1/31. Radiologic differential diagnosis. Radiologic pattern: solitