Hemoptysis

咯血
  • 文章类型: Case Reports
    系统性红斑狼疮(SLE)是一种自身免疫性疾病,以II型和III型超敏反应为特征,影响多个器官,包括关节,心,肺,大脑,皮肤,还有肾脏.SLE患者会出现一系列症状,从发烧和关节痛到独特的蝴蝶面部皮疹。严重的并发症可能包括弥漫性肺泡出血(DAH),肺动脉高压,和狼疮性肾炎,在其他人中。其中,DAH,严重的SLE肺部并发症,涉及由于免疫复合物损伤引起的间质毛细血管和肺泡出血。此病例报告描述了最初被误诊但后来被证实患有SLE的患者。患者出现持续症状,包括咳嗽,呼吸困难,发烧,超过两周,随后在过去两天内出现血尿和咯血。症状的进展导致急性加重,导致她进入急诊科。随后的评估证实了狼疮性肾炎和DAH的诊断。此病例强调了在不明原因的全身症状的鉴别诊断中考虑SLE的重要性,并强调了迫切需要对DAH进行医疗干预以大大降低死亡率。
    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by type II and type III hypersensitivity reactions that affect multiple organs, including the joints, heart, lungs, brain, skin, and kidneys. Patients with SLE can experience a range of symptoms, ranging from fever and joint pain to a distinctive butterfly facial rash. Severe complications may encompass conditions such as diffuse alveolar hemorrhage (DAH), pulmonary hypertension, and lupus nephritis, among others. Among them, DAH, a critical pulmonary complication in SLE, involves bleeding from interstitial capillaries and alveoli due to immune complex damage. This case report describes a patient who was initially misdiagnosed but later confirmed to have SLE. The patient presented with persistent symptoms, including cough, dyspnea, and fever, over two weeks and subsequently developed hematuria and hemoptysis within the last two days. The progression of symptoms led to an acute exacerbation, resulting in her admission to the emergency department. Subsequent evaluations confirmed the diagnosis of lupus nephritis and DAH. This case highlights the importance of considering SLE in the differential diagnosis of unexplained systemic symptoms and underscores the urgent need for medical intervention in DAH to substantially reduce mortality.
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  • 文章类型: Case Reports
    随着右肺动脉发育不全(PAA)的儿科患者的成熟,她逐渐出现肺动脉高压和咯血的症状。关于这种情况的临床文献有限,目前,关于其诊断和治疗尚无共识。本文介绍一例16岁女性右肺动脉发育不全患者的病例研究,提供对她的发育进展的全面总结和分析,病理学,诊断,和治疗。
    As the pediatric patient with right pulmonary artery agenesis (PAA) matured, she progressively presented symptoms of pulmonary hypertension and hemoptysis. There is limited clinical literature on this condition, and currently, there is no consensus regarding its diagnosis and treatment. This article presents a case study of a 16-year-old female patient with right pulmonary artery hypoplasia, providing a comprehensive summary and analysis of her developmental progression, pathology, diagnosis, and treatment.
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  • 文章类型: Case Reports
    该报告描述了一名20多岁的男性,他有2个月的反复咯血和胸痛病史。慢性感染,如肺结核,被怀疑。过去,他曾接受过心包内包虫囊肿的手术切除。他的血液检查显示周围嗜酸性粒细胞增多,他的胸部X光检查显示左上区有囊性卵圆病变。CT肺血管造影显示,双侧节段和亚节动脉充盈缺损,左上叶囊性病变。进一步的工作,包括支气管肺泡灌洗培养和胸部MRI,确诊为包虫囊肿的肺包虫病。此病例说明了在没有其他危险因素的年轻男性中出现多系统包虫病。最初接受手术切除和抗蠕虫治疗。这种疾病后来复发,这需要长时间的药物治疗,使病人得到缓解.
