Subject(s)
Bronchitis , Tracheitis , Humans , Bronchitis/diagnostic imaging , Tracheitis/diagnostic imagingABSTRACT
Pulmonary extra-intestinal manifestations of inflammatory bowel disease are rare, comprising 0.21% to 0.4% of the inflammatory bowel disease population. Common symptoms include cough, chest pain, and dyspnea. Abnormal pulmonary function tests are common in these patients, with restrictive, obstructive, and diffusion capacity defects. CT scanning remains the most sensitive imaging technique to detect abnormalities. Pulmonary manifestations are diverse and include airway, parenchymal, and pleural disease. Large airway disease predominates, particularly bronchiectasis. Upper airway disease is rare but concerning for the development of acute airway compromise. To our knowledge, there are no reports of concurrent mediastinitis with tracheitis in the setting of inflammatory bowel disease. We present a case of a patient with ulcerative proctitis who experienced the development of inflammatory tracheitis and mediastinitis. Her disease responded to systemic steroids and biologic therapy. In addition to our case, we reviewed the literature and provide an approach to pulmonary complications as extra-intestinal manifestation of inflammatory bowel disease.
Subject(s)
Bronchoscopy/methods , Colitis, Ulcerative , Infliximab/administration & dosage , Mediastinitis , Steroids/administration & dosage , Tracheitis , Adult , Antirheumatic Agents/administration & dosage , Biopsy/methods , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/physiopathology , Colitis, Ulcerative/therapy , Diagnosis, Differential , Drug Administration Routes , Drug Monitoring/methods , Female , Humans , Mediastinitis/diagnostic imaging , Mediastinitis/etiology , Mediastinitis/physiopathology , Mediastinitis/therapy , Tomography, X-Ray Computed/methods , Trachea/pathology , Tracheitis/diagnostic imaging , Tracheitis/etiology , Tracheitis/physiopathology , Tracheitis/therapy , Treatment Outcome , Ultrasonography, Interventional/methodsSubject(s)
Bronchoscopy , Colon/diagnostic imaging , Colonoscopy , Crohn Disease/diagnostic imaging , Tracheitis/diagnostic imaging , Colon/pathology , Cough , Crohn Disease/drug therapy , Crohn Disease/pathology , Crohn Disease/physiopathology , Fatigue , Gastrointestinal Agents/therapeutic use , Glucocorticoids/therapeutic use , Humans , Infliximab/therapeutic use , Male , Middle Aged , Prednisone/therapeutic use , Tomography, X-Ray Computed , Tracheitis/drug therapy , Tracheitis/pathology , Tracheitis/physiopathology , Vocal Cords/pathology , Weight LossSubject(s)
Betacoronavirus , Bronchitis/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Pandemics , Pneumonia, Viral/diagnostic imaging , Single Photon Emission Computed Tomography Computed Tomography , Tracheitis/diagnostic imaging , Ventilation-Perfusion Scan , Aged , Albumins , Betacoronavirus/isolation & purification , Bronchitis/etiology , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Humans , Male , Pneumonia, Viral/complications , Radiopharmaceuticals , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Sodium Pertechnetate Tc 99m , Technetium Tc 99m Aggregated Albumin , Tracheitis/etiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Crohn Disease/complications , Tracheitis/etiology , Bronchitis/etiology , Tomography, X-Ray Computed , Tracheitis/diagnostic imaging , Bronchitis/diagnostic imagingSubject(s)
Bronchitis/diagnosis , Colitis, Ulcerative/complications , Respiratory Tract Infections/complications , Tracheitis/diagnosis , Aged , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Bronchitis/complications , Bronchitis/diagnostic imaging , Bronchitis/drug therapy , Diagnosis, Differential , Drug Administration Schedule , Humans , Male , Prednisone/administration & dosage , Prednisone/therapeutic use , Respiratory Function Tests , Tomography, X-Ray Computed , Tracheitis/complications , Tracheitis/diagnostic imaging , Tracheitis/drug therapySubject(s)
Bronchitis/microbiology , Pulmonary Aspergillosis/microbiology , Tracheitis/microbiology , Aspergillus/isolation & purification , Bronchitis/diagnostic imaging , Bronchoscopy , Female , Granuloma/diagnostic imaging , Humans , Immunocompetence , Middle Aged , Pulmonary Aspergillosis/diagnostic imaging , Tomography, X-Ray Computed , Tracheitis/diagnostic imagingSubject(s)
