Sujet(s)
Actinomycose/diagnostic , Actinomycose/microbiologie , Maladies du thorax/diagnostic , Maladies du thorax/microbiologie , Actinomycose/traitement médicamenteux , Adolescent , Antibactériens/usage thérapeutique , Toux/microbiologie , Diagnostic différentiel , Femelle , Humains , Maladies du thorax/traitement médicamenteux , Paroi thoracique/microbiologie , Perte de poidsRÉSUMÉ
BACKGROUND: Thoracic endometriosis syndrome (TES) is a rare condition that occurs in women when endometriosis implants into the thoracic cavity. Catamenial hemoptysis, the occurrence of hemoptysis with menstruation, is a recognized clinical manifestation of TES commonly treated with hormonal therapy. CASE SUMMARY: We present the first documented case describing the recrudescence of catamenial hemoptysis in the setting of Lumacaftor/Ivacaftor administration in a 25-year-old woman with cystic fibrosis (CF). DISCUSSION: We review the literature on TES, pharmacologic management, and reported cystic fibrosis transmembrane conductance regulator (CFTR) modulator drug interactions. We propose that our patient's recrudescence of catamenial hemoptysis was secondary to a drug-drug interaction between Lumacaftor/Ivacaftor and oral contraceptive therapy. CONCLUSION: Our case suggests that women with CF who have catamenial hemoptysis and a genetic mutation approved for Tezacaftor/Ivacaftor or Elexacaftor/Tezacaftor/Ivacaftor can be managed effectively with either CFTR modulator and hormonal contraceptive therapy.
Sujet(s)
Aminophénols/usage thérapeutique , Aminopyridines/usage thérapeutique , Benzodioxoles/usage thérapeutique , Mucoviscidose , Endométriose , Hémoptysie , Indoles/usage thérapeutique , Leuprolide/administration et posologie , Pyrazoles/usage thérapeutique , Pyridines/usage thérapeutique , Quinoléines/usage thérapeutique , Quinolinone/usage thérapeutique , Adulte , Bronchoscopie/méthodes , Agonistes de canaux chlorure/usage thérapeutique , Mucoviscidose/complications , Mucoviscidose/diagnostic , Mucoviscidose/traitement médicamenteux , Mucoviscidose/physiopathologie , Association médicamenteuse , Association de médicaments/méthodes , Endométriose/complications , Endométriose/diagnostic , Endométriose/traitement médicamenteux , Endométriose/physiopathologie , Femelle , Fécondostimulants féminins/administration et posologie , Hémoptysie/diagnostic , Hémoptysie/étiologie , Hémoptysie/prévention et contrôle , Humains , Radiographie thoracique/méthodes , Maladies du thorax/complications , Maladies du thorax/diagnostic , Maladies du thorax/traitement médicamenteux , Maladies du thorax/physiopathologie , Tomodensitométrie/méthodesSujet(s)
Endométriose/traitement médicamenteux , Hormone de libération des gonadotrophines/usage thérapeutique , Hémoptysie/traitement médicamenteux , Hémothorax/traitement médicamenteux , Pneumothorax/traitement médicamenteux , Maladies du thorax/traitement médicamenteux , Adulte , Endométriose/complications , Endométriose/anatomopathologie , Femelle , Études de suivi , Hémoptysie/complications , Hémoptysie/anatomopathologie , Hémothorax/complications , Hémothorax/anatomopathologie , Humains , Pneumothorax/complications , Pneumothorax/anatomopathologie , Pronostic , Maladies du thorax/complications , Maladies du thorax/anatomopathologieSujet(s)
Sarcoïdose/diagnostic , Maladies de l'estomac/diagnostic , Maladies du thorax/diagnostic , Bronchoscopie , Diagnostic différentiel , Femelle , Glucocorticoïdes/usage thérapeutique , Humains , Adulte d'âge moyen , Radiographie thoracique , Sarcoïdose/complications , Sarcoïdose/traitement médicamenteux , Maladies de l'estomac/complications , Maladies de l'estomac/traitement médicamenteux , Maladies du thorax/complications , Maladies du thorax/traitement médicamenteux , TomodensitométrieRÉSUMÉ
Thoracic actinomycosis with involvement of the vertebral column and chest wall is rare in children and may resemble malignant tumors. A 12-year-old girl was admitted to our clinic having B-symptoms, cachexia, and painful scoliosis (Karnofsky index 20%). Imaging showed a large thoracic left-sided paravertebral tumor with infiltration of the vertebrae, destruction of the chest wall and multiple intrapulmonary nodules. Initially, Ewing sarcoma was suspected and chemotherapy started without previous biopsies. Definite diagnosis of actinomycosis was established later upon histopathologic examination and successfully treated by ß-lactam antibiotics. Collectively, this case illustrates that actinomycosis can be an oncological pitfall and possible differential diagnosis.
Sujet(s)
Actinomycose , Maladies du rachis , Maladies du thorax , Actinomycose/imagerie diagnostique , Actinomycose/traitement médicamenteux , Enfant , Femelle , Humains , Sarcome d'Ewing/imagerie diagnostique , Sarcome d'Ewing/traitement médicamenteux , Maladies du rachis/imagerie diagnostique , Maladies du rachis/traitement médicamenteux , Maladies du rachis/microbiologie , Maladies du thorax/imagerie diagnostique , Maladies du thorax/traitement médicamenteux , Maladies du thorax/microbiologieSujet(s)
Toux , Infections à mycobactéries non tuberculeuses/diagnostic , Infections à mycobactéries non tuberculeuses/traitement médicamenteux , Bruits respiratoires , Maladies du thorax/diagnostic , Maladies du thorax/traitement médicamenteux , Antibactériens/usage thérapeutique , Biopsie , Bronchoscopie , Diagnostic différentiel , Imagerie diagnostique , Femelle , Humains , NourrissonSujet(s)
Endométriose/complications , Hémopneumothorax/étiologie , Maladies du thorax/complications , Antinéoplasiques hormonaux/usage thérapeutique , Endométriose/imagerie diagnostique , Endométriose/traitement médicamenteux , Femelle , Goséréline/usage thérapeutique , Hémopneumothorax/imagerie diagnostique , Humains , Imagerie par résonance magnétique , Adulte d'âge moyen , Tomographie par émission monophotonique couplée à la tomodensitométrie , Maladies du thorax/imagerie diagnostique , Maladies du thorax/traitement médicamenteuxRÉSUMÉ
BACKGROUND: An adult male galago (Otolemur garnettii) presented for fight wounds following pairing for breeding. Treatment was symptomatic with recovery. Following resolution, the animal re-presented and died, despite additional treatment. METHODS: Necropsy, histopathology, bacterial cultures, and 16S RNA sequencing. RESULTS: A large intrathoracic/intra-abdominal abscess due to Trueperella pyogenes was found at necropsy. CONCLUSIONS: T. pyogenes should be considered in abscesses/wounds of galagos.