    This report describes a male in his late 20s who presented with a 2-month history of recurrent haemoptysis and chest pain. A chronic infection, such as tuberculosis, was suspected. He had undergone surgical resection of an intrapericardial hydatid cyst in the past. His blood investigations showed peripheral eosinophilia, and his chest X-ray showed a cystic oval lesion in the left upper zone. A CT pulmonary angiogram revealed filling defects in the bilateral segmental and subsegmental arteries with a cystic lesion in the left upper lobe. Further workup, including bronchoalveolar lavage culture and MRI of the thorax, confirmed the diagnosis of a hydatid cyst of pulmonary echinococcosis. This case illustrates the presentation of multisystemic echinococcosis in a young male with no other risk factors, initially treated with surgical resection and antihelminthic therapy. The disease later recurred, which required prolonged medications, which brought the patient into remission.
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  • 文章类型: Case Reports
    肺隔离症(PS)是一种罕见的先天性异常,其特征是无功能的肺组织异常形成,全身血液供应异常。尽管它很罕见,PS提出了重大的诊断和管理挑战,通常需要多学科方法来获得最佳患者预后。本病例报告提供了对临床表现的见解,诊断方式,和PS的管理策略。
    作者介绍了一例30岁男性,主诉慢性咳嗽和咯血,最终通过计算机断层扫描(CT)成像诊断为叶内PS。病人接受了外科手术,特别是肺叶切除术,来处理肺组织。
    叶内PS的诊断通过CT成像证实,表现出异常的特征,包括不规则的囊性通讯。全身动脉供应异常和静脉液体变化的大面积区域。该患者出现与PS一致的症状,包括慢性咳嗽和咯血,强调及时诊断和干预以预防危及生命的并发症的重要性。
    肺隔离术由于其可变的临床表现和潜在的误诊而具有诊断挑战。然而,技术的进步,比如CT血管造影,使准确的诊断和精确的手术计划更容易。通过肺叶切除术或动脉栓塞术进行及时干预对于降低与PS相关的危及生命的并发症的风险很重要。这些数据突出了医生之间多学科合作的重要性,放射科医生,和外科医生有效管理PS并改善患者预后。
    UNASSIGNED: Pulmonary sequestration (PS) is a rare congenital anomaly characterized by aberrant formation of nonfunctional lung tissue with anomalous systemic blood supply. Despite its rarity, PS presents significant diagnostic and management challenges, often necessitating a multidisciplinary approach for optimal patient outcomes. This case report provides insights into the clinical presentation, diagnostic modalities, and management strategies for PS.
    UNASSIGNED: The authors present a case of a 30-year-old male who complained of chronic cough and hemoptysis and was eventually diagnosed with intralobar PS by computed tomography (CT) imaging. The patient underwent a surgical procedure, specifically a lobectomy, to address the lung tissue.
    UNASSIGNED: The diagnosis of intralobar PS is confirmed by CT imaging, showing features of abnormalities, including irregular cystic communication. A large area with abnormal systemic arterial supply and variable venous fluid. This patient presented with symptoms consistent with PS, including chronic cough and hemoptysis, highlighting the importance of timely diagnosis and intervention to prevent life-threatening complications.
    UNASSIGNED: Lung sequestration has diagnostic challenges due to its variable clinical presentation and potential for misdiagnosis. However, advances in technology, such as CT angiography, make accurate diagnosis and precise surgical planning easier. Prompt intervention via lobectomy or transarterial embolization is important to reduce the risk of life-threatening complications associated with PS. These data highlight the importance of multidisciplinary collaboration between physicians, radiologists, and surgeons to effectively manage PS and improve patient outcomes.
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  • 文章类型: Case Reports
    Behçet病是一种病因不明的慢性全身性炎症性血管炎。它的特点是口腔口疮溃疡反复发作,生殖器溃疡,皮肤损伤,眼部病变,和其他表现。这种疾病影响许多器官和系统,表现出广泛的临床特征。尽管肺动脉受累在Behçet病中并不常见,它的存在带来了巨大的死亡风险。本报告提供了一名25岁男性因生咳入院的详细病史,咯血,轻微劳累时呼吸困难,发烧,和胸痛。他有复发性睾丸炎和附睾炎7年,以及口腔和生殖器溃疡和严重头痛。临床检查显示右中肺呼吸音减少。胸部CT血管造影证实双侧多发肺动脉动脉瘤。病人被诊断出患有Behçet病,并开始免疫抑制治疗。随访期间,患者未报告任何并发症.该病例报告强调了临床医生将Behçet病作为出现咯血并有睾丸炎和附睾炎病史的患者的鉴别诊断的重要性。鉴于Behçet病很少引起肺动脉动脉瘤。
    Behçet\'s disease is a chronic systemic inflammatory vasculitis of unknown etiology. It is characterized by recurrent episodes of oral aphthous ulcers, genital ulcers, skin lesions, ocular lesions, and other manifestations. This disease affects many organs and systems, showing a wide range of clinical features. Although pulmonary artery involvement is not common in Behçet\'s disease, its presence carries a substantial risk of mortality. This report provides a detailed history of a 25-year-old male who was admitted with productive cough, hemoptysis, dyspnea on minimal exertion, fever, and chest pain. He had recurrent orchitis and epididymitis for 7 years, as well as oral and genital ulcers and severe headache. Clinical examination revealed decreased breath sounds at the right middle lung. Thoracic computed tomography angiography confirmed multiple pulmonary artery aneurysms bilaterally. The patient was diagnosed with Behçet\'s disease, and immunosuppression therapy was initiated. During follow-up, the patient did not report any complications. This case report underscores the significance for clinicians to consider Behçet\'s disease as a differential diagnosis in patients presenting with hemoptysis and a history of orchitis and epididymitis, given that Behçet\'s disease rarely causes pulmonary artery aneurysms.
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  • 文章类型: Case Reports
    我们描述了一名33岁的年轻妇女的情况,该妇女在CT扫描时被转诊到我们的诊所,以获取迁移的空洞结节的证据,呼吸困难,还有血痰.她的身体检查显示皮肤透明而薄,明显的静脉血管模式,嘴唇稀薄的朱红色,小颌畸形,瘦小的鼻子,和偶尔的雷诺现象。我们开了另一个CT扫描,显示双肺有多个肺结节,其中一些有气蚀的证据。因为支气管镜检查不能诊断,我们决定进行外科肺活检.在组织学检查中,我们发现不规则形状的存在,但主要不是树枝状的,骨化灶通常包含骨髓,并被腱样纤维组织包埋或包围。在纳入组织学检查的数据后,我们决定使用全外显子组测序进行遗传咨询和基因检测.基因检测揭示了COL3A1基因的杂合从头错义突变,编码III型胶原蛋白合成,并可能导致血管Ehlers-Danlos综合征.
    We describe the case of a young 33-year-old woman that was referred to our clinic for evidence of migrant cavitary nodules at CT scan, dyspnea, and blood sputum. Her physical examination showed translucent and thin skin, evident venous vascular pattern, vermilion of the lip thin, micrognathia, thin nose, and occasional Raynaud phenomenon. We prescribed another CT scan that showed multiple pulmonary nodules in both lungs, some of which had evidence of cavitation. Because bronchoscopy was not diagnostic, we decided to perform surgical lung biopsy. At histologic examination, we found the presence of irregularly shaped, but mainly not dendritic, foci of ossification that often contained bone marrow and were embedded or surrounded by tendinous-like fibrous tissue. After incorporating data from the histologic examination, we decided to perform genetic counseling and genetic testing with the use of whole-exome sequencing. The genetic test revealed a heterozygous de novo missense mutation of COL3A1 gene, which encodes for type III collagen synthesis, and could cause vascular Ehlers-Danlos syndrome.
