RESUMO
Endometriosis is defined as the presence of endometrial tissue in extra uterine sites. It affects 5-15% of females during their reproductive years. Thoracic endometriosis syndrome is characterized by the presence of functional endometrial tissue within the pleura, the lung parenchyma or the airway. The overall prevalence of this condition is unknown due to a lack of epidemiological studies, variety of symptoms, signs and locations. We present the first reported case of recurrent catamenial pneumothorax in Puerto Rico and a review of recent literature.
Assuntos
Endometriose/diagnóstico , Doenças Pleurais/diagnóstico , Adulto , Feminino , Humanos , Porto RicoRESUMO
We describe two adult cases of neurologic complications occurring after the administration of the influenza vaccine. The first case described is a 68 year-old man who experienced paresthesias of the upper and lower extremities two weeks after vaccination, and the second case was a 64 year-old female who exhibited paraplegia eighteen days after vaccination. Diagnosis of acute idiopathic demyelinating polyradiculopathy (Guillain-Barré syndrome) was made for both patients, and intravenous gammaglobulin therapy was given with marked improvement of the first case, but poor response on the second case. Although the efficacy of influenza vaccination has been widely accepted, such neurologic complications might occur in the elderly and adult population. Even if Guillain-Barré syndrome was a true side effect of vaccination, the risk is substantially lower than is the risk for complications following influenza. The rare occurrence of neurological complications after influenza vaccine should not discourage against the vaccination.
Assuntos
Síndrome de Guillain-Barré/induzido quimicamente , Vacinas contra Influenza/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Our medical staff identified a case of a forty-six years old Armed Force active duty female that presented with multiple systemic and pulmonary signs and symptoms, such as hemoptysis, arthralgias, chest pain and dyspnea after being exposed to a humid and old wooden building one year ago in the state of Georgia. Various imaging studies (cervical & thoracic x-rays and CT Scans), revealed diffuse small nodules at cervical & thoracic areas, osteolytic lesions and lymphadenopathy. Suspecting a malignant process, a PET-CT Scan was performed revealing a right lung lower lobe nodule consistent with a primary malignancy, metastatic disease, active infectious or inflammatory process. She underwent a CT-guided needle biopsy followed by an open thoracotomy. These results were negative for malignancy and positive for chronic granulomatous inflammatory process. Therefore, special immunologic stains were undertaken revealing a granulomatous process with Histoplasmosis capsulatum. This case was diagnosed in the most unusual manner, given the presenting symptoms and pathological findings which suggested a malignant process, later confirmed by multiple specialized imaging studies and tests. This presumptive diagnosis turned out to be an inflammatory/infectious (fungal) process. We must keep in mind that not all mass lesions encountered by special imaging studies should be considered malignant. This case exemplifies the need of clinicians to exercise strong clinical and critical thinking skills to consider the broad diagnostic possibilities of pulmonary nodules presenting as a malignancy.
Assuntos
Erros de Diagnóstico , Granuloma do Sistema Respiratório/etiologia , Histoplasmose/diagnóstico por imagem , Pneumopatias Fúngicas/diagnóstico por imagem , Militares , Doenças Profissionais/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Nódulo Pulmonar Solitário/etiologia , Tomografia Computadorizada por Raios X , Biópsia por Agulha , Exposição Ambiental , Reações Falso-Positivas , Feminino , Georgia , Granuloma do Sistema Respiratório/diagnóstico por imagem , Granuloma do Sistema Respiratório/patologia , Histoplasma/isolamento & purificação , Histoplasmose/complicações , Histoplasmose/patologia , Humanos , Pneumopatias Fúngicas/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Pessoa de Meia-Idade , Doenças Profissionais/patologia , Osteólise/etiologia , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/patologia , Espondilite/etiologia , ToracotomiaRESUMO
Central Venous Port Catheters are increasingly used in critically ill patients for intravenous treatments and nutrition, and lately, a main focus of oncology patients receiving chemotherapy. Besides all advantages they have also added a new set of challenges. In this case report we describe the acute presentation of a right hemidiaphragm paralysis in an oncology patient with recurrent breast ductal carcinoma as an immediate rare complication of a right subclavian vein catheterization and port insertion.