Sujet(s)
Abcès/médecine vétérinaire , Infections à Actinomycetales/médecine vétérinaire , Arcanobacterium/isolement et purification , Galago , Abcès abdominal/diagnostic , Abcès abdominal/traitement médicamenteux , Abcès abdominal/microbiologie , Abcès abdominal/médecine vétérinaire , Abcès/diagnostic , Abcès/traitement médicamenteux , Abcès/microbiologie , Infections à Actinomycetales/diagnostic , Infections à Actinomycetales/traitement médicamenteux , Infections à Actinomycetales/microbiologie , Animaux , Antibactériens/administration et posologie , Arcanobacterium/génétique , Association de médicaments/médecine vétérinaire , Mâle , ARN bactérien/génétique , ARN ribosomique 16S/génétique , Analyse de séquence d'ARN , Maladies du thorax/diagnostic , Maladies du thorax/traitement médicamenteux , Maladies du thorax/microbiologie , Maladies du thorax/médecine vétérinaireSujet(s)
Déficits immunitaires/complications , Complexe Mycobacterium avium/isolement et purification , Infection due à Mycobacterium avium-intracellulare/diagnostic , Infection due à Mycobacterium avium-intracellulare/anatomopathologie , Maladies du thorax/diagnostic , Maladies du thorax/anatomopathologie , Paroi thoracique/anatomopathologie , Antituberculeux/usage thérapeutique , Australie , Enfant d'âge préscolaire , Débridement , Prédisposition aux maladies , Femelle , Histocytochimie , Humains , Infection due à Mycobacterium avium-intracellulare/traitement médicamenteux , Infection due à Mycobacterium avium-intracellulare/chirurgie , Radiographie thoracique , Maladies du thorax/traitement médicamenteux , Maladies du thorax/chirurgie , Paroi thoracique/imagerie diagnostique , Paroi thoracique/chirurgieSujet(s)
Échinococcose/chirurgie , Ostéolyse/chirurgie , Maladies du thorax/chirurgie , Vertèbres thoraciques/chirurgie , Thoracotomie/méthodes , Adulte , Anthelminthiques/usage thérapeutique , Association thérapeutique , Échinococcose/traitement médicamenteux , Humains , Mâle , Ostéolyse/traitement médicamenteux , Ostéolyse/parasitologie , Côtes/parasitologie , Côtes/chirurgie , Maladies du rachis/traitement médicamenteux , Maladies du rachis/parasitologie , Maladies du rachis/chirurgie , Maladies du thorax/traitement médicamenteux , Maladies du thorax/parasitologie , Vertèbres thoraciques/parasitologieSujet(s)
Abcès/diagnostic , Maladies du thorax/diagnostic , Paroi thoracique/anatomopathologie , Tuberculose/diagnostic , Abcès/traitement médicamenteux , Abcès/microbiologie , Abcès/chirurgie , Adulte , Antituberculeux/usage thérapeutique , Diabète/épidémiologie , Femelle , Humains , Immunocompétence , Sujet immunodéprimé , Mâle , Adulte d'âge moyen , Ostéolyse/étiologie , Radiographie , Côtes/imagerie diagnostique , Côtes/microbiologie , Fumer/épidémiologie , Maladies du thorax/traitement médicamenteux , Maladies du thorax/microbiologie , Maladies du thorax/chirurgie , Paroi thoracique/microbiologie , Paroi thoracique/chirurgie , Tuberculose/traitement médicamenteux , Tuberculose/microbiologie , Tuberculose/chirurgie , Tuberculose ostéoarticulaire/complications , Tuberculose ostéoarticulaire/imagerie diagnostique , Tuberculose pleurale/complications , Jeune adulteSujet(s)
Actinomycose/complications , Actinomycose/diagnostic , Maladies pulmonaires/complications , Maladies pulmonaires/diagnostic , Maladies du thorax/complications , Maladies du thorax/diagnostic , Actinomycose/traitement médicamenteux , Antibactériens/usage thérapeutique , Biopsie , Enfant , Produits de contraste , Diagnostic différentiel , Femelle , Douleur du flanc/traitement médicamenteux , Douleur du flanc/étiologie , Douleur du flanc/microbiologie , Humains , Amélioration d'image , Poumon/microbiologie , Poumon/anatomopathologie , Maladies pulmonaires/traitement médicamenteux , Imagerie par résonance magnétique , Pénicillines/usage thérapeutique , Maladies du thorax/traitement médicamenteux , Thorax/microbiologie , Thorax/anatomopathologie , TomodensitométrieRÉSUMÉ
Fungal mycetoma are inflammatory pseudo-tumors of subcutaneous tissues and possibly bones due to exogenous fungi. They have a chronic course, often poly-fistulated with an emission of fungal grains. We report the case of a 65-year-old farmer with a thoracic fungal mycetoma discovered incidentally, associated with bone involvement. The diagnosis was confirmed by the positive culture to Madurella mycetomatis. The outcome was favorable with terbinafine 1g per day for 12 months associated with complete excision of oncologic type followed by a skin graft.