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  • 文章类型: Case Reports
    一种罕见的先天性呼吸道畸形,支气管肺隔离症(BPS),可能在儿童或青少年时期早期出现症状。成人BPS通常是在胸部成像上发现的偶然发现。目前有四种已知类型的BPS。ILS是其中最常见的,也是文献中最常见的形式。在我们的案例报告中,我们报告了一名健康的成年女性,她出现咯血,导致诊断出最罕见的BPS形式;叶外隔离(ELS)。一种在文献中不常见的描述,尤其是在成年后期报道的。本病例报告旨在教育和避免临床医生对这种罕见的病因进行区分和指导,以指导其调查和管理。
    在此案例报告中,一名56岁的妇女,在由她的全科医生(GP)转诊后到门诊呼吸诊所就诊。呼吸小组进行了彻底的检查,最终诊断为ELS。患者的自主性以及风险和收益得到了遵守,这导致了非手术管理方法。她显着地解决了症状。
    对这种罕见疾病的认识和熟悉,ELS,当没有其他常见原因时,应提示人们考虑其诊断。通常可以通过放射学进行诊断。ELSs的治疗应取决于多种因素。
    UNASSIGNED: A rare congenital malformation of the respiratory tract, bronchopulmonary sequestration (BPS), may present symptomatically early on in childhood or adolescent years. Adult BPS is typically an incidental finding found on thoracic imaging. There are currently four known types of BPS. Intralobar sequestrations (ILSs) are the most common of them and the most commonly reported form in literature. In our case report, we report of a healthy adult female who presented with hemoptysis that resulted in the diagnosis of the rarest form of BPSs; extralobar sequestration (ELS). One that is not commonly described in literature, especially of one reported in late adulthood. This case report aims to educate and elude clinicians to this rare cause as a differential and guidance on its investigation and management.
    UNASSIGNED: In this case report, a 56-year-old woman who presented to an outpatient respiratory clinic after being referred by her general practitioner (GP) of a queried BPS. A thorough workup was done by the respiratory team that derived at the final diagnosis of an ELS. The patient\'s autonomy was adhered to along with risks and benefits which resulted in a non-surgical approach to management. One that she remarkably achieved a resolution of her symptoms.
    UNASSIGNED: An awareness and familiarity of this rare disease, ELS, should prompt one to consider its\' diagnosis when no other common causes are apparent. Often the diagnosis can be made radiologically. Treatment of ELSs should depend on multiple factors.
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  • 文章类型: Case Reports
    虽然异物吸入气管和支气管可能发生在所有年龄组,在婴幼儿中更为常见。气管支气管树中的异物在成人中并不常见,主要存在于吞咽困难和意识水平改变的患者中。气管支气管树中异物的识别经常被忽视或延迟,导致患者后来出现慢性症状和潜在并发症。这些并发症可能包括持续咳嗽,喘息,阻塞性肺炎,支气管扩张,反复肺部感染继发的脓肿形成。本文旨在介绍一名没有误吸危险因素的27岁患者的病例,该患者经历了五年的复发性自限性咯血发作。支气管镜检查发现中叶支气管入口处有异物。任何复发性咯血患者应考虑气管支气管树中异物的存在。支气管镜检查导致准确的诊断,治疗,预防并发症。
    Although aspiration of a foreign body into the trachea and bronchi can occur in all age groups, it is more common in infants and young children. Foreign bodies in the tracheobronchial tree are uncommon in adults and mainly present in patients with dysphagia and an altered level of consciousness. The identification of foreign bodies in the tracheobronchial tree is frequently overlooked or delayed, leading patients to present later with chronic symptoms and potential complications. These complications may include persistent coughing, wheezing, obstructive pneumonitis, bronchiectasis, and abscess formation secondary to recurrent pulmonary infections. This article aims to present the case of a 27-year-old patient without risk factors for aspiration who has experienced recurrent self-limiting hemoptysis episodes for five years. Bronchoscopy revealed a foreign body at the entrance to the middle lobe bronchus. The presence of a foreign body in the tracheobronchial tree should be considered in any patient with recurrent hemoptysis. Bronchoscopy leads to accurate diagnosis, treatment, and prevention of complications.
