Hemoptysis and pulmonary cavitation in a 37-year-old man
Article Abstract:
A case is described of a 37-year-old man with hemoptysis, the spitting up of blood from the respiratory tract, and pulmonary cavitation, the formation of a cavity in the lungs. A year and three months before admission, the man had developed mild hemoptysis, and a chest X-ray revealed the presence of cavities in his lungs. A year later, the hemoptysis worsened and he developed a right-sided chest pain. The man had no history of asthma, tuberculosis, or pneumonia, but smoked two packages of cigarettes daily for 20 years. His work exposed him to extensive soil contact. Abnormal physical and laboratory findings included breath sounds in the right upper lung lobe; mild clubbing of the fingers; mild breathing defect; and lung abnormalities, including cavities in the upper lobes; thickening of lung tissue near the cavitary lesions; and accumulations of cells in the lungs. The patient had no evidence of bacterial infection of the lungs. Cavities may result from lung cancer or infections by mycobacteria, fungi, or bacteria. Based on the results from microbiological cultures, the patient was diagnosed with infection with the fungus Sporothrix schenckii, also known as Sporotrichum schenckii. This fungus grows as a mold at room temperature and as a yeast at higher temperatures, and can be found in the soil and vegetation in temperate and subtropical regions. The most common form of sporotrichosis, or infection with Sporotrichum, is skin infection, which may spread to other body sites via the lymphatic system, the circulation, or respiratory tract. There have been 70 cases of pulmonary sporotrichosis reported, mainly in men. Risk factors include alcoholism or chronic obstructive pulmonary disease. Pulmonary sporotrichosis is characterized by the formation of thin-walled cavities in the top portions of the lung lobes. This disease is treated by surgical removal of the affected tissue or antifungal agents, such as amphotericin B. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Mechanical ventilation in patients with acute severe asthma
Article Abstract:
Asthma causes extensive disease and death in the United States and is the cause of over one million visits to hospital emergency rooms each year. In 1983, 459,000 persons were hospitalized and 3,440 persons died from asthma. The rates of hospitalization due to asthma continue to increase. Mechanical ventilation, artificial assistance for breathing using specialized machines, is an important and effective method for support and treatment of patients with severe asthma and respiratory failure. However, the use of mechanical ventilation in these severely ill patients is also associated with serious hazards and a death rate of up to 38 percent. In addition, complications of mechanical ventilation may lead to extensive disease. However, few studies have documented these effects in asthmatic patients. In this study, medical records of patients requiring mechanical ventilation for acute asthma between 1980 and 1988 were reviewed. Mechanical ventilation was required for 32 episodes of asthma in 27 patients, and was associated with a death rate of 22 percent; 76 complications also occurred. The average time of artificial ventilation was 114 hours for patients who did not survive the asthma attack, and 77 hours for survivors. The results show that mechanical ventilation of critically ill asthmatic patients may be associated with extensive disease and a high death rate. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Use of intracavitary amphotericin B in a patient with aspergilloma and recurrent hemoptysis
Article Abstract:
Pulmonary aspergilloma, infection of the lung by the fungus Aspergillus, tends to develop in abnormal cavities within the lung tissue. These lung cavities may form after infection with Mycobacterium tuberculosis (TB or tuberculosis), or sarcoidosis (widespread development of granular lesions). Aspergilloma is complicated by hemoptysis, the spitting up of blood from the respiratory tract, which is very difficult to control. A case is described of a 29-year-old man with tuberculosis who developed pulmonary aspergilloma with hemoptysis. He was treated with steroids, but the hemoptysis persisted. The patient was not considered a suitable candidate for surgical treatment because of his underlying lung disease and impaired lung function. The patient could not tolerate intravenously administered amphotericin B (a drug used to cure fungus infections). However, when amphotericin B was administered directly into the lung cavities (intracavitary administration), the hemoptysis completely resolved. Various other studies have reported the use of amphotericin B and other antifungal drugs administered directly into the lung. This case shows the difficulty in controlling hemoptysis associated with aspergilloma, and the benefits of intracavitary amphotericin B in treating this condition. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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