Sujet(s)
Madurella/isolement et purification , Mycétome , Naphtalènes/usage thérapeutique , Maladies du thorax , Sujet âgé , Diagnostic différentiel , Humains , Résultats fortuits , Mâle , Mycétome/traitement médicamenteux , Mycétome/microbiologie , Mycétome/chirurgie , Transplantation de peau , Terbinafine , Maladies du thorax/traitement médicamenteux , Maladies du thorax/microbiologie , Maladies du thorax/chirurgie , Tumeurs du thorax/diagnosticRÉSUMÉ
OBJECTIVE: Thoracic endometriosis is a relatively rare type of endometriosis and includes catamenial pneumothorax, hemothorax and hemoptysis, and presence of intrathoracic endometriotic nodules. We want to clarify and resume the most appropriate management of this pathology. STUDY DESIGN: We retrospectively reviewed all the cases of thoracic endometriosis diagnosed and followed up in our Unit from 2005 to 2013. This search revealed five women, with a mean age of 34.5 (26-44). Four had previous history of endometriosis or severe dysmenorrhea. One patient complained of chronic shoulder pain with diaphragmatic implants, another one presented catamenial hemoptysis, and three women suffered from catamenial pneumothorax, with right-side preference. RESULTS: Three patients underwent surgery and all of them were treated with GnRH agonists at least during 6 month referring improvement in symptoms. After 1-8 years follow-up, all these patients remain asymptomatic. CONCLUSION: The optimal management of thoracic endometriosis needs further evaluation but the combined approach by hormonal therapy and surgery could be the best option.
Sujet(s)
Endométriose/thérapie , Pneumothorax/thérapie , Maladies du thorax/thérapie , Adulte , Femelle , Humains , Pneumothorax/traitement médicamenteux , Pneumothorax/chirurgie , Études rétrospectives , Maladies du thorax/traitement médicamenteux , Maladies du thorax/chirurgieRÉSUMÉ
Thoracic endometriosis is a rare form of extrapelvic endometriosis. These patients typically present with catamenial pneumothorax or hemoptysis. Adequate clinical history coupled with HRCT helps in early diagnosis and appropriate management of thoracic endometriosis.
Sujet(s)
Endométriose/imagerie diagnostique , Maladies du thorax/imagerie diagnostique , Adulte , Contraceptifs oraux/usage thérapeutique , Endométriose/complications , Endométriose/traitement médicamenteux , Femelle , Hémoptysie/étiologie , Humains , Mâle , Pneumothorax/étiologie , Maladies du thorax/complications , Maladies du thorax/traitement médicamenteux , TomodensitométrieSujet(s)
Endométriose/complications , Pneumothorax/traitement médicamenteux , Pneumothorax/étiologie , Maladies du thorax/complications , Adulte , Endométriose/traitement médicamenteux , Femelle , Gonadotrophines/usage thérapeutique , Humains , Troubles de la menstruation/complications , Troubles de la menstruation/traitement médicamenteux , Pneumothorax/diagnostic , Récidive , Maladies du thorax/traitement médicamenteux , Chirurgie thoracique vidéoassistéeRÉSUMÉ
Thoracic endometriosis is a rare disease, which presents in women at a mean age of 35 years, later than for pelvic endometriosis. There are no known predisposing factors for the condition and its pathogenesis is not yet clearly established. The symptoms always appear in connection with the periods of the person affected by the condition, occurring within 24-48 h after the start of menstruation. Catamenial pneumothorax is the most common clinical entity. It is associated with pelvic endometriosis in 30-50% of cases. Thoracoscopy, preferably performed during menstruation, allows full inspection of the diaphragm and the pleural cavity for defects in the diaphragm, endometrial nodules and bullae. The level of CA 125 is often elevated but this is not a reliable or specific marker. Medical treatment is aimed at blocking the action of estrogen on the endometrium and ectopic endometrial implants. GnRH analogues or danazol are the preferred treatments. Surgery to repair and strengthen the diaphragm and/or resect nodules or bullae also has a role, supplemented by pleurodesis to prevent further pneumothorax or effusions. The main risk is recurrence, and thus the current usual practice is to combine surgery, immediately followed by hormone therapy focusing on GnRH analogues.
