• Title/Summary/Keyword: Interstitial Lung Disease

Search Result 208, Processing Time 0.021 seconds

Treatment of Multidrug-Resistant Acinetobacter baumannii Pneumonia after Glucocorticoids Administration for Interstitial Lung Disease: A Case Report (사례 보고: 간질성 폐질환 치료를 위한 glucocorticoids 투여 환자에게 발생한 다제 내성 Acinetobacter baumannii 폐렴의 치료)

  • Kim, Hae-Sook;Shin, Hyun-Taek;Kim, Hyun-Ah
    • Korean Journal of Clinical Pharmacy
    • /
    • v.22 no.2
    • /
    • pp.181-186
    • /
    • 2012
  • Objective: To report a fatal case of Multidrug-resistant Acinetobacter baumannii (MDR-AB) in a patient with interstitial lung disease (ILD) on high-dose glucocorticoids. Case Summary: A 66-year-old man with a history of coniosis was transferred to the hospital with progressive cough and sputum production. This patient has been diagnosed with pneumonia and ILD on admission, requires antimicrobial therapy and systemic immunosuppressants. He received high dose of methylprednisolone and cyclophosphamide for ILD as well as ceftriaxone and azithromycin for pneumonia. On day 7 in the intensive care units (ICUs), patient had fever and leukocytosis, thus antimicrobials were switched to piperacillin. After 13 days in the ICU, Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA) were isolated on transtracheal aspirate (TTA) and meropenem was initiated. However, it was revealed a multidrug-resistant Acinetobacter baumannii (MDR-AB) species, resistant to carbapenem. Patient was administered colistin but expired due to septic shock on day 84. Discussion: Systemic immunosuppressive therapy can result in infections that may compromise patient's survival. MDR-AB has emerged as a serious cause of nosocomial infections in immunocompromised patients. MDR-AB is resistant to most standard antimicrobials and therapeutic options are limited. Conclusion: We report our recent experience with a fatal MDR-AB pneumonia in a patient with ILD, who had to be treated with high dose glucocorticoids and immunosuppressnts.

A case of Nonspecific Interstitial Pneumonitis Mimicking Pneumoncystis carinii Pneumonia in HIV-Positive Patient (AIDS 환자에서 뉴모시스티스 카리니 폐렴(P. carinii pneumonia)과 유사한 소견을 보인 비특이적 간질성 폐렴(Nonspecific interstitial pneumonitis) 1예)

  • Lee, Sang-Yeub;Oh,, Yu-Whan;Kim, Han-Kyeom;Shin, Bong-Kyung;Park, Sang-Myun;Lee, Sin-Hyung;Shin, Chol;Shim, Jae-Jeong;Cho, Jae-Youn;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.47 no.6
    • /
    • pp.843-849
    • /
    • 1999
  • The prevalence of nonspecific interstitial pneumonitis(NSIP) in HIV-positive patients with pulmonary disease has varied from 11 to 38%. But NSIP in HIV-positive patients is indistinguishable from Pneumocystis carinii pneumonia(PCP) clinically and radiologically. The number of HIV-positive patients is less in Korea than in western developed countries, so little attention has been paid to the differential diagnosis between NSIP and PCP. We report a case of NSIP in HIV-positive, 61-year-old man which mimicked PCP. He presented with cough, sputum and mild exertional dyspnea. Lung sound was clear. But, chest X-ray and HRCT demonstrated diffuse patch and bilateral ground-glass opacities in central and perihilar area of both lung. Microbial pathogens were not found on sputum, BAL fluid and tissues taken by TBLB. In transbronchial lung biopsy specimen, interstitial infiltrates with lymphocytes were distributed on peribronchiolar regions. A pathologic diagnosis of NSIP was suggested, he received symptomatic treatment. The follow-up chest X-ray showed near complete resolution.

  • PDF

Clinical, virological, imaging and pathological findings in a SARS CoV-2 antibody positive cat

