1/25. Occupational neutrophilic asthma.Occupational asthma is typically associated with an eosinophilic bronchitis. The case of a 41-year-old woman who developed symptoms of asthma after occupational exposure to metal working fluids is reported. The diagnosis of asthma was confirmed by an forced expiratory volume in 1 s (FEV1) of 1.7 (59% predicted), with 11% reversibility after inhaled bronchodilator and a provocation concentration of methacholine to cause a fall in FEV1 of 20% (PC20) of 0.4 mg/mL. Induced sputum examination showed a marked neutrophilia. Over the next six months, serial sputum analyses confirmed the presence of a marked sterile neutrophilic bronchitis during periods of occupational exposure to metal working fluids, which resolved when the patient was away from work and recurred when she returned to work. The sputum findings were mirrored by corresponding changes in spirometry and PC20 methacholine. The findings indicate the occurrence of occupational asthma associated with an intense, sterile neutrophilic bronchitis after exposure to metal working fluids.- - - - - - - - - - ranking = 1keywords = bronchitis (Clic here for more details about this article) |
2/25. bronchiectasis: the 'other' obstructive lung disease.bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to mind as a possible cause. Chronic airway inflammation leads to bronchial dilation and destruction, resulting in recurrent sputum overproduction and pneumonitis. Once the diagnosis is confirmed, any potential predisposing conditions should be aggressively sought. The relapsing nature of bronchiectasis can be controlled with antibiotics, chest physiotherapy, inhaled bronchodilators, proper hydration, and good nutrition. In rare circumstances, surgical resection or bilateral lung transplantation may be the only option available for improving quality of life. prognosis is generally good but varies with the underlying syndrome.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
3/25. Development of irreversible airflow obstruction in a patient with eosinophilic bronchitis without asthma.Eosinophilic bronchitis is a recently described condition presenting with chronic cough and sputum eosinophilia without the abnormalities of airway function seen in asthma. The patient, a 48-yr-old male who had never smoked, presented with an isolated chronic cough. He had normal spirometric values, peak flow variability and airway responsiveness, but an induced sputum eosinophil count of 33% (normal <1%). Although his cough improved with inhaled corticosteroids the sputum eosinophilia persisted. Over 2 yrs he developed airflow obstruction, which did not improve following nebulized bronchodilators and a 2-week course of prednisolone 30 mg once daily sufficient to return the sputum eosinophilia to normal (0.5%). It is suggested that the progressive irreversible airflow obstruction was due to persistent structural change to the airway secondary to eosinophilic airway inflammation, and it is further speculated that eosinophilic bronchitis may be a prelude to chronic obstructive pulmonary disease in some patients.- - - - - - - - - - ranking = 2keywords = bronchitis (Clic here for more details about this article) |
4/25. Tracheal lipoma: a rare intrathoracic neoplasm.Primary tracheal lipomas are extremely rare neoplasms. The typical patient is a middle-aged man with complaints of cough and shortness of breath. Often, the diagnosis is delayed, and patients are treated for asthma or bronchitis. The diagnosis of a tracheal lipoma is best approached by computed tomography (CT) and bronchofibroscopy. Tracheobronchial lipomas may be successfully excised endoscopically or by laser therapy. Open surgical resection is required when the lipoma extends extraluminally.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
5/25. adult long-segment tracheal stenosis attributable to complete tracheal rings masquerading as asthma.OBJECTIVE: a) To report on an adult patient with congenital long-segment tracheal stenosis from complete tracheal rings complicated by tracheomalacia; b) to highlight the fact that some patients with airway narrowing could be misdiagnosed as having bronchial asthma; and c) to discuss our management with a custom-made tracheostomy tube extending to the carina. DESIGN: Case report. SETTING: A university hospital's 14-bed medical/surgical intensive care unit. PATIENT: A 21-yr-old patient, with a history of what was labeled as asthma, was admitted to the intensive care unit with diabetic ketoacidosis, pneumonia, respiratory failure, and septic shock. INTERVENTIONS: Her therapy included assisted mechanical ventilation through an endotracheal tube. Initially, a size 6.0 endotracheal tube was used. Finally, a custom-made tracheostomy tube extending to the carina was inserted to manage her persistent infantile trachea. MEASUREMENT AND MAIN RESULTS: During 4 months in the intensive care unit, she suffered numerous airway problems from her narrow trachea that were eventually attributed to congenital long-segment tracheal stenosis from complete tracheal rings. Bacterial pneumonia, viral tracheobronchitis, and tracheomalacia complicated her course. Multiple attempts at extubation failed and, after translaryngeal endotracheal tubes and tracheostomy tubes of decreasing size, her airway was managed with a size 5.0 custom-made tracheostomy tube with the tip extending to her carina. She was totally dependent on this tube. CONCLUSION: Airway narrowing may masquerade as asthma. Congenital tracheal stenosis is rare and is associated with a high mortality rate. Complete tracheal rings presenting in adulthood are extremely rare, and we report the first case of long-segment pantracheal stenosis presenting in adulthood. Surgical treatment with tracheoplasty is difficult. A custom-made tracheostomy tube to stent the entire trachea is one management option. tracheal stenosis should be excluded in patients with a chronic lack of response to therapy for asthma.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
