Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 68-year-old man being treated for a Staphylococcus aureus bacteremia developed hemoptysis. A transesophageal echocardiogram (TEE) and computed tomographic (CT) scan showed a large descending thoracic aorta pseudoaneurysm. The patient died before surgical intervention could be performed. Pathological examination revealed the presence of a saccular pseudoaneurysm originating from a mural defect at the site of an ulcerated atherosclerotic plaque. There was rupture into the mediastinum with contained hematoma. Microscopic examination documented numerous Gram-positive bacterial cocci at the rupture site.
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PMID:Ruptured mycotic pseudoaneurysm of the thoracic aorta. 1653 2

Mediastinal abscess is a rare but life-threatening disease with grave prognosis if not recognized in time. The diagnosis of this entity is hampered by its nonspecific presentation. Thus, a high index of clinical suspicion is one of the keystones in the successful management of these patients. Currently, mediastinitis occurred mostly as a complication post cardiovascular or thoracic surgical procedures. Rarely, primary mediastinitis developed as a result of hematogenous spread. We report the case of primary mediastinitis in a renal failure patient who had Staphylococcus aureus bacteremia. Despite antibiotic treatment, she had massive hemoptysis and eventually succumbed to the disease. To our knowledge, this is the first report of Staphylococcus aureus bacteremia complicating mediastinal abscess in a dialysis patient with a native arteriovenous shunt. Our experience in this case suggests that dialysis patients are under constant risk of staphylococcal infection due to regular venous puncture. Measures should be taken to reduce the risk and staphylococcal infection should not be forgotten in any dialysis patient with fever of unknown origin.
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PMID:Posterior mediastinal abscess in a hemodialysis patient - a rare but life-threatening complication of Staphylococcus bacteremia. 1920 58

Thoracic type B2 fractures are high-energy injuries. It is crucial to maintain a high index of suspicion for concomitant visceral injuries. A 33-year-old man presented after a motor vehicle accident with a T4 type B2.3 fracture with an associated sternum fracture. He was treated with a T4 corpectomy and an expandable titanium cage and lateral plate construct at T3-T5. Two months later he developed focal kyphosis and loosening of his screws. This was addressed with an instrumented posterior fusion from T1 to T8 complicated by a wound infection, pneumonia, and fungal esophagitis requiring several debridements and vacuum assisted closure therapy. Worsening back pain prompted a thoracic computed tomography scan, revealing a dissecting thoracic-aortic aneurysm, which was treated with an endovascular stent graft. Few months later, he presented with fevers, chills, and hemoptysis secondary to Staphylococcus aureus bacteremia, endovascular leak, and T3-T5 osteomyelitis. He was transferred to our institution and restented by the cardiothoracic service. Subsequently, he underwent a thoracotomy, evacuation of infected aneurysmal hematoma with removal of instrumentation. A revision corpectomy with iliac crest autograft reconstruction was performed without complications. The patient's infection and thoracic pain resolved. However, there was a significant delay in treatment, resulting in substantial morbidity. Patients with thoracic type B2 fractures require careful evaluation for concomitant aortic and visceral injuries. Missed associated injuries result in increased morbidity and mortality.
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PMID:Thoracic aortic dissection and mycotic pseudoaneurysm in the setting of an unstable upper thoracic type b2 fracture. 2435 65

Over the last decades, post-infectious glomerulonephritis underwent major changes in its epidemiology, pathophysiology, and outcomes. We are reporting a case of IgA-dominant post-infectious glomerulonephritis (IgA-PIGN) presenting as a fatal pulmonary-renal syndrome. An 86-year-old Filipino man presented with worsening dyspnea, hemoptysis, and decreased urine output over 2 weeks. Past medical history is significant for hypertension, chronic kidney disease stage III, and pneumonia 3 weeks prior treated with intravenous cefazolin for methicillin-sensitive Staphylococcus aureus bacteremia. Physical examination was remarkable for heart rate of 109/min and respiratory rate of 25/min saturating 99% on 3 liters via nasal cannula. There were bibasilar rales in the lungs and bilateral ankle edema. A chest radiograph showed bibasilar opacifications. Blood work was significant for hemoglobin of 8.3 g/dL and creatinine of 9.2 mg/dL (baseline of 1.67). TTE showed EF 55%. Urinalysis revealed large blood and red blood cell casts. Kidney ultrasound showed bilateral echogenicity compatible with renal disease. Pulse methylprednisolone therapy and hemodialysis were initiated with patient's condition precluding kidney biopsy. Serology workup for rapidly progressive glomerulonephritis was negative. On day 7, the patient required mechanical ventilation; bronchoscopy showed alveolar hemorrhage and plasmapheresis was initiated. Renal biopsy revealed IgA-PIGN with endocapillary and focal extracapillary proliferative and exudative features. IgA-PIGN occurs in diabetic elderly (mean age of 60 years), 0-16 weeks after an infection mainly by Staphylococcus. However, this nondiabetic patient had normal complement IgA-PIGN with fatal pulmonary-renal syndrome. Understanding the pathogenesis and identifying the nephrotoxic bacteria species and the aberrant IgA molecule will open new insights toward prevention and treatment.
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PMID:IgA-dominant post-infectious glomerulonephritis presenting as a fatal pulmonary-renal syndrome. 2634 10