Eosinophilia/etiology , Pulmonary Eosinophilia/etiology , Smoking/adverse effects , Tracheitis/etiology , Acute Disease , Bronchoscopy , Eosinophilia/diagnostic imaging , Eosinophilia/drug therapy , Eosinophilia/pathology , Glucocorticoids/therapeutic use , Humans , Male , Prednisolone/therapeutic use , Pulmonary Eosinophilia/diagnostic imaging , Pulmonary Eosinophilia/drug therapy , Pulmonary Eosinophilia/pathology , Radiography, Thoracic , Tomography, X-Ray Computed , Tracheitis/diagnostic imaging , Tracheitis/drug therapy , Tracheitis/pathology , Young AdultABSTRACT
Pulmonary aspergillosis encompasses a heterogeneous group of mycoses that result from either colonisation or pathogenic damage of lung tissue by Aspergillus fungi. These clinical entities range from relatively benign saprophytic hypersensitivity associated with fungal inhabitation to life threatening invasive disease. The diagnosis of pulmonary disorders related to Aspergillus is on the increase and it is more important than ever those both general and respiratory physicians have a good understanding of these disorders. This paper reviews the contemporary understanding of the clinical, radiographic and histopathological aspects of pulmonary aspergillosis.
Subject(s)
Pulmonary Aspergillosis/diagnostic imaging , Asthma/diagnostic imaging , Bronchitis/diagnostic imaging , Bronchitis/microbiology , Diagnosis, Differential , Humans , Invasive Pulmonary Aspergillosis/diagnostic imaging , Invasive Pulmonary Aspergillosis/microbiology , Pulmonary Aspergillosis/therapy , Rhinitis/diagnostic imaging , Rhinitis/microbiology , Sinusitis/diagnostic imaging , Sinusitis/microbiology , Tomography, X-Ray Computed , Tracheitis/diagnostic imaging , Tracheitis/microbiologyABSTRACT
Pathologies acquired after the establishment of an artificial airway include stenosis, granulomas and the formation of pseudomembranes, to name a few. The most common form of presentation in adults is circumferential stenosis, which often requires therapeutic endoscopic measures to achieve resolution. This Case Report describes the case of an obstructive inflammatory tracheal pseudomembrane in the shape of a tracheal septum secondary to repeated intubations that was resolved with conservative treatment. The clinical presentation of this entity generally includes the appearance of respiratory infection and/or atelectasis after the withdrawal of the orotracheal tube as a consequence of the accumulation of secretions between the tracheal wall and the pseudomembrane. Inflammatory pseudomembranes can resolve spontaneously with the help of glucocorticoids, although on occasion they require an invasive endotracheal procedure depending on the evolution.
Subject(s)
Airway Obstruction/etiology , Intubation, Intratracheal/adverse effects , Trachea/injuries , Tracheitis/complications , Aged , Airway Obstruction/diagnostic imaging , Anti-Inflammatory Agents/therapeutic use , Bronchi/metabolism , Combined Modality Therapy , Cough/etiology , Exudates and Transudates , Female , Humans , Hypercapnia/therapy , Kyphosis/complications , Methylprednisolone/therapeutic use , Mucus/metabolism , Prednisone/therapeutic use , Pulmonary Atelectasis/etiology , Pulmonary Disease, Chronic Obstructive/complications , Respiration, Artificial , Respiratory Insufficiency/therapy , Respiratory Therapy , Scoliosis/complications , Tomography, X-Ray Computed , Tracheitis/diagnostic imaging , Tracheitis/drug therapy , Tracheitis/etiologyABSTRACT
First clinical experiences with the organ care system (OCS) in lung transplantation showed that this device allows perfusion and ventilation of the lungs under practically physiological conditions. Some pulmonary pathologies necessitate ex situ operations, e.g. to avoid pneumonectomy. The objective of this work was to investigate the feasibility of ex situ pulmonary surgery within the OCS.In the first procedure a large tracheobronchial leakage was covered with a pericardial patch. The procedure was authorized by the local committee of animal welfare. In the second surgery a replacement of the distal trachea using an aortic graft was performed after removal of the heart-lung segment from a pig from the slaughterhouse. The postoperative ventilation of both lungs was free of problems. The mean pressure of the pulmonary artery remained steady during the whole experiment. The setup to prevent lung edema was basically successful.Performing thoracic surgery with the OCS is feasible; however, this approach is reserved for very special indications. Further investigations to optimize technical details of the OCS setup for this purpose are necessary.
