografia Computadorizada por Raios X , Turquia
13.
Ann Thorac Surg ; 66(1): 187-92, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9692462

RESUMO

BACKGROUND: The use of video-assisted thoracic surgery for diagnosis and treatment of mediastinal tumors in a multiinstitution patient population is not well understood. METHODS: We studied 48 cases from Cancer and Leukemia Group B thoracic surgeons. Of 21 men and 27 women, aged 41 +/- 16 years, 22 patients were asymptomatic. In the others, 92% of tumor-related symptoms improved or resolved after treatment. Five tumors involved the anterior compartment, 19 the middle, and 24 the posterior compartment. Diagnoses were typical for each compartment but also included uncommon problems such as superior vena cava hemangioma and a histoplasmosis cyst causing hoarseness. Of the lesions, a biopsy of 12 was done without excision and the rest were excised completely. Fifteen were cystic and 10 were malignant (8 biopsy only). Maximal dimensions were 5.2 +/- 3.3 cm. RESULTS: Operations were briefer for 24 posterior (93 +/- 41 min) than 5 anterior (195 +/- 46 min, p < 0.01) or 19 middle mediastinal tumors (170 +/- 78 min, p < 0.01). Although 96% had vital mediastinal relations, only six open conversions were performed because of bleeding (n = 3), large size, impaired exposure, or rib attachments, and no patient had morbidity beyond that expected for the thoracotomy. Postoperative stay was shorter for the nonconversion group (3.2 +/- 2.8 versus 5.5 +/- 2.1 days, p = 0.05), as was chest tube duration (1.7 +/- 1.4 days versus 3.2 +/- 1.9 days, p = 0.03). There were no postoperative deaths or major complications, but 7 patients had minor complications. During a mean of 20 months of surveillance (range, 1 to 52 months), one cyst recurred (asymptomatic) as did one sarcoma that was excised. CONCLUSIONS: Video-assisted thoracic surgery is a safe technique for benign mediastinal tumors, typically those in the middle and posterior mediastinum.


Assuntos
Endoscopia , Neoplasias do Mediastino/diagnóstico , Toracoscopia , Toracotomia/métodos , Adulto , Biópsia , Perda Sanguínea Cirúrgica , Tubos Torácicos , Endoscopia/efeitos adversos , Endoscopia/métodos , Feminino , Seguimentos , Hemangioma/diagnóstico , Hemangioma/cirurgia , Histoplasmose/diagnóstico , Histoplasmose/cirurgia , Rouquidão/etiologia , Humanos , Tempo de Internação , Masculino , Cisto Mediastínico/diagnóstico , Cisto Mediastínico/microbiologia , Cisto Mediastínico/cirurgia , Neoplasias do Mediastino/cirurgia , Recidiva Local de Neoplasia/diagnóstico , Recidiva , Estudos Retrospectivos , Costelas/patologia , Segurança , Sarcoma/diagnóstico , Sarcoma/cirurgia , Toracoscopia/efeitos adversos , Toracoscopia/métodos , Toracotomia/efeitos adversos , Fatores de Tempo , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/cirurgia , Veia Cava Superior/patologia , Gravação em Vídeo
14.
Clin Infect Dis ; 27(2): 353-7, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9709886

RESUMO

We describe a patient who presented with a massive chest-wall abscess after a severe debilitating illness that lasted 3 months. Steroid therapy, administered for 4 weeks, masked the slow development of an extensive axillary and chest-wall abscess. After multiple negative tests, the patient's prolonged illness was diagnosed as cat-scratch disease (CSD). An indirect fluorescent antibody test revealed that two convalescent serum samples were positive for IgG to Bartonella clarridgeiae, but no other Bartonella species. We also review 12 cases of severe chest and pulmonary disease due to CSD that were reported in the English-language literature. Thoracopulmonary findings associated with CSD, pathogenic mechanisms of bartonella infections, diagnostic criteria, and management of CSD are presented.


Assuntos
Abscesso/microbiologia , Bartonella/isolamento & purificação , Doença da Arranhadura de Gato/diagnóstico , Cisto Mediastínico/microbiologia , Adulto , Anticorpos Antibacterianos/análise , Doença da Arranhadura de Gato/fisiopatologia , Humanos , Pneumopatias/microbiologia , Doenças Linfáticas/microbiologia , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...