6/25. COPD: clinical phenotypes.Different phenotypic presentations in advanced stages of COPD are less common than in years past because of therapies that alter the manifestations of disease. Early stages of COPD are often asymptotic, but may present as asthma, chronic bronchitis, emphysema or combinations. Unusual presentations at young age are not common, but may be dramatic.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
7/25. Baker's asthma: a case report.Bakers are known to experience respiratory complaints ranging from allergic rhinitis to chronic bronchitis and asthma. We report here the first confirmed case of baker's asthma in singapore. The patient is a 40 year-old Chinese male, working at a biscuit factory for the last 14 years as a mixer. He developed asthmatic attacks five years after joining the factory and had been on bronchodilators and oral steroids. He was confirmed to have occupational asthma due to wheat flour, following a bronchial challenge test. He was subsequently transferred to another section and there was marked improvement in the frequency of attacks and the peak expiratory flow rate. This case illustrates the need to consider workplace factors in the diagnosis and management of asthma among the working population. Medical treatment alone is insufficient in the management of occupational and work-related asthma.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
8/25. morbidity and mortality of asthma.morbidity and mortality of asthma has been on the upswing since the 1960s, as marked by increased hospitalizations with asthma since the early 1980s. This has not been explained adequately. The possibility of change in the natural history or increased exposure to environmental irritant chemicals or allergens has been suggested by some. There probably has been better recognition and diagnosis of asthma by distinguishing it from bronchitis, recurrent croup, and bronchiolitis in children. Despite evidence to suggest that this is the case, there are still some missing factors. The increase in asthma mortality is more understandable when one considers the fact the management of asthma has changed greatly in the past two decades. The use of corticosteroids orally, parenterally, and by inhalation has been a double-edged sword. There is no doubt that many asthmatics have a much improved sense of well-being and have lived more normal lives due to the use of corticosteroids. The inability of some patients, parents, or physicians to perceive impending respiratory difficulty, however, may result in underuse of drugs, including corticosteroids, leading to increased mortality. Other factors have led to increased mortality from asthma in recent years, and they include arrhythmias with combinations of theophylline, beta-agonists, and hypoxia. The psychological factors attendant to adolescence and psychological problems are probably quite important in the recent upsurge in asthma deaths in the 15- to 25-year age group. Many deaths are occurring outside of the hospital environment and may be largely preventable. There must be increased awareness by the patient, the family, and the physician. In view of the increased hospitalizations, the total number of deaths is not increasing at an alarming rate, yet it is necessary to make all of us who care for asthmatics aware and take corrective action as soon as we are aware of an asthmatic with respiratory problems.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
9/25. Allergic granulomatous angiitis.A 15-year-old boy died after a 3 years' illness; asthmatic bronchitis, recurrent heart failure and eosinophilia were the essential manifestations. The autopsy elicited a diagnosis of allergic granulomatous angiitis, because of angiitis with fibrinoid necrosis and granulomatous lesions in vascular and extravascular regions. The most important differential diagnostic aspects of this disease are discussed, especially the resemblances to Wegener's granulomatosis, hypersensitivity angiitis and polyarteritis nodosa.- - - - - - - - - - ranking = 0.33333333333333keywords = bronchitis (Clic here for more details about this article) |
10/25. Clinical presentations of chronic obstructive pulmonary disease.The diagnosis of chronic obstructive pulmonary disease covers a wide range of lung problems that have as their base the partial blockage of the smooth movement of air from the lungs during expiration. asthma, simple bronchitis, chronic obstructive bronchitis, and emphysema are the diseases usually considered as chronic obstructive disease. Many of their multiple presentations are quite common in clinical medicine but are sometimes difficult to recognize. Once the inciting event is identified, it is often reversible.- - - - - - - - - - ranking = 0.66666666666667keywords = bronchitis (Clic here for more details about this article) |
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