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  • 文章类型: Case Reports
    人类感染主要由嗜水气单胞菌引起,鱼气单胞菌,和veronii气单胞菌.近年来,达克气单胞菌已被认为在环境中广泛分布,有很强的毒力.然而,这种细菌感染通常不会出现在肺炎患者的首发症状中。
    我们报告了一名26岁的男子,他以社区获得性肺炎为首发症状入院,并出现了溶血性尿毒综合征等严重病症,多器官功能障碍,短时间内失血性休克。他入院13小时后死亡,随后的宏基因组-下一代测序测试证实了最终确定的感染病原体为达克氏杆菌。
    气单胞菌是社区获得性肺炎诊断中发现的一种罕见病原体。因此,医生需要发展他们的经验,以确定病原微生物引起的感染之间的差异。在可以通过经验性药物控制的呼吸道症状发生期间,医疗护理至关重要,如头孢菌素类或喹诺酮类。当社区获得性肺炎患者在临床治疗中出现咯血和多器官功能障碍时,应该考虑不寻常的病原体感染,应尽早明确病因,以便及时治疗。
    UNASSIGNED: Infections in humans are mainly caused by Aeromonas hydrophila, Aeromonas caviae, and Aeromonas veronii. In recent years, Aeromonas dhakensis has been recognized as widely distributed in the environment, with strong virulence. However, this bacterial infection usually does not appear in patients with pneumonia as the first symptom.
    UNASSIGNED: We report a 26-year-old man who was admitted to the hospital with community-acquired pneumonia as the first symptom and developed serious conditions such as hemolytic uremic syndrome, multiple organ dysfunction, and hemorrhagic shock within a short period. He died after 13 h of admission, and the subsequent metagenomic-next generation sequencing test confirmed the finally identified pathogen of infection as A. dhakensis.
    UNASSIGNED: Aeromonas is a rare pathogen identified in the diagnosis of community-acquired pneumonia. Hence, doctors need to develop their experience in identifying the difference between infections caused by pathogenic microorganisms. Medical attention is essential during the occurrence of respiratory symptoms that could be controlled by empirical drugs, such as cephalosporins or quinolones. When patients with community-acquired pneumonia present hemoptysis and multiple organ dysfunction in clinical treatment, an unusual pathogen infection should be considered, and the underlying etiology should be clarified at the earliest for timely treatment.
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  • 文章类型: Case Reports
    特发性肺含铁血黄素沉着症(IPH)是弥漫性肺泡出血(DAH)的罕见原因。它与高死亡率和广泛的肺泡出血的反复发作有关,最常见于儿童。这里,我们在一名74岁男性中发现了罕见的迟发型特发性肺含铁血黄素沉着症.他因非解决性肺炎入院,咯血,和1型呼吸衰竭,伴随着副作用性贫血.胸部影像显示双侧上叶及右侧中叶肺泡影。评估过程中排除了弥漫性肺泡出血的感染性和自身免疫性病因。经支气管肺活检可见斑片状肺泡出血和丰富的含铁血黄素色素沉积,揭示特发性肺含铁血黄素沉着症。患者成功口服类固醇治疗,随后在1年随访时,放射学完全消退,无临床复发.
    Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage (DAH). It is associated with a high mortality rate and recurrent episodes of widespread alveolar hemorrhage and most commonly affects children. Here, we present a rare occurrence of late-onset idiopathic pulmonary hemosiderosis in a 74-year-old male. He was admitted for non-resolving pneumonia, hemoptysis, and type 1 respiratory failure, along with sideropenic anemia. Chest imaging showed bilateral upper lobe and right middle lobe alveolar opacities. Infective and autoimmune etiologies of diffuse alveolar hemorrhage were ruled out during the evaluation. Transbronchial lung biopsy showed patchy alveolar hemorrhage and abundant hemosiderin pigment deposition, revealing idiopathic pulmonary hemosiderosis. The patient was successfully treated with oral steroids, followed by complete radiological resolution without clinical relapse at one-year follow-up.
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