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3.
Khirurgiia (Mosk) ; (6): 18-23, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32573527

RESUMO

OBJECTIVE: To analyze contamination of surgical wound during tracheal resection depending on the mode of mechanical ventilation. MATERIAL AND METHODS: There were 976 patients. Circular tracheal resection was made in 396 of these patients. RESULTS: Overall postoperative morbidity was 15.7%, mortality - 0.8%. Bacteriological examination of surgical wound was performed before tracheotomy and after formation of anastomosis depending on the method of mechanical ventilation. Surgical field was sterile before tracheotomy in all cases, contamination was confirmed after tracheotomy in all patients. Minimal contamination was observed in case of apneic oxygenation (100 times less than volumetric mechanical ventilation or high frequency mechanical ventilation). In all cases, several species of pathogenic microorganisms were identified. The number of species was also minimal in case of hypnotic mechanical ventilation. CONCLUSION: Contamination does not directly affect the development of local purulent-inflammatory process. However, this factor should not be ignored and compliance with all preventive measures is required.


Assuntos
Respiração Artificial/efeitos adversos , Infecção da Ferida Cirúrgica/microbiologia , Ferida Cirúrgica/microbiologia , Traqueia/cirurgia , Doenças da Traqueia/cirurgia , Traqueotomia/efeitos adversos , Anastomose Cirúrgica , Humanos , Respiração Artificial/métodos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Traqueia/microbiologia , Doenças da Traqueia/microbiologia , Estenose Traqueal/microbiologia , Estenose Traqueal/cirurgia , Traqueotomia/métodos
4.
Res Vet Sci ; 130: 144-152, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32179292

RESUMO

Avian pathogenic Escherichia coli (APEC) can lead to extraintestinal disease in avian species via respiratory tract infection. However, the regulatory mechanism of APEC on the pathogenicity of chicken trachea epithelium remains unknown. In this study, we examined pathological changes in chicken trachea at different infection times (4, 8, 12 and 24 h). The RNA sequencing of APEC infection group and the PBS group (negative control) of chicken trachea epithelium were analysed. Our studies revealed that the oedema, heterophil infiltration and hyperaemia appeared at 8 and 12 h post APEC infection. And the hyperaemia phenomenon and heterophilic granulocyte infiltration disappeared at 24 h post infection. Then RNA sequencing showed many genes were dynamically expressed in the APEC infection group. At 4, 8 and 12 h post infection, the mRNA of differentially expressed genes were enriched by cytokine-cytokine receptor interaction and the toll-like receptor signalling pathway. The cell cycle pathway was enriched at 24 h post infection. Altogether, these findings suggest that APEC infection induces pathological change in the chicken trachea, the mRNA of differentially expressed genes participating in inflammation and hyperplasia signalling pathways. Which not only provide more evidence for regulatory mechanism of APEC on the pathogenicity of chicken trachea epithelium, but also facilitate the effective management of APEC infections in poultry through trachea.


Assuntos
Proteínas Aviárias/metabolismo , Galinhas , Citocinas/metabolismo , Infecções por Escherichia coli/veterinária , Doenças das Aves Domésticas/patologia , Receptores de Citocinas/metabolismo , Doenças da Traqueia/veterinária , Animais , Ciclo Celular , Escherichia coli/fisiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Infecções por Escherichia coli/fisiopatologia , Feminino , Doenças das Aves Domésticas/microbiologia , Doenças das Aves Domésticas/fisiopatologia , RNA Mensageiro/metabolismo , Traqueia/patologia , Traqueia/fisiopatologia , Doenças da Traqueia/microbiologia , Doenças da Traqueia/patologia , Doenças da Traqueia/fisiopatologia
5.
Medicine (Baltimore) ; 98(49): e18288, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804372

