Respirology Case Reorts

Benjamin Earnest Williams, Avinash A Nair, Prince James, Barney Isaac, Richa Gupta, Anand Ashok
DOI: 10.1002/rcr2.1214

In rapid worsening respiratory failure in previously normal orthopaedic surgery or trauma patients, orthopaedic surgeons and clinicians need to be aware of an unknown differential called ‘Fat Embolism related Diffuse Alveolar Haemorrhage’ (FEDAH).

Leslie E Kao, Diane Stover
DOI: 10.1002/rcr2.1223

Radiation recall is an unpredictable, poorly understood inflammatory reaction within the confines of previously irradiated tissue that occurs following exposure to a systemic agent. In this article, we will focus on a subcategory of radiation recall, called radiation recall pneumonitis (RRP) precipitated by immune checkpoint inhibitors (ICI). Up until now, RRP following exposure to ICIs has been described in patients who have received radiation to the lung itself. Here we present three cases of RRP in patients who received radiation to areas adjacent to the lung parenchyma, and developed pulmonary infiltrates in an area adjacent to the radiation field while on ICI therapy. Since ICI induced RRP is treatable and steroid sensitive, early recognition and treatment are important.

Cheuk Cheung Derek Leung, Yiu Cheong Yeung
DOI: 10.1002/rcr2.1229

Organizing pneumonia, a form of interstitial lung disease, may occur in patients who have recovered from COVID-19. In this article, we report three cases of post COVID-19 organizing pneumonia, proven histologically with transbronchial lung biopsies showing fibroblastic plugs in the alveolar spaces. Our patients received a range of 86–166 days of continuous corticosteroid therapy and all of them made excellent recovery.

Citra Cesilia, Elmi Ridar, Hariadi Hatta, Andreas Makmur, FW Wiwit Ade, Heda Melinda Nataprawira
DOI: 10.1002/rcr2.1206

Kasabach-Merritt phenomenon (KMP) is a rare condition that is associated with two rare vascular tumours: Kapossiform haemangioendothelioma (KHE) and tufted angioma (TA). We present the fatal case of a 2-years girl diagnosed with KMP based on clinical, laboratory and imaging findings but died due to spontaneous rebleeding before biopsy could be performed.

Sabrina Ermayanti, Afriani Afriani, Dimas Bayu Firdaus
DOI: 10.1002/rcr2.1210

This case report discusses an illustrative case with elevated procalcitonin levels in a patient with squamous cell carcinoma and multiple metastases. The increase in procalcitonin in patients may be due to an inflammatory state in the tumour microenvironment. Elevated procalcitonin is associated with disease progression, the presence of metastases, and a poor prognosis.

Peter T Bell, James Anderson, Christopher Coulter, Andrew J Dettrick, Andrew Burke, Timothy Baird
DOI: 10.1002/rcr2.1211

In humans, Mycobacterium marinum infections are acquired through direct inoculation of skin wounds and are almost exclusively localized to skin and soft tissues. Pulmonary infection with M. marinum is extremely rare, and to our knowledge, invasive endobronchial disease has not been reported previously. Here, we present a case of a 71-year-old apparently immunocompetent male surfer with invasive endotracheal M. marinum granulomatous disease. The patient was successfully cured with a 12-month regimen of azithromycin 250 mg daily, ethambutol 900 mg daily and rifampicin 600 mg daily.

Sachie Koike, Nobutaka Kobayashi, Masahisa Miyazawa, Naho Yamashita
DOI: 10.1002/rcr2.1215

We present a case of spontaneous hemothorax which was caused by carcinoma of unknown primary. Since it was very rare cause of hemothorax, we had difficulty in deciding the course of treatment.

Siavash Abedi, Masoud Aliyali, Amir-Hassan Bordbari, Mostafa Soleymani, Zakaria Zakariaei, Mahdi Fakhar
DOI: 10.1002/rcr2.1216

Trichobezoars are hairballs in the gastrointestinal tract that usually develop due to the consumption of hair after pulling it. We present an unusual case of a 25-year-old woman who experienced dyspnea, productive cough, and leukocytosis and was found to have a trichobezoar in her respiratory tract, accompanied by the presence of hair in her digestive tract.

Chiaki Kato, Muneyuki Sekiya, Ryo Sekiguchi, Akira Yamasaki, Takahiro Yoshizawa, Kazutoshi Isobe, Naobumi Tochigi, Kazutoshi Shibuya, Kazuma Kishi
DOI: 10.1002/rcr2.1217

We encountered a case of SIADH induced by entrectinib administered for ROS1-positive non-small cell lung cancer (NSCLC). And suggested a dose-dependent association in entrectinib induction of SIADH.

