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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Invasive pulmonary aspergillosis is an opportunistic infection occurring in a background of severe immune depression. The majority of cases occur in patients who have malignant hematologic disease, particularly during chemotherapy induction or consolidations phases for acute non-lymphocytic leukemia. The principal risk factors are profound (PN < 500 per mm3) and prolonged (very high risk beyond 20 days) neutropenia, perturbed phagocyte function and cellular immune deficiency (AIDS, immunosuppressive treatment in organ and bone marrow recipients). Clinically, invasive pulmonary aspergillosis presents as acute non-specific pneumonia with cough, chest pain and fever. The severe infection rapidly becomes life-threatening. The development of massive hemoptysis is a major risk. We report four cases of invasive pulmonary aspergillosis in patients who had hemoptysis. All four patients developed non-specific pneumonia resistant to broad-spectrum antibiotics during post-chemotherapy aplasia. Computed tomography of the thorax and bronchoscopy with bronchoalveolar lavage was performed due to the occurrence of hemoptysis. In the first two cases, the patients were recovering from aplasia. The thoracic CT scan showed evidence of a cavitating mass with peripheral vessels. Bronchoscopy findings suggested mucosal lesions. The patients were managed surgically. Pathology confirmed the diagnosis of invasive pulmonary aspergillosis with the presence of ischemic necrosis of the pulmonary parenchyma harboring numerous aspergillus filaments. Outcome was favorable and chemotherapy was re-initiated in one case. These two patient died from their hematological disease a few months later. The other two patients remained in aplasia. A CT of the thorax showed multifocal infiltration with vascular contact. Bronchoscopy was again suggestive. One patient developed massive hemoptysis with respiratory distress. Embolization was performed but the patient died two days after onset of hemoptysis. In the last case, embolization was successful and outcome was favorable enabling a bone marrow allograft; the patient died a few months later from the hematological disease. The potential gravity of hemoptysis in the course of invasive pulmonary aspergillosis should lead to early treatment with emergency CT scan and, if possible, bronchoscopy with bronchoalveolar lavage to establish the therapeutic strategy based on surgical excision or embolization of the pulmonary or bronchial arteries.
Rev Mal Respir 1998 Dec
PMID:[Management of hemoptysis in invasive pulmonary aspergillosis]. 992 34

Mechanical ventilation is one of the fundamentals of intensive care assuring the correction of blood gas anomalies in patients with respiratory distress. However, positive pressure ventilation is extremely deleterious for the lung due to barotrauma. Among avenues of research over the last twenty years is a technique which has been successfully developed in neonatal intensive care: ventilation by high frequency oscillation (VOHF). Experimental studies have shown a net benefit in terms of oxygenation and diminution of barotrauma. A unique feature of this mechanical ventilation technique is that the clinical studies comparing VOHF to conventional ventilation have shown that for certain individuals there is decreased morbidity, notably in the incidence of bronchopulmonary dysplasia. In a paradoxical manner VOHF assures adequate gas exchange by using tidal volumes which are lower than the anatomical dead space. The usual model for alveolar ventilation is unable to explain how gas exchange is possible with this mode of ventilation. The explanations are still incomplete but this new type of artificial ventilation is in line with current studies by physiologists whose research may explain this totally new type of pulmonary physiology. However, it should be used cautiously and reserved to those practitioners experienced in the technique.
Rev Mal Respir 1999 Sep
PMID:[Ventilation at high-frequency oscillation: towards diminished barotrauma in the ventilated newborn?]. 1054 55

We report a case of bilateral chylothorax revealing diffuse tuberculosis. The clinical presentation was complicated by the apparition of a massive acute pulmonary embolism and an acute respiratory distress syndrome. Mycobacterium tuberculosis was isolated from the cultures of the bronchi aspiration of the bronchoscopic examination. With antituberculous chemotherapy, the course of the chylothorax was satisfactory.
Rev Mal Respir 1999 Nov
PMID:[Spontaneous bilateral chylothorax revealing disseminated tuberculosis complicated by massive pulmonary embolism]. 1061 55

The etiology of the respiratory distress syndrome is dominated by pulmonary edema and the septic shock. We report a rare etiology of a respiratory distress secondary to a rupture of a well treated tuberculous latero-tracheal adenopathy. A 24-year-old woman was treated a year ago for a peripheral and mediastinal lymph node tuberculosis confirmed by the biopsy of a left supra clavicular adenopathy, by two months of isoniazid-rifampicin-pyrazinamide-ethambutol and seven months of isoniazid-rifampicin. The patient completed 9 month treatment with a good clinical and radiology course. Two months after stopping the antibacillary treatment, the patient was admitted to an intensive care unit with a respiratory distress syndrome requiring both intubation and artificial ventilation. The bronchial aspiration brought back plain pus. The telethorax from admission was normal and the retrospective history suggested the diagnostic of a ganglio-bronchial fistula which was confirmed by bronchial fibroscopy demonstrating right latero-tracheal fistula. The course was good with recovery of consciousness on the seventh day. Direct bacilloscopies and culture were negative. The digestive fibroscopy was normal. Finally, fistulization of a tuberculous adenopathy must be considered among the etiologies of respiratory distress even in a patient appropriately treated for mediastinal lymph node tuberculosis.
Rev Mal Respir 1999 Dec
PMID:[Phantom thoracic opacity]. 1063 18