RESUMO

RATIONALE: The patient in this case report has been diagnosed with multidrug resistant lymph node fistula tracheobronchial tuberculosis (TBTB). The PubMed was searched using the keywords "Tuberculosis, Multidrug-Resistant", "Tuberculosis", and "Bronchial Fistula", and the results yielded no similar case reports. Therefore, this report helps us to explore more on the causes of multidrug resistance and formation of lymph node fistula, as well as associated treatment strategies. PATIENT CONCERNS: A 15-year old Tibetan girl who was previously treated in the local Hospital for Infectious Diseases for repeated TBTB demonstrated poor treatment outcomes, and so was further diagnosed in our hospital. After standard treatments, the cough and expectoration of the girl showed improvement, and mycobacterium culture showed negative results. Thoracic CT showed local compression of the right bronchus, and disappearance of stenosis. Bronchoscopy showed that the fistula was closed and healed. DIAGNOSES: Multidrug resistant lymph node fistula TBTB. INTERVENTIONS: Antituberculosis drugs such as pyrazinamide (0.75 g/time, twice per day), moxifloxacin (0.4 g per day), protionamide enteric-coated tablets (0.2 g/time, 3 times per day), pasiniazide tablets (0.3 g/time, 3 times per day), and capreomycin (0.75 g per day) were orally administered. The treatment included an 8-month intensive treatment phase and a 12-month consolidation phase. Bronchoscopic local injection combined with cryotherapy was also conducted. OUTCOMES: Bronchoscopy showed that the fistula was closed and healed, mycobacterium culture showed negative results, and thoracic CT showed local compression of the right bronchus, disappearance of stenosis after treatment. LESSONS: (1) This girl had a history of long-term oral intake of antituberculosis drugs, but the treatment effectiveness remained poor. Therefore, resistance to tuberculosis can be considered, and also mycobacterium culture and drug sensitivity tests should be considered. After these, the treatment strategies should be adjusted accordingly.(2) TBTB should be further classified by analyzing under the bronchoscope to decide the best treatment strategy accordingly.


Assuntos
Antituberculosos/uso terapêutico , Broncopatias/tratamento farmacológico , Fístula/tratamento farmacológico , Doenças da Traqueia/tratamento farmacológico , Tuberculose dos Linfonodos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose Pulmonar/tratamento farmacológico , Adolescente , Broncopatias/microbiologia , Broncoscopia , Quimioterapia Combinada , Feminino , Fístula/microbiologia , Humanos , Tibet , Tomografia Computadorizada por Raios X , Doenças da Traqueia/microbiologia
7.
Vet Radiol Ultrasound ; 60(2): E20-E23, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28547920

RESUMO

A Staffordshire terrier presented for evaluation of a chronic, nonproductive cough that was unresponsive to antibiotic therapy. A large mass identified in the pulmonary hilum was most consistent with tracheobronchial lymphadenopathy on radiographic and computed tomography (CT) images. Bronchoscopy confirmed a mass compressing the dorsal portion of the intrathoracic trachea. Bronchoscopic biopsies of the tracheal mass revealed necrosuppurative and eosinophilic inflammation with intralesional Pythium insidiousum hyphae. Pythiosis should be included as a differential diagnosis for tracheobronchial lymphadenopathy and bronchopneumopathy in dogs, especially when the patient is from or has visited a region endemic for Pythium insidiosum.


Assuntos
Broncopatias/veterinária , Tosse/veterinária , Doenças do Cão/diagnóstico , Pneumopatias/veterinária , Linfadenopatia/veterinária , Pitiose/diagnóstico , Doenças da Traqueia/veterinária , Animais , Broncopatias/diagnóstico , Broncopatias/diagnóstico por imagem , Broncopatias/microbiologia , Broncoscopia/veterinária , Tosse/diagnóstico por imagem , Diagnóstico Diferencial , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/microbiologia , Cães , Pneumopatias/diagnóstico , Pneumopatias/diagnóstico por imagem , Pneumopatias/microbiologia , Linfadenopatia/diagnóstico , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/microbiologia , Masculino , Pitiose/diagnóstico por imagem , Pitiose/microbiologia , Pythium/fisiologia , Radiografia/veterinária , Tomografia Computadorizada por Raios X/veterinária , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/microbiologia
8.
Microb Pathog ; 118: 285-289, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29605650

