Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 41-year-old man was admitted for evaluation of hemoptysis, dysphagia, and pleuritic chest pain associated with a mediastinal mass. Esophagography demonstrated a fistula between the mass and the esophagus. Results of histoplasmosis complement fixation serologic testing suggested an active infection. A methenamine silver stain of a lymph node obtained at mediastinoscopy revealed Histoplasmosis capsulatum. The patient was successfully treated with amphotericin B. This is believed to be the first reported case of an esophageal fistula as a complication of mediastinal histoplasmosis successfully treated with amphotericin B.
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PMID:Esophageal fistula complicating mediastinal histoplasmosis. Response to amphotericin B. 361 35

A 52-year-old man presented with a four-month history of malaise, low-grade fever, decreased appetite, and a 20-pound weight loss. He complained of joint pain and swelling, proximal muscle weakness, exertional dyspnea, and a dry cough. He also noted that his fingers had turned white and then blue when chilled and red when rewarmed. He had not had pleuritic chest pain, dysphagia, dry eyes or mouth, rash, or skin photosensitivity.
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PMID:A man with vague rheumatic complaints. 975 May 51

A 64-year-old woman presented with shortness of breath, right-sided pleuritic chest pain and dry cough. She was systemically anticoagulated with warfarin for a pulmonary embolism diagnosed 3 months previously, with an international normalised ratio (INR) of 3.0 on presentation. Chest radiograph demonstrated a new right paratracheal abnormality, and CT scan showed a large mediastinal mass not present 3 weeks earlier. MRI demonstrated an ovoid mass with a fluid/fluid level with high T2 and dark T1 signal consistent with a mediastinal haematoma. The patient's anticoagulation was emergently reversed and a temporary inferior vena cava filter was placed. The haematoma slowly resolved on serial follow-up with no additional intervention. Spontaneous mediastinal haematoma is a rare but life-threatening diagnosis that frequently presents with chest pain, dry cough and dysphagia. It is frequently associated with therapeutic anticoagulation and may potentially be caused by sudden, atraumatic rise in intrathoracic pressure (ie, cough or emesis).
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PMID:Spontaneous mediastinal haematoma: a rare complication of warfarin therapy. 2271 29

An elderly gentleman presented with acute dyspnoea and right-sided pleuritic chest pain. Two-weeks previously an oesophageal stent had been inserted for dysphagia secondary to oesophageal carcinoma. With low PaO(2), a neutrophilic leucocytosis, raised inflammatory markers and a right-sided pleural effusion, antibiotics were prescribed for pneumonia. Computed tomographic pulmonary angiogram (CTPA) ruled out pulmonary embolus. The patient rallied transiently and his effusion improved. His respiratory distress returned 14 days later. A chest x-ray revealed a right-sided hydropneumothorax, and a chest drain-released stomach contents from the pleural cavity. A gastrografin swallow and endoscopy demonstrated malignant oesophageal rupture. An attempt to re-stent failed, and the patient returned to the ward for palliation. His initial presentation was likely that of an oesophageal leak, and not pneumonia. Oesophageal rupture is difficult to diagnose due to ambiguous signs, symptoms and radiological findings. Swift diagnosis significantly improves the outcome, therefore clinicians presented with similar cases should consider the diagnosis early.
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PMID:Oesophageal rupture: a tough diagnosis to swallow. 2329 21

The diagnosis of systemic histoplasmosis may be delayed due to underlying pulmonary conditions in patients from an endemic area. An adolescent White male from the Midwestern United States with a history of moderate persistent asthma presented to the pulmonary clinic with a 10-day's history of cough. The patient had no response to modifications of his asthma treatment regimen and proceeded to experience worsening symptoms, including pleuritic chest pain and dysphagia. Chest imaging revealed multiple pulmonary nodules, right mainstem bronchus narrowing, bilateral hilar adenopathy, and esophageal thickening. Ophthalmologic examination revealed an ocular "histo spot", but the patient denied any ocular symptoms. Despite negative initial histoplasmosis antibody testing, the patient began oral itraconazole therapy for presumed histoplasmosis infection. Follow-up histoplasmosis antibody titers were positive, and the patient responded well to itraconazole. Disseminated histoplasmosis can have a wide range of presenting symptoms, which may delay its diagnosis among patients with pre-existing asthma.
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PMID:An adolescent with asthma presenting with worsening cough. 2551 22