The diagnosis and early extraction of a respiratory foreign body (FB) in a child requires a rapid bronchoscopy. Thus, the possibility of a foreign body requires an endoscopy even in the absence of clinical or radiological signs. While the sensitivity of "the foreign body syndrome" is important (79-85%) its specificity is low (21-46%) which results in numerous endoscopies which do not show FB. This justifies the promotion of flexible fibroscopy, under a simple local anaesthesia of the upper airways and some sedation, each time that the foreign body is not obvious. That is when there is an absence of a radio-opaque foreign body (2-20% of cases) or an absence of associated unilateral diminution in breath sounds or ipsilateral obstructive emphysema (a positive predicted value of 94%, 95% confidence interval: 71-100%). The complications of flexible fibroscopy are rare but still justify its performance in an environment where there is resuscitation equipment and the possibility of rapidly performing a rigid bronchoscopy. Rigid bronchoscopy, which requires a general anaesthesia, remains the best technique to remove a foreign body in a child. It is also indicated initially in cases of respiratory distress where there is a fear of a foreign body in the trachea. The extraction of the CE by flexible fibroscopy under general anaesthesia has been reported in children but it is more difficult and more risky.
Rev Mal Respir 1999 Nov
PMID:[Indications of bronchial endoscopy in suspected tracheo-bronchial foreign body in children]. 1089 30

Cardiac involvement in legionella infection is rare but it is the most common extra-pulmonary complication. It usually takes the form of pericarditis, but a case of legionella myoparicarditis with global left ventricular hypokinesia on echocardiography has been described. The authors report a case of myopericarditis with massive pulmonary oedema and respiratory distress which regressed clinically and on echocardiography with reduction in chamber dilatation and complete recovery of left ventricular function. Legionellosis was confirmed on serology. The infection was probably contracted during a previous hospital admission, therefore, probably a nosocomial infection. Following the description of this case, a review of the literature is proposed.
Arch Mal Coeur Vaiss 2000 Mar
PMID:[Legionella myopericarditis]. 1100 78

We report a case of acute pneumonitis with pleural effusion and respiratory distress syndrome that was the inaugural sign of leptospirosis in a 37-year-old patient exposed to rat dejections at home. The patient was given penicillin and oxygen therapy with evacuation of the pleural effusion. Lung manifestations in leptospirosis usually occur as non-specific cough and hemoptysis. Pleural effusion is uncommon. Adult respiratory distress syndrome and profuse hemoptysis can also occur, requiring special care.
Rev Mal Respir 2000 Nov
PMID:[Acute pleuro-pneumonitis resulting from leptospirosis]. 1113 76

Cryptogenic organising pneumonitis (COP) is now a well defined clinico-pathological entity. It may be idiopathic or secondary to infection, a drug reaction or a connective tissue disorder. Corticosteroid treatment is remarkably effective. We describe a case of COP occurring during the course of an acute respiratory distress syndrome in a pregnant woman. The unusual association of blood and pulmonary eosinophilia leads us to envisage a borderline form of COP and eosinophilic pneumonitis. Other unusual features were the poor response to steroids and the rapid improvement following death of the foetus.
Rev Mal Respir 2002 Oct
PMID:[A case of atypical cryptogenic organising pneumonitis during pregnancy]. 1247 51

Gemcitabine is used to treat solid tumours such as non small-cell lung cancer. In general, it is a well tolerated cytotoxic agent and myelosuppression is the major dose limiting side-effect. Pulmonary toxicity has been described and dyspnoea occurs in approximately 8% of patients in whom, for the majority, it is mild and reversible. But several cases of acute respiratory distress syndrome (ARDS) related to Gemcitabine treatment have been reported since 1997 and a few were fatal. We present a case of Gemcitabine toxicity in a patient treated for a lung cancer. He presented with a respiratory distress syndrome due to acute interstitial pneumonitis from which he promptly recovered with corticosteroid therapy.
Rev Mal Respir 2002 Oct
PMID:[Severe interstitial pneumonitis related to Gemcitabine]. 1247 53

A 33 year old female had febrile aplasia following a first chemotherapy treatment for acute T lymphoid leukaemia. She was transferred to intensive care for acute respiratory distress due to bilateral pneumonia with Stenotrophomonas maltophilia septicaemic shock. After an initial improvement with antibiotic treatment, she developed multiple necrotic cutaneous lesions. A skin biopsy showed the presence of Aspergillus flavus in large quantities in the vascular lumina. Echocardiography revealed a voluminous vegetation on the mitral valve supporting aspergillus endocarditis. Despite antifungal treatment, shock and coma developed rapidly. Cerebral CT scan suggested multiple septic emboli. Within several hours, the scenario progressed towards multiorgan failure leading the death of the patient. Aspergillus endocarditis is exceptional and usually only occurs in immunosuppressed patients. The diagnosis is difficult, and the prognosis is appalling with a mortality greater than 90% despite treatment.
Arch Mal Coeur Vaiss 2004 Feb
PMID:[Aspergillus flavus endocarditis on a native valve]. 1503 19


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