  • Ozer, Kursat;Yilmaz, Aysun;Carossino, Mariano;Ozturk, Gulay Yuzbasioglu;Bamac, Ozge Erdogan;Tali, Hasan E.;Mahzunlar, Egemen;Cizmecigil, Utku Y.;Aydin, Ozge;Tali, Hamid B.;Yilmaz, Semaha G.;Mutlu, Zihni;Kekec, Ayse Ilgin;Turan, Nuri;Gurel, Aydin;Balasuriya, Udeni;Iqbal, Munir;Richt, Juergen A.;Yilmaz, Huseyin
    • Journal of Veterinary Science
    • /
    • v.23 no.4
    • /
    • pp.52.1-52.7
    • /
    • 2022
  • This paper reports a presumptive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a cat. A cat with respiratory disease living with three individuals with coronavirus disease 2019 showed bilateral ground-glass opacities in the lung on X-ray and computed tomography. The clinical swabs were negative for SARS-CoV-2 RNA, but the serum was positive for SARS-CoV-2 antibodies. Interstitial pneumonia and prominent type 2 pneumocyte hyperplasia were noted on histopathology. Respiratory tissues were negative for SARS-CoV-2 RNA or antigen, but the cat was positive for feline parvovirus DNA. In conclusion, the respiratory disease and associated pathology in this cat could have been due to exposure to SARS-CoV-2.

Pulmonary Alveolar Proteinosis - A Case Report with Diagnostic Features in Bronchoalveolar Lavage Specimen - (폐포 단백증의 세포학적 소견 - 1예 보고 -)

  • Ha, Seung-Yeon;Cho, Hyun-I;Oh, Young-Ha
    • The Korean Journal of Cytopathology
    • /
    • v.11 no.2
    • /
    • pp.103-108
    • /
    • 2000
  • Pulmonary alveolar proteinosis(PAP) is a rare disease in which the alveolar spaces are filled with an eosinophilic, PAS-positive material, whereas the interstitial architecture of the lung usually remains unaffected. Although a definitive diagnosis is usually made by an open lung biopsy, bronchoalveolar lavage(BAL) cytology may play a decisive role in the diagnosis and therapy of these patients and may spare a patient a more invasive diagnostic procedure. The author presents a patient in whom BAL cytology specimen contained the characteristic globules of amorphous proteinaceous PAS-positive material accompanied by background of rare macrophages and inflammatory cells. Ultrastructural study using BAL specimen can confirm the diagnosis of PAP.

  • PDF

Review of Respiratory Disorders in terms of Insurance (주요 호흡기질환의 보험의학적 이해)

  • Lee, Sinhyung
    • The Journal of the Korean life insurance medical association
    • /
    • v.32 no.2
    • /
    • pp.39-49
    • /
    • 2013
  • The textbook of insurance medicine is very bulky volume and it's revision time may be long. Nowadays medical knowledge and evidences are developing rapidly. It is necessary to revise current insurance risk of certain disease. Review of respiratory diseases in terms of insurance medicine may be valuable information for insurance doctors and life underwriters. Newly estimated mortality ratio and excess death rate of several respiratory diseases in this review are organizing pneumonia, 266%/44‰; multi-drug resistant tuberculosis, 1200%/110‰; idiopathic interstitial pneumonia, 869%/85‰; VATS lobectomy of stage I lung cancer, 550%/33‰; lymphangioleiomyomatosis 9826%/66‰; lung transplantation 2026%/92‰, respectively.

  • PDF

Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis

  • Jong Eun Lee;Won Gi Jeong;Hyo-Jae Lee;Yun-Hyeon Kim;Kum Ju Chae;Yeon Joo Jeong
    • Korean Journal of Radiology
    • /
    • v.23 no.10
    • /
    • pp.998-1008
    • /
    • 2022
  • Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan-Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02-6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion: Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

The Etiology of the Diffuse Infiltrative Disease of the Lung in Korea (한국에서의 미만성 침윤성 폐질환의 원인별 분포)

  • Kim, J.H.;Choi, S.J.;Kim, D.S.;You, J.H.;Kang, H.M.;You, S.H.;Jo, D.I.;Kim, J.W.;Han, S.K.;Kim, K.Y.;Kim, Y.S.;Park, C.S.;Kim, W.S.;Kim, W.D.;Jang, J.;Lee, W.Y.;Choi, B.H.;Hue, S.H.;Shin, D.H.;Lee, J.H.
    • Tuberculosis and Respiratory Diseases
    • /
    • v.38 no.1
    • /
    • pp.1-7
    • /
    • 1991
  • To study the frequency of the underlying disease of the diffuse pulmonary infiltrates in korea, we ansalyzed retrospectively 982 patients who were seen at nine university hospitals and one general hospital in Seoul area. The results are folloing: 1) Among the total 982 patients, 490 patients were male and 492 patients were female. The mean age was 44.3 years. 2) The most common etiology was milliary tuberculosis (38%), which was followed by, idopathic pulmonary fibrosis (27%), pulmonary fibrosis associated with collagen-vascular disease (15%), and diffuse pulmonary infiltrates by malignancy (10%). 3) Amon the connective tissue disease which was accompanied by the interstitial lung disease, rheumatoid arthritis was the most common disease (43%), systemic lupus erythematosus was the 2nd (28%), and progressive systemic sclerosis was the 3re (16%). 4) Among 101 cases of malignant disease, lung was the most frequent primary site (31%), which was followed by stomach (28%), thyroid (16%), and breast (6%). 5) For the diagnosis of the underlying disease of pulmonary infiltrates, the transbronchial lung biopsy was performed in 21% of the patients and open lung biopsy was done in 7%.

