Respiratory medicine case reports 

About: Respiratory medicine case reports is an academic journal published by Elsevier BV. The journal publishes majorly in the area(s): Medicine & Pneumonia. It has an ISSN identifier of 2213-0071. It is also open access. Over the lifetime, 1877 publications have been published receiving 7711 citations.

Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases.

Abstract: Purpose Infection with COVID-19 potentially can result in severe outcomes and death from "cytokine storm syndrome", resulting in novel coronavirus pneumonia (NCP) with severe dyspnea, acute respiratory distress syndrome (ARDS), fulminant myocarditis and multiorgan dysfunction with or without disseminated intravascular coagulation. No published treatment to date has been shown to adequately control the inflammation and respiratory symptoms associated with COVID-19, apart from oxygen therapy and assisted ventilation. We evaluated the effects of using high dose oral and/or IV glutathione in the treatment of 2 patients with dyspnea secondary to COVID-19 pneumonia. Methods Two patients living in New York City (NYC) with a history of Lyme and tick-borne co-infections experienced a cough and dyspnea and demonstrated radiological findings consistent with novel coronavirus pneumonia (NCP). A trial of 2 g of PO or IV glutathione was used in both patients and improved their dyspnea within 1 h of use. Repeated use of both 2000 mg of PO and IV glutathione was effective in further relieving respiratory symptoms. Conclusion Oral and IV glutathione, glutathione precursors (N-acetyl-cysteine) and alpha lipoic acid may represent a novel treatment approach for blocking NF-κB and addressing "cytokine storm syndrome" and respiratory distress in patients with COVID-19 pneumonia.

Acute eosinophilic pneumonia following electronic cigarette use.

Abstract: Electronic cigarette (e-cigarette) use, or vaping, is gaining widespread popularity among adults aged 18-35. Vaping is commercially promoted as a safer alternative to traditional cigarette smoking. Previous studies have reported a close relationship between conventional cigarette smoking and acute eosinophilic pneumonia (AEP), but only one case report to date associates vaping with AEP in a male patient. We present the first case of AEP involving a young female after use of e-cigarettes. Clinicians should consider AEP when evaluating young patients with hypoxic respiratory failure and a recent history of e-cigarette use. This case highlights the need for more research into the relationship between e-cigarettes and AEP.

Invasive aspergillosis related to ibrutinib therapy for chronic lymphocytic leukemia

Abstract: We report a case of invasive pulmonary aspergillosis in a patient taking ibrutinib, a Bruton's tyrosine kinase inhibitor used to treat refractory chronic lymphocytic leukemia. We hypothesize that ibrutinib promoted this infection by suppressing innate immune responses against Aspergillus. Clinicians should be aware of potential Aspergillus infections in patients treated with this drug.

COVID-19 promoting the development of active tuberculosis in a patient with latent tuberculosis infection: a case report

Abstract: We report the case of a 40-year-old female diagnosed with COVID-19 after presenting to our institution with fever, cough and myalgia for three days. Her nasopharyngeal swab tested positive for SARS COV-2 by real time PCR and her plain chest radiograph was reported as normal. She did not require hospitalization and at telephone follow up she confirmed her illness lasted 11 days. Seven weeks later she presented with chest pain, dyspnea and fever for two days. Her repeat chest imaging showed right upper zone consolidation and this culminated in a microbiological diagnosis of pulmonary tuberculosis. The patient's daughter had been treated for tuberculosis two years earlier and unfortunately family screening for latent TB was not undertaken. This case appears to confirm the concerns that the CD4+ T-cell depletion associated with COVID-19 may promote the development of active tuberculosis from latent infection much like HIV does. If this effect is widespread it may have a significant impact on the worldwide TB burden. We suggest vigilance to ensure patients are diagnosed early and meticulous contact tracing is undertaken to treat those with latent tuberculosis.

Acute kidney injury in pregnant women following SARS-CoV-2 infection: A case report from Iran.

Abstract: We reported a 33-year-old female case with novel coronavirus disease 2019 (COVID-19) accompanied by Acute tubular necrosis (ATN). She had a gestational age of 34 weeks. The patient referred to treatment clinic for COVID-19 in Imam Reza hospital of Tabriz (Iran) after having flu-like symptoms. In radiologic assessment, ground glass opacity (GGO) with consolidation was found in upper right lobe. Lopinavir/ritonavir (200mg/50mg) two tablet tow times, Ribavirin 200mg every six hours, and Oseltamivir 75mg tow times were given for the treatment of COVID-19. The medications used for treatment of pneumonia were Meropenem, Ciprofloxacin, Vancomycin. All doses of medications were administrated by adjusted dose assuming the patient is anephric. Also, a few supplements were also given after ATN development including daily Rocaltrol and Nephrovit (as a multivitamin appropriate for patients with renal failure), Folic acid and Calcium carbonate. The patient is still under ventilator with a Fraction of inspired oxygen (FiO2) of 60% and Positive end-expiratory pressure (PEEP) of eight. SpO2 is 94% but the patient's ATN problem has been resolved. We started weaning from mechanical ventilator. The patient is conscious with full awareness to time, person and place. The maternal well-being is achieved and her neonate was discharged.