Seigo Miyoshi, Miyuki Tanabe, Mayuko Semba, Chika Sato, Sanae Aoyama, Akira Watanabe, Ryoji Ito, Kumi Hamada, Akira Watanabe, Masahiro Abe
DOI: 10.1002/rcr2.1221

Here, we describe a case of Exophiala dermatitidis coinfection with nontuberculous mycobacteria (NTM) and review clinical reports describing the features of pulmonary infections caused by E. dermatitidis in non-CF patients.

Yuki Hayakawa, Takako Kawaguchi, Kei Yamasaki, Miyu Endo, Masaya Komatsu, Yutaka Ishiguro, Yuichi Murata, Kazuhiro Yatera
DOI: 10.1002/rcr2.1222

We present a case of asthma and chronic obstructive pulmonary disease overlap (ACO) induced by long-term nivolumab maintenance therapy in a patient with lung adenocarcinoma and no history of asthma.

Esther-Lee Marcus, Amir Hush, Hisham Atrash, Roaia Shibli, Samuel N Heyman
DOI: 10.1002/rcr2.1224

A patient with chronic obstructive pulmonary disease who is managed with prolonged mechanical ventilation is described. The patient progressively developed episodes of severe bronchospasm over a few weeks. This has eventually been attributed to an angiotensin-converting enzyme (ACE) inhibitor the patient has been treated with for years. Detailed are pitfalls in recognizing this condition, specifically in the setup of chronic invasive ventilation. Accordingly, we propose that ARBs might be preferred over ACE inhibitors in such circumstances.

Jane Sandra Afriyie-Mensah, Hafisatu Gbadamosi, Afua Owusua Darkwah Abrahams
DOI: 10.1002/rcr2.1225

Adult-onset asthma is extremely variable in its phenotypic presentation and has gained notoriety for the overall poorer treatment outcomes even on standard asthma therapy. Tracheal tumours are rare but when present, exhibit asthma-like phenomenon in adult patients posing great diagnostic challenges. We report two adult patients with tracheal adenoid cystic tumours who were initially treated for adult-onset asthma.

Masaaki Iwabayashi, Junji Takiguchi, Hiromi Tomioka
DOI: 10.1002/rcr2.1227

We report an immunocompetent case of pulmonary nocardiosis with nocardia brasiliensis. As the present case report demonstrates, disseminated nocardiosis caused by this species can progress from a primary cutaneous lesion even in immunocompetent individuals, if the initiation of appropriate treatment is delayed. Therefore, careful evaluation is warranted when Nocardia species are detected.

Kenichiro Takeda, Yuki Yato, Mikihito Saito, Go Saito, Akira Nishiyama, Hajime Kasai, Takuji Suzuki
DOI: 10.1002/rcr2.1212

Intrathoracic extramedullary haematopoiesis (EMH) can present as nodular lesions that need to be differentiated from malignancy. 111In-bone marrow scintigraphy can be useful for the non-invasive diagnosis of intrathoracic EMH because the extramedullary accumulation of 111In can be determined as EMH.

Yuki Hayakawa, Kei Yamasaki, Midori Funada, Masaya Komatsu, Yukinori Maeda, Kazuhiro Yatera
DOI: 10.1002/rcr2.1213

Although rare, physicians should remain vigilant for pulmonary artery aneurysm when treating a lung abscess and the patient presents with hemoptysis.

Kei Yamasaki, Yuto Iwanaga, Takumu Uryu, Tomoki Sato, Takako Kawaguchi, Chinatsu Nishida, Kazuhiro Yatera
DOI: 10.1002/rcr2.1219

Pulmonary veno-occlusive disease (PVOD) is an extremely rare cause of pulmonary hypertension. We present a case with CT imaging with disappearance of pulmonary consolidation upon repositioning.

Cheng-Hsien Tsou, Hwa-Yen Chiu
DOI: 10.1002/rcr2.1226

A 55-year-old female with childhood asthma came to our chest clinic for shortness of breath for months. Her oxygen saturation was 92% under ambient air. Chest radiography was taken. What's the diagnosis?

Hironori Oyamatsu, Takaki Fujimura, Takehiko Okagawa, Seijirou Niimi
DOI: 10.1002/rcr2.1218

The thoracic apex is a narrow and complicated area with nerves and vessels, making it difficult to secure a visual field and perform surgical operations. In this report, we present the clinical video of Robot-Assisted Thoracic Surgery, which enabled minimally invasive and safe thoracic apical tumour resection.