RESUMO

OBJECTIVE: Pseudomonas aeruginosa, an opportunistic pathogen, can cause serious health problems and produces several virulence factors. The most important of these factors is biofilm. Many studies suggest administration of new generation of antibiotics, as P. aeruginosa biofilm has developed high resistance to antimicrobial drugs. Emergence of multidrug resistant (MDR) strains has resulted in screening biofilm inhibitors from natural products or modified from natural compounds. To test this hypothesis, we evaluated the inhibitory effects (antibacterial and antibiofilm) of Juglans regia L. extract on biofilm formation by clinical isolates of P. aeruginosa. METHODS: Samples collected from burn, tracheal and urine infections of hospitalized patients (Shahid Motahari Hospital, Tehran, Iran) were identified as P. aeruginosa using traditional biochemical tests. Antibiotic susceptibility testing of isolates was performed using disk diffusion method. The microtiter plate method was used to evaluate the ability of pathogenic strains in producing biofilm. Antibacterial and antibiofilm effects of aqueous and methanol Juglans regia L. leaf extracts were determined by microtiter plate method. RESULTS: 46.7% of P. aeruginosa isolates (n = 50) were resistant to gentamicin and 100% of them could form a biofilm. All isolates (100%) exhibited MDR phenotype. Various concentrations of Juglans regia L. extracts exhibited significant effects on the growth and biofilm inhibition of the isolates. In addition, aqueous Juglans regia L. leaf extract had better inhibition activity on planktonic growth, and methanol extract was more effective on inhibiting biofilm of P. aeruginosa. CONCLUSIONS: The results of this study indicate that antibiotic-resistant strains were significantly associated with biofilm formation. The J. regia L. extract, at various concentrations, may provide an alternative to control biofilm-related infections caused by P. aeruginosa. Further analyses are needed to validate the antibiofilm activity of these medicinal plants.


Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Juglans/química , Extratos Vegetais/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Humanos , Irã (Geográfico) , Testes de Sensibilidade Microbiana , Folhas de Planta/química , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Doenças da Traqueia/microbiologia , Uremia/microbiologia , Fatores de Virulência
9.
Equine Vet J ; 50(6): 752-758, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29603335

RESUMO

BACKGROUND: Tracheal wash sample neutrophilia is common in lower airway inflammation of various causes; however, relevance of cytomorphological features to culture of bacterial pathogens has not been established. OBJECTIVES: To investigate whether the presence of nondegenerate or degenerate neutrophils in tracheal washes is associated with culture of bacteria and, if so, whether this is influenced by age or temporal factors. STUDY DESIGN: Cross-sectional study. METHODS: Tracheal wash samples submitted to Rossdales LLP from 1/1/2013 to 31/7/2015 were evaluated using set criteria. Neutrophilia and degenerate neutrophilia (graded ≥2/4 on Rossdales cytological scale [0-4]) were analysed in relation to bacterial isolates considered potentially pathogenic in respiratory disease. Statistical analyses included multivariable logistic regression to identify associations between two separate outcomes: 1) the presence of neutrophilia compared with no neutrophilia and 2) the presence of degenerate neutrophilia compared with nondegenerate neutrophilia and four independent variables. RESULTS: Sufficient data for inclusion in the multivariable model for nondegenerate neutrophilia were available from 1100 horses. Culture of potentially pathogenic bacteria was associated with increased odds of degenerate neutrophilia compared with samples with negative culture (OR 4.5, 95% CI 3.1, 6.4, P-value<0.001). Horses over 9 years old had lower odds of having degenerate neutrophilia than those aged 1-3 years (OR 0.6, 95% CI 0.4, 0.9, P-value<0.02). In the spring/summer, horses had reduced odds of a degenerate neutrophilia compared with winter (OR 0.4, 95% CI 0.3, 0.7, P-value <0.001). MAIN LIMITATIONS: The study relied on routine laboratory submissions, with no control over sample collection or submitted clinical history. CONCLUSIONS: Cytological evaluation of tracheal washes should include cytomorphological features of the neutrophil response. The presence of degenerate neutrophils, especially in young horses, indicates added value of culture and sensitivity for antimicrobial therapeutics. The absence of degenerate changes, in combination with clinical factors, can help support diagnosis of a nonseptic cause of airway neutrophilia.


