ABSTRACT
A obstrucao de via aerea proximal levando a asfixia com risco de vida imediato e o evento mais importante na aspiracao de corpo estranho. Contudo, pequenos corpos estranhos que atravessam a laringe sao geralmente assintomaticos no inicio e provocam sintomas respiratorios semanas ou anos antes do diagnostico. Nos descrevemos tres pacientes com evolucao clinica diferente e revisamos tecnicas de diagnostico e abordagens terapeuticas.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Bronchi , Foreign Bodies/diagnosis , Inhalation , Airway Obstruction/etiology , Bronchoscopy , Foreign Bodies , Foreign Bodies/therapyABSTRACT
A proteinose alveolar e uma entidade rara caracterizada pelo acumulo de material lipoproteinaceo PAS-positivo na luz alveolar. Apesar da caracterizacao precisa do material acumulado, a etiopatogenia da doenca permanece mal definida. Apresentamos quatro casos acompanhados em nosso servico no periodo de 1983 a 1989. Houve confirmacao diagnostica por biopsia em todos os casos. Tres pacientes apresentaram melhora clinica e radiologica apos a lavagem pulmonar e um paciente apresentou remissao espontanea.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pulmonary Alveolar Proteinosis/diagnosis , Age Factors , Bronchoalveolar Lavage Fluid , Pulmonary Alveolar Proteinosis/pathology , Pulmonary Alveolar Proteinosis/therapy , SmokingABSTRACT
Apresentamos o caso de um paciente com embolia septica de pulmao cujo foco primario era em ouvido medio. As bacterias implicadas foram aerobios Gram positivos, Gram negativos e anaerobios, sendo isolados oito diferentes agentes etiologicos em hemoculturas. As culturas de urina e escarro tambem se mostraram positivas. O tratamento consistiu em antibioticoterapia de amplo espectro e na exploracao cirurgica do foco inicial. A resposta foi favoravel apos 40 dias de antibioticoterapia.
Subject(s)
Humans , Male , Middle Aged , Bacteremia/etiology , Otitis Media/complications , Pulmonary Embolism/etiology , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Culture Media , Ear, Middle/surgery , Otitis Media/drug therapy , Otitis Media/surgery , Pulmonary Embolism , Pulmonary Embolism/drug therapyABSTRACT
Pulmonary alveolar proteinosis is a rare disease characterized by the filling of the alveolar spaces of the lung by a PAS-positive lipoproteinaceous material. Despite the clear characterization of this material, the etiopathogenesis of the disease remains obscure. We present four patients who were admitted in our Department over the last seven years. The diagnosis was confirmed by lung biopsy in all cases. Three patients improved after bronchoalveolar lavage. Spontaneous remission was observed in one case.
Subject(s)
Pulmonary Alveolar Proteinosis/diagnosis , Adult , Age Factors , Bronchoalveolar Lavage Fluid , Female , Humans , Male , Middle Aged , Pulmonary Alveolar Proteinosis/pathology , Pulmonary Alveolar Proteinosis/therapy , SmokingABSTRACT
A case of septic pulmonary embolism is presented in which the primary site of infection was the middle ear. The implicated bacteria were aerobics both Gram positive and Gram negative and anaerobics. There were 8 different agents isolated from blood cultures. The cultures of urine and sputum were also positive. The patient received a broad spectrum antibiotic therapy and a surgical exploration of the initial site of infection was performed. A favorable response was observed after 40 days of treatment with antibiotics.
Subject(s)
Otitis Media/complications , Pulmonary Embolism/etiology , Anti-Bacterial Agents/therapeutic use , Culture Media , Ear, Middle/surgery , Gram-Negative Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/microbiology , Humans , Male , Middle Aged , Otitis Media/drug therapy , Otitis Media/microbiology , Otitis Media/surgery , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/drug therapy , RadiographyABSTRACT
Proximal airway obstruction and acute life-threatening asphyxia is the most important complication of foreign body aspiration. Small foreign bodies that transverse the larynx may be initially asymptomatic appearing serious respiratory disturbances only later. Three patients with different clinical evolutions are reported and the diagnostic and therapeutic approaches, discussed.