Subject(s)
Aorta/transplantation , Bronchi/surgery , Bronchial Neoplasms/surgery , Carcinoid Tumor/surgery , Lung Neoplasms/surgery , Lung Transplantation/instrumentation , Organ Preservation/instrumentation , Pericardium/transplantation , Pneumonectomy/instrumentation , Trachea/surgery , Tracheitis/surgery , Aged , Animals , Bronchial Neoplasms/diagnostic imaging , Carcinoid Tumor/diagnostic imaging , Female , Humans , Image Interpretation, Computer-Assisted , Intraoperative Complications/prevention & control , Lung Neoplasms/diagnostic imaging , Necrosis , Oxygen/blood , Perfusion/instrumentation , Pulmonary Edema/prevention & control , Respiration, Artificial/instrumentation , Swine , Tomography, X-Ray Computed , Trachea/diagnostic imaging , Tracheitis/diagnostic imaging , Transplantation, HeterologousABSTRACT
Pediatric disorders that involve actual or potential airway compromise are among the most challenging cases that emergency department providers face. This article discusses the diagnosis and management of common and uncommon conditions in infants and children who may present with airway obstruction.
Subject(s)
Airway Obstruction/diagnostic imaging , Airway Obstruction/etiology , Respiratory System/diagnostic imaging , Airway Obstruction/therapy , Bronchoscopy , Child , Child, Preschool , Emergency Service, Hospital , Epiglottitis/complications , Epiglottitis/diagnostic imaging , Foreign Bodies/diagnostic imaging , Humans , Radiography , Retropharyngeal Abscess/complications , Retropharyngeal Abscess/diagnostic imaging , Tracheitis/complications , Tracheitis/diagnostic imagingABSTRACT
Tracheomalacia is a frequent disease in the older population involving excessive airway collapse and it may present symptoms similar to pulmonary emboli. This is a case study depicting a patient's inadvertent breathing during a CT scan, performed to rule out pulmonary emboli. This examination revealed significant tracheomalacia, a condition usually diagnosed by bronchoscopy or specially tailored CT.
Subject(s)
Tomography, X-Ray Computed/adverse effects , Tracheitis/diagnostic imaging , Tracheitis/etiology , Aged , Aged, 80 and over , Bronchoscopy , Humans , Pulmonary Embolism/diagnostic imagingABSTRACT
Invasive fungal infections of the respiratory tract are a major cause of serious morbidity and mortality especially in immunocompromised patients due to neutropenia, corticosteroids, or hematologic malignancy. The role of imaging is very important in the management of patients with fungal infections and chest x-ray is still the most used exploration. Nevertheless, new approaches recommend the systematic use of computed tomography scan for early documentation of invasive fungal infection. Combination of clinical setting with recognition of radiological pattern is the best approach to pulmonary fungal diseases. The following is a review of the imaging features of different invasive fungal infections we can face in our daily practice.
Subject(s)
Lung Diseases, Fungal/diagnostic imaging , Aspergillosis/diagnostic imaging , Bronchitis/diagnostic imaging , Bronchitis/microbiology , Candidiasis/diagnostic imaging , Disease Susceptibility , Fungemia/complications , Hematologic Neoplasms/complications , Humans , Immunocompromised Host , Lung Abscess/diagnostic imaging , Lung Abscess/microbiology , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/pathology , Magnetic Resonance Imaging , Opportunistic Infections/diagnostic imaging , Opportunistic Infections/microbiology , Tomography, X-Ray Computed/methods , Tracheitis/diagnostic imaging , Tracheitis/microbiologyABSTRACT
The spectrum of radiographic findings in pulmonary infections due to M. tuberculosis (TB) and non-tuberculous mycobacteria (NTM) are being increasingly discussed, primarily as a result of the increasing prevalence of these infections. The NTM organisms are often overlooked as potential infecting organisms, diagnosis is often delayed and radiologists tend not to include NTM in their differential diagnosis. The literature on the imaging appearances of NTM pulmonary infections is now sufficiently large as to identify some features that would help to distinguish an NTM infection from conventional pulmonary tuberculosis, allowing the radiologist at least to raise the possibility of NTM infection. This review article is intended to describe the radiological features, in the immunocompetent host, that accompany TB and NTM pulmonary infections and highlight the imaging features that would favour an NTM as the causative organism.
Subject(s)
Mycobacterium Infections, Nontuberculous/diagnostic imaging , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnostic imaging , Bronchitis/diagnostic imaging , Bronchitis/microbiology , Humans , Tracheitis/diagnostic imaging , Tracheitis/microbiologyABSTRACT
OBJECTIVE: To examine the potential of the two tumour necrosis factor (TNF) inhibitors infliximab and etanercept as remission-inducing agents in chronic therapy-resistant inflammatory disorders of immune or non-immune pathogenesis. METHODS: 14 patients with adult Still's disease/macrophage activation syndrome (4), Wegener's disease (3), Behçet's disease (3), keratoscleritis (1), lymphomatous tracheo-bronchitis (1) Cogan's syndrome (1), and rapidly destructive crystal arthropathy (1) were treated with infliximab (n = 10) and etanercept (n = 4). All patients showed organ-threatening progression of their diseases with resistance to conventional immunosuppressive medication. Therapeutic benefit was assessed clinically and by documenting organ-specific functional and morphological alterations. Side effects were compared with the data of our clinic's rheumatoid arthritis (RA) patients treated by TNF inhibitors. RESULTS: A rapid and dramatic beneficial effect was documented in 9 patients and a moderate one in 5. Best responses (clinical and laboratory parameters) were seen in patients with macrophage activation syndrome/adult Still's disease and Behçet's disease, while the results were less impressive in those with Wegener's disease, Cogan's syndrome, idiopathic cerato-scleritis and lymphomatous tracheobronchitis. In all cases immunosuppressive agents and systemic glucocorticoids could be reduced or discontinued. CONCLUSIONS: TNF inhibition may be highly effective in patients with severe, therapy-resistant chronic inflammatory disorders.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis/drug therapy , Autoimmune Diseases/drug therapy , Behcet Syndrome/drug therapy , Bronchitis, Chronic/drug therapy , Granulomatosis with Polyangiitis/drug therapy , Immunoglobulin G/therapeutic use , Keratosis/drug therapy , Receptors, Tumor Necrosis Factor/therapeutic use , Scleritis/drug therapy , Signal Transduction/drug effects , Still's Disease, Adult-Onset/drug therapy , Tracheitis/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adult , Arthritis/diagnostic imaging , Arthritis/physiopathology , Autoimmune Diseases/diagnostic imaging , Autoimmune Diseases/physiopathology , Behcet Syndrome/diagnostic imaging , Behcet Syndrome/physiopathology , Bronchitis, Chronic/diagnostic imaging , Bronchitis, Chronic/physiopathology , Chronic Disease , Etanercept , Female , Granulomatosis with Polyangiitis/diagnostic imaging , Granulomatosis with Polyangiitis/physiopathology , Humans , Infliximab , Keratosis/diagnostic imaging , Keratosis/physiopathology , Male , Middle Aged , Radiography , Remission Induction , Scleritis/diagnostic imaging , Scleritis/physiopathology , Signal Transduction/physiology , Still's Disease, Adult-Onset/diagnostic imaging , Still's Disease, Adult-Onset/physiopathology , Syndrome , Tracheitis/diagnostic imaging , Tracheitis/physiopathologyABSTRACT
Computed tomographic (CT) findings are described in three diabetic patients with central airways mucormycosis. The CT findings of the tracheobronchial mucormycosis include enhancing areas of mural thickening (n = 3), luminal narrowing (n = 3), intramural air (n = 3), low-attenuation nonenhancing bronchial wall thickening (n = 2), and bronchonodal fistula formation (n = 1). These CT features in a diabetic patient should raise a high index of suspicion for tracheobronchial mucormycosis, particularly when typical radiographic features of pulmonary tuberculosis are absent.