Assuntos
Bactérias/isolamento & purificação , Doenças dos Cavalos/microbiologia , Neutrófilos/citologia , Traqueia/microbiologia , Doenças da Traqueia/veterinária , Fatores Etários , Animais , Bactérias/classificação , Estudos Transversais , Doenças dos Cavalos/patologia , Cavalos , Modelos Logísticos , Análise Multivariada , Neutrófilos/microbiologia , Estudos Retrospectivos , Estações do Ano , Fatores de Tempo , Traqueia/patologia , Doenças da Traqueia/microbiologia , Doenças da Traqueia/patologia
10.
Clin Respir J ; 12(4): 1651-1660, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29028140

RESUMO

OBJECTIVES: Tracheobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree. DATA SOURCE: At a 3500-bed tertiary care center. STUDY SELECTION: This was a retroactive study of 12 cases of tracheobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. RESULTS: Rhizopus was the predominant species of pathogen (66.7%). Primary bronchus was the most frequently involved location (38.2%), and upper lobes (51% of cases) were a predilection. Obstructive necrosis and mucosal necrosis were the most common pathological forms (40% and 34.5%, respectively). Fever (59.3%), cough (59.3%), dyspnea (40.7%) and hemoptysis (30.5%) were the most common symptoms. 51.4% patients had rales, 40% had moist rales and 28.6% had negative physical findings. Ninety-five percent patients had immunosuppressive diseases. Diabetes mellitus (66.7%), diabetes ketoacidosis (21.7%), corticosteroid therapy (20%) and kidney insufficiency (18.3%) were the most common predisposing factors. 13.2% had neutropenia which was mostly among the non-diabetic patients (P = .006). Endobronchial lesion of 23.2% had imaging reports with 33.9% exhibiting single mass. Pathological diagnosis of 76.7% used the transbronchial biopsy. The most frequent antifungal therapies were intravenous amphotericin B (79.7%), surgery (33.3%) and surgery combined with amphotericin B therapy (28.3%). Overall in-hospital mortality was 52.5%, with hemoptysis (P = .017), dyspnea at presentation (P = .022) and angioinvasion (P = .03) as independent risk prognostic factors. In contrast, surgery (P = .003) was an independent protection prognostic factor. CONCLUSIONS: Tracheobronchial mucormycosis is a rare but severe disease with high mortality because of its nonspecific clinical presentations and variable predisposing factors.


Assuntos
Anfotericina B/uso terapêutico , Broncopatias/diagnóstico , Pulmão/diagnóstico por imagem , Mucormicose/diagnóstico , Doenças da Traqueia/diagnóstico , Antifúngicos/uso terapêutico , Broncopatias/tratamento farmacológico , Broncopatias/microbiologia , Broncoscopia , Feminino , Humanos , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Mucorales/isolamento & purificação , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Tomografia Computadorizada por Raios X , Doenças da Traqueia/tratamento farmacológico , Doenças da Traqueia/microbiologia
12.
J Cyst Fibros ; 16(6): 735-743, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28757079