Sujet(s)
Endométriose/diagnostic , Maladies du thorax/diagnostic , Adulte , Marqueurs biologiques/sang , Antigènes CA-125/sang , Association thérapeutique , Danazol/usage thérapeutique , Diagnostic différentiel , Endométriose/sang , Endométriose/complications , Endométriose/traitement médicamenteux , Endométriose/chirurgie , Modulateurs des récepteurs des oestrogènes/usage thérapeutique , Femelle , Hormone de libération des gonadotrophines/agonistes , Humains , Leuprolide/usage thérapeutique , Adulte d'âge moyen , Pneumothorax/étiologie , Emphysème pulmonaire/diagnostic , Récidive , Maladies du thorax/sang , Maladies du thorax/traitement médicamenteux , Maladies du thorax/chirurgie , Chirurgie thoracique vidéoassistée , Thoracoscopie , Déficit en alpha-1-antitrypsine/diagnosticRÉSUMÉ
A case of a sternal mass mimicking a chest wall tumor and finally diagnosed as primary sternal tuberculosis is presented. Fine needle biopsy was inconclusive and surgery included excision and drainage of a large abscess in the soft tissues around the involved bone. Pathology revealed multiple granulomatous and necrotic lesions consistent with tuberculous osteomyelitis. On a 4-drug antituberculous regimen the patient is an excellent condition 6 months later.
Sujet(s)
Maladies du thorax/diagnostic , Tuberculose/diagnostic , Antituberculeux/usage thérapeutique , Diagnostic différentiel , Humains , Mâle , Adulte d'âge moyen , Radiographie thoracique , Sternum , Maladies du thorax/traitement médicamenteux , Maladies du thorax/chirurgie , Tumeurs du thorax/diagnostic , Tuberculose/traitement médicamenteux , Tuberculose/chirurgieRÉSUMÉ
A case of thoracic mass infiltrating the chest wall mimicking a pulmonary invasive neoplasm is reported. Differential diagnosis and characteristic radiological and histological imaging had a decisive role in the case management. Actinomycosis is caused by a gram-positive, filamentous, microaerophilic bacteria. About 15% of the infections caused by Actinomyces involve the thorax. If not promptly diagnosed and treated thoracic actinomycosis may determine contiguous and systemic involvement. Actinomycosis is an anaerobic-to-microaerophilic bacteria and direct identification and isolation are difficult to obtain. In depth discussion diagnostic and therapeutic features are described in this report.
Sujet(s)
Actinomycose/diagnostic , Tumeurs du poumon/diagnostic , Maladies du thorax/diagnostic , Actinomycose/traitement médicamenteux , Actinomycose/microbiologie , Antibactériens/usage thérapeutique , Biopsie , Diagnostic différentiel , Humains , Mâle , Adulte d'âge moyen , Pénicillines/usage thérapeutique , Maladies du thorax/traitement médicamenteux , Maladies du thorax/microbiologie , Tomodensitométrie , Résultat thérapeutiqueRÉSUMÉ
Isolated thoracic parietal involvement is a very rare form of tuberculosis and multifocal localization is exceptional. It often poses a diagnostic problem with parietal tumours requiring recourse to surgical biopsy. We report a case of tuberculous abscess localized to the anterior and superior part of the chest wall with a second abdominal localization but without any pulmonary involvement. The patient was a woman of 56 years presenting with a one-year history of a swelling to the right of the sternum accompanied after several months by a second swelling to the right side of the abdomen. The radiological and biological investigations revealed a parietal tumour in two separate areas. The diagnosis was confirmed by histological examination of a surgical biopsy and bacteriological examination of a percutaneous aspirate of the collection. Standard anti-tuberculosis treatment was given for nine months with good clinical and radiological resolution. In this case report, we study the anatomical and clinical features of this condition and discuss the diagnostic difficulties.