  • PDF

Acute Respiratory Failure Developed in Non-small Cell Lung Cancer Patients Treated With Gefitinib (비소세포 폐암환자에서 Gefitinib 투여 중 발생한 급성호흡부전)

  • Ryu, Jeong-Seon;Kim, Lucia;Kim, Chul-Hyun;Kim, Hyun-Jung;Cho, Jae-Hwa;Kwak, Seung-Min;Lee, Hong-Lyeol
    • Tuberculosis and Respiratory Diseases
    • /
    • v.62 no.2
    • /
    • pp.144-148
    • /
    • 2007
  • Gefitinib is an oral selective inhibitor that targets the tyrosine kinase of the epidermal growth factor receptor. The prevalence of interstitial lung disease is 2% in Japan and 0.3% in the USA with a mortality rate of up to one third. We describe two non-small cell lung cancer patients who developed acute respiratory failure after gefitinib, and suggest that clinicians take extreme caution when deciding to treat patients with gefitinib.

Successful Rechallenge with Imatinib in a Patient with Chronic Myeloid Leukemia Who Previously Experienced Imatinib Mesylate Induced Pneumonitis

  • Go, Seong Woo;Kim, Boo Kyeong;Lee, Sung Hak;Kim, Tae-Jung;Huh, Joo Yeon;Lee, Jong Min;Hah, Jick Hwan;Kim, Dong Whi;Cho, Min Jung;Kim, Tae Wan;Kang, Ji Young
    • Tuberculosis and Respiratory Diseases
    • /
    • v.75 no.6
    • /
    • pp.256-259
    • /
    • 2013
  • Imatinib mesylate is a targeted therapy that acts by inhibiting tyrosine kinase of the bcr-abl fusion oncoprotein, which is specific to chronic myeloid leukemia (CML), and the c-transmembrane receptor, which is specific to gastrointestinal stromal tumors. Interstitial pneumonitis is a rare adverse event of imatinib therapy. It is clinically difficult to distinguish from infectious pneumonia, which can frequently occur due to the underlying disease. The standard treatment for imatinib-induced pneumonitis is to discontinue the medication and optionally administer corticosteroids. However, there are a few cases of successful retrial with imatinib. We describe a case of successful rechallenge of imatinib in a patient with imatinib-induced interstitial pneumonitis and CML without a recurrence of the underlying disease after 3 months of follow-up.

Clinical Evaluation of Video-Assisted Thoracic Surgery (VATS) (비디오 흉강경 수술의 임상적 고찰)

  • 원경준;최덕영
    • Journal of Chest Surgery
    • /
    • v.29 no.10
    • /
    • pp.1133-1137
    • /
    • 1996
  • From September 1994 to October 1995, we are reporting clinical results of 67 patients whom underwent video-assisted trio rabic surgery(VATS). 1. They were diagnosed as spontaneous pneumothorax In )5, diffuse interstitial lung disease in 9, empyema in 7, hemothorax in 5, malignant pleural effusion in 3, hyperhidrosis in 3, foreign body in chest cavity in 2, mesothelioma in 1, miliary tuberculosis in 1 and organizing pneumonia in 12. In pneumothorax, bullectomy in 33 and open bellectoiny in 2 due to pleural adhesion was done Hemostasis in 5, irrigation in 7, foreign body removal in 2, talcum powder insufrlation in 3, sympathectomy 3 as done. Thoracoscopic biopsy watt done In 12 3. For pneumothorax, operation was indicated as recurrent pneumothorax in 18, persistent air leak in 12, visible bullae In chest X-ray in 5. 4 Thoracoscopic biopsy was done in 12. They were interstitial pulmonary fibrosis in 9, miliary tuberculosis in 1, mesothelioma in 1, and organizing pneumonia in 1 .Among interstitial pulmonary fibrosis, usual interstitial pneumonia were 2 and diffuse interstitial pneumonia were 7. 5. Wo complication was found in 6) patients among 67 patients. The complication was found in 4 patients (2 persistent air leak, 2 contralateral lung atelectasis). We concluded that VATS was safe and beneficial in reducing postoperative complication and the role of thoracic surgery will increase markefdly.

  • PDF