RESUMO

BACKGROUND: Tracheal diverticula (TD) are rare anomalies that may harbor infected secretions, posing potential risk to patients with lung disease. In an end-stage cystic fibrosis (CF) cohort, we describe the characteristics and associated post-lung transplant (LTx) outcomes of TD. METHODS: Pre-transplant computed tomography (CT)'s were reviewed in CF patients undergoing LTx. TD were characterized radiographically and on autopsy when available. Pre-transplant clinical variables and post-transplant outcomes were compared by TD status. RESULTS: Of 93 patients, 35 (37.6%) had TD. 58% of TD had fat-stranding, and post-mortem TD examinations revealed histology carrying intense submucosal inflammation, and purulent contents that cultured identical species to sputum. There was no difference in post-LTx survival [HR 1.77 (0.82-3.82), p=0.147], bacterial re-colonization, or rejection in patients with TD compared to those without. Patients with TD were more likely to die from infection, but the result was not statistically significant [HR 2.02 (0.62-6.63), p=0.245]. CONCLUSIONS: We found a high prevalence of TD in end-stage CF, where diverticula may represent a large-airway bacterial reservoir. TD were not associated with differences in post-LTx outcomes, but given the infectious concerns further investigation is necessary.


Assuntos
Fibrose Cística , Divertículo , Doenças da Traqueia , Adulto , Autopsia/métodos , Autopsia/estatística & dados numéricos , Bactérias/isolamento & purificação , Fibrose Cística/complicações , Fibrose Cística/mortalidade , Fibrose Cística/fisiopatologia , Fibrose Cística/cirurgia , Progressão da Doença , Divertículo/diagnóstico , Divertículo/epidemiologia , Divertículo/etiologia , Divertículo/microbiologia , Feminino , Humanos , Masculino , Cuidados Pré-Operatórios/métodos , Prevalência , Escarro/microbiologia , Estatística como Assunto , Tomografia Computadorizada por Raios X/métodos , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/epidemiologia , Doenças da Traqueia/etiologia , Doenças da Traqueia/microbiologia , Estados Unidos/epidemiologia
14.
Sarcoidosis Vasc Diffuse Lung Dis ; 32(4): 336-41, 2016 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-26847101

RESUMO

OBJECTIVE: To evaluate the value of T-SPOT.TB in the diagnosis of tracheobronchial tuberculosis. METHODS: This study included in January 2010 to October 2014 in the three gorges university during the first clinical medical college of final 283 diagnosed with tracheal bronchus TB patients (including 273 patients with pathological biopsy diagnosis and 10 called suspected TB patients), at the same time will be 283 active TB patients as a parallel control group included in this study. They were all given traditional detection methods acid fast stain and diseased tissue pathological biopsy and the new detection method T-SPOT.TB. RESULTS: Sputum smear acid-fast stain sensitivity rate is 39.2% (111/283), typical TB diseased tissue pathology biopsy pathology morphology of 221 cases (78.1%), tend to TB 52 cases (18.4%),while T-SPOT. TB testing sensitivity and speciality rate is 93.6% (265/283) and 85.1% (241/283), which is much higher then the former two. CONCLUSION: T-SPOT.TB can provide important basis for the diagnosis of tracheobronchial tuberculosis.It is the fastest and most accu-rate method in the diagnosis of tracheobronchial tuberculosis.


Assuntos
Broncopatias/diagnóstico , ELISPOT , Testes de Liberação de Interferon-gama , Mycobacterium tuberculosis/imunologia , Linfócitos T/microbiologia , Doenças da Traqueia/diagnóstico , Tuberculose Pulmonar/diagnóstico , Adolescente , Adulto , Biomarcadores/metabolismo , Broncopatias/imunologia , Broncopatias/microbiologia , China , Feminino , Humanos , Interferon gama/metabolismo , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Escarro/microbiologia , Linfócitos T/imunologia , Doenças da Traqueia/imunologia , Doenças da Traqueia/microbiologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-26769262

RESUMO

INTRODUCTION: Tracheal rhinoscleroma is an infectious granulomatosis of the tracheobronchial tract caused by a Gram-negative bacillus. Exclusively tracheal involvement has been rarely reported in the literature. The purpose of this study was to report a case of subglottic stenosis secondary to rhinoscleroma. SUMMARY: A 46-year-old North African woman with no medical or surgical history presented with inspiratory dyspnoea that had been present for several years. Endoscopic examination under general anaesthesia revealed tracheal stenosis. Histological examination of mucosal biopsies demonstrated Mikulicz cells and culture of bacteriological samples taken during a second biopsy confirmed the diagnosis of rhinoscleroma. CO2 laser subglottic obstruction relief was performed and treatment with ofloxacin was initiated. No recurrence of tracheal stenosis was observed with a follow-up of 6 months. DISCUSSION: The diagnosis of rhinoscleroma is based on histological and bacteriological examination. Cultures are positive in 60% of cases, but negative cultures do not exclude the diagnosis of rhinoscleroma. Specific treatment consists of long-term antibiotic therapy, while surgery may be indicated for symptomatic treatment.


