Negative pressure pulmonary edema following laryngospasm after dental abscess: A case report.

Negative pressure pulmonary edema (NPPE), also known as post-obstructive pulmonary edema, is a rare and life-threatening condition. It occurs when a person breathes against an obstructed glottis, causing negative thoracic pressure in the lungs. This negative pressure can lead to fluid accumulation in the lungs, resulting in pulmonary edema. The obstructed glottis might be caused by laryngospasm, which occurs when the muscles around the larynx involuntarily spasm and can lead to complete upper airway occlusion. This report shares the case of a 33-year-old woman hospitalized for periapical dental abscess, facial swelling, and shortness of breath. The patient exhibited signs of poor oral hygiene. After the exacerbation of her symptoms, she showed signs of asphyxia and decreased oxygen saturation, which led to her intubation. Imaging revealed bilateral pleural effusion and patchy ground glass opacities favoring NPPE. After three days of treatment with diuretics and other conservative measures, her condition was alleviated, and she was extubated. Laryngospasm in the presence of a dental abscess is uncommon. Identification of imaging favoring NPPE in this setting is even more rare. In cases of laryngospasm, prompt intubation is crucial. Therapy with diuretics and other conservative measures can effectively treat NPPE following laryngospasm.

Pulmonary apoplexy following severe mitral valve stenosis: A case report.

Hemoptysis is a common clinical symptom in emergency patients. It is characterized by the discharge of bloody sputum, which originates from the lower respiratory tract. In the majority of cases, this event is self-limiting, and only in less than 5% of cases, it is massive. Mitral valve stenosis is an uncommon cause of hemoptysis, with a prevalence of 4.2%. In rare cases of this condition, massive and sudden hemoptysis occurs, which is called pulmonary apoplexy. Here, a 35-year-old woman with a history of mitral valve stenosis is introduced who was referred to the hospital with a complaint of massive hemoptysis and sudden shortness of breath. According to the history of mitral valve stenosis, the patient was diagnosed with pulmonary apoplexy. After treatment, both the imaging findings and the patient's symptoms resolved within a short period of time. Even though pulmonary apoplexy is often severe, it can still respond well to conservative treatments and may indicate a need for immediate attention to the stenosis of the mitral valve.

Amiodarone-induced blue man syndrome: a case report.

BACKGROUND: Amiodarone is one of the most commonly used and effective antiarrhythmic drugs to treat ventricular and supraventricular arrhythmias. Besides its advantages, this drug has side effects like liver, digestive, pulmonary, thyroid, neural, skin, optical, hematologic, psychiatric, and cardiac complications. Blue-gray cutaneous discoloration, also known as blue man syndrome, is an undesirable and unusual side-effect of chronic amiodarone therapy in less than 3% of patients. CASE PRESENTATION: This report presents a 51-year-old Caucasian man treated for the past 3 years with amiodarone and implantable cardioverter defibrillators due to his ventricular arrhythmia and cardiomyopathy, without any follow-up visit to his doctor. He was referred to the medical center for blue-gray discoloration on his nose and cheeks, which had started to appear in the last 3 weeks. CONCLUSION: Considering the findings obtained in this report and the numerous side effects of amiodarone, the blue-man syndrome is a rare yet important finding of this drug which may influence the patient's daily life. It is recommended that all patients under treatment with this drug be notified about its side effects and visit their doctors regularly. Regarding the high therapeutic value of this drug, the lack of any association between blue man syndrome and other complications, and the related aesthetic problems, the role of the caregiver becomes much more critical in the prescription of amiodarone.

A Case of Acute Respiratory Distress Syndrome Following Pleurodesis With Talc.

Management of malignant pleural effusion is a medical challenge, and several methods have been proposed to deal with it including thoracentesis, indwelling pleural catheter placement, and chemical or mechanical pleurodesis. Each method, however, has its advantages and disadvantages. Talc pleurodesis is generally recognized as the most effective and safest method for the induction of chemical pleurodesis. However, in rare cases, it can lead to acute respiratory distress syndrome (ARDS). In this article, we report the case of a patient with metastatic adenocarcinoma to the pleura who presents with shortness of breath and malignant pleural effusion, develops ARDS after pleurodesis with talc, and expires despite the partial improvement of lung involvement. The symptoms and causes of this rare side effect as well as the methods that can be used to deal with it are reviewed in this article.

Implanting jejunostomy tube as conservative management of tracheoesophageal fistula in a COVID-19 patient.

A 44-year-old woman with Behcet's disease experienced a severe COVID-19 infection and developed a tracheoesophageal fistula. Despite the need for surgical treatment, she did not consent. Therefore, the patient underwent supportive treatment with a jejunostomy tube. After four weeks of follow-up, the fistula was repaired spontaneously.

Mortality Rate of Sepsis Patients in the Intensive Care Unit: The Prognostic Role of Ejection Fraction and Procalcitonin.

Sepsis is the second leading cause of death in the intensive care unit (ICU) and is one of the important causes of death for all hospitalized patients [1]. Evidence revealed procalcitonin as the critical risk factor for determining the prognosis of septic patients [2,3].Also, new studies indicated that diastolic dysfunction and low ejection fraction (EF) were identified as risk factors for death in septic patients [4]. Indeed, septic patients with lower EF had higher mortality rates than other septic patients [5]. Hence, in the pilot study, we determine the mortality rate of hospitalized patients in our clinic during 2020. Besides, EF was evaluated via echocardiography, and also serum PCT was measured on the first day of admission to ICU. Our results indicate that 35 % and 65 % of patients were expired and discharged, respectively. The association between EF and mortality is shown in Figure-1. There were no significant differences between EF and mortally among studied patients (P=0.79). The mean PCT in expired patients was 7.67 ±5.52 ng/ml, while in the discharged patients was 4.21±3.1 ng/ml. On the other hand, although the mean PCT level in the expired patients was higher than those discharged, this difference was not significant. Our study revealed that although PCT and EF statistically were not different in expired patients compared to those discharged, both PCT and EF could be considered important prognostic factors for mortality among sepsis patients in the ICU. However, more studies with larger sample sizes and more parameters for the determination of EF and PCT are recommended.