Assuntos
Rinoscleroma/diagnóstico , Rinoscleroma/terapia , Doenças da Traqueia/microbiologia , Doenças da Traqueia/terapia , Antibacterianos/uso terapêutico , Dispneia/etiologia , Feminino , Humanos , Terapia a Laser , Pessoa de Meia-Idade , Ofloxacino/uso terapêutico , Doenças da Traqueia/diagnóstico , Estenose Traqueal/etiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-26473629

RESUMO

OBJECTIVE: To describe a case of acute tracheal compression due to a dorsal tracheal membrane abscess in a dog. CASE SUMMARY: A 3-year-old intact male Bluetick Coonhound presented for evaluation of 36 hours of marked inspiratory dyspnea and stridor. A radiographic diagnosis of tracheal collapse was made on thoracic radiographs, which was confirmed to be static compression by tracheoscopy. Dorsal extraluminal tracheal compression from a fluid filled structure adjacent to the trachea was suspected based on ultrasonography. Endoscopic-guided transtracheal fine needle aspiration yielded septic suppurative inflammation. At surgery an abscess in the dorsal tracheal membrane was identified, lanced, and lavaged, which resulted in restoration of normal tracheal diameter. The dog developed bilateral pneumothorax, which was treated medically by thoracostomy tube placement and manual evacuation of the accumulated air. Postoperative radiographs also revealed evidence of pneumomediastinum. Pneumothorax and pneumomediastinum likely occurred secondary to the surgical approach, worsened by positive pressure ventilation. Cultures of the abscess isolated a nonhemolytic Streptococcus species but with no evidence of anaerobic bacteria. The dog made a full functional recovery. NEW OR UNIQUE INFORMATION PROVIDED: Tracheal compression is a rare diagnosis in dogs. To the authors' knowledge, this represents the first report of an abscess in the dorsal tracheal membrane, diagnosed by endoscopic-guided transtracheal fine needle aspiration, causing clinically relevant acute tracheal obstruction.


Assuntos
Abscesso/veterinária , Doenças do Cão/diagnóstico , Infecções Estreptocócicas/veterinária , Doenças da Traqueia/veterinária , Abscesso/complicações , Abscesso/diagnóstico , Animais , Cães , Masculino , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Doenças da Traqueia/microbiologia
17.
Transpl Infect Dis ; 17(6): 872-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26369902

RESUMO

Invasive tracheal aspergillosis (ITA) is an infection that is unique to patients who have undergone lung transplantation (LT). Although the activity of this disease often appears on imaging, we encountered a case of ITA that became exacerbated, despite few computed tomography (CT) findings, during rituximab combined chemotherapy for diffuse large B-cell lymphoma. ITA developed during immunosuppressive therapy after LT. Because CT findings may show false-negative results, bronchoscopy is recommended for such cases.


Assuntos
Antineoplásicos/efeitos adversos , Aspergilose/patologia , Imunossupressores/efeitos adversos , Linfoma de Células B/tratamento farmacológico , Rituximab/efeitos adversos , Doenças da Traqueia/microbiologia , Adulto , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Aspergilose/etiologia , Evolução Fatal , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/farmacologia , Transplante de Pulmão/efeitos adversos , Masculino , Rituximab/administração & dosagem , Rituximab/farmacologia , Doenças da Traqueia/patologia
18.
Respir Care ; 59(11): e178-81, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25006272

RESUMO

This article reports an unusual case of tracheal mucormycosis following H1N1 pneumonia and reviews previously reported cases. A 40-y-old female with a 5-y history of diabetes mellitus, adequately controlled by oral hypoglycemic agents, developed tracheal mucormycosis after successful treatment for H1N1 pneumonia. The condition was diagnosed during workup for decannulation due to subglottic and upper tracheal obstruction by necrotic chewing gum-like tissue and cartilage. The patient was managed successfully by treatment with amphotericin B and surgical intervention in the form of laryngofissure and Montgomery tube placement. A review of the literature revealed only 5 previously reported cases of tracheal mucormycosis. A high degree of suspicion, early endoscopy and biopsy, histopathological evidence of the infection, and early institution of therapy are the keys to successful outcome.


Assuntos
Mucorales/isolamento & purificação , Mucormicose/diagnóstico , Pneumonia/diagnóstico , Traqueia/microbiologia , Doenças da Traqueia/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Endoscopia , Feminino , Humanos , Mucormicose/microbiologia , Pneumonia/microbiologia , Tomografia Computadorizada por Raios X , Doenças da Traqueia/microbiologia
19.
BMC Infect Dis ; 14: 242, 2014 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-24886249

RESUMO

BACKGROUND: Penicillium marneffei is the only dimorphic member of the genus and is an emerging pathogenic fungus that can cause fatal systemic mycosis. Penicillium marneffei disseminates hematogenously to other locations. Penicillium marneffei infection most commonly involves the skin, lungs, and reticuloendothelial system, including the bone, bone marrow, joints, lymph nodes, pericardium, liver, and spleen. Involvement of the mesenteric and central nervous systems has also been reported. Infection involving the trachea has not been previously reported. CASE PRESENTATION: We herein report a previously healthy 28-year-old male farmer from Guangxi Province without HIV who became infected with P. marneffei. The infection primarily affected the trachea, resulting in structural damage to the cartilage, tracheal stenosis, and tracheal absence. The infection also involved the lungs and lymph nodes. After antifungal treatment and surgery, his symptoms, signs, and lung imaging findings showed significant improvement. This is the first such case report. CONCLUSION: Penicillium marneffei infection in normal hosts is characterized by an insidious onset, various clinical manifestations, and common misdiagnosis, leading to high mortality rates. Penicillium marneffei hematogenously disseminates throughout the whole body. This is the first reported case of P. marneffei infection involving the main trachea with subsequent structural damage to the tracheal cartilage, severe tracheostenosis, and tracheal absence.


Assuntos
Antifúngicos/uso terapêutico , Micoses/microbiologia , Penicillium/isolamento & purificação , Doenças da Traqueia/microbiologia , Adulto , Animais , China , Humanos , Masculino , Micoses/diagnóstico , Micoses/tratamento farmacológico , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/tratamento farmacológico
20.
Ann Thorac Surg ; 96(6): 2256-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24296207

RESUMO

Tracheobronchial aspergillosis is a rare entity mainly observed in immune-compromised patients or those who have undergone transplantation. It may cause airway ulcerations or bleeding. We report the case of a 17-year-old patient receiving chemotherapy for acute lymphoblastic leukemia who presented with right-sided tension pneumothorax. Chest tube drainage revealed a massive air leak without reexpansion of the lung, and bronchoscopy showed a 15- × 15-mm defect of the distal trachea related to aspergillosis infection. The defect was closed by an intrathoracic transposition of a pedicled latissimus dorsi muscle flap, which was sutured into the debrided defect followed by temporary endotracheal stenting and antifungal medication.


Assuntos
Aspergilose/complicações , Drenagem/métodos , Pneumotórax/cirurgia , Retalhos Cirúrgicos , Traqueia/cirurgia , Doenças da Traqueia/complicações , Adolescente , Aspergilose/microbiologia , Aspergilose/cirurgia , Broncoscopia , Humanos , Masculino , Pneumotórax/etiologia , Traqueia/microbiologia , Doenças da Traqueia/microbiologia , Doenças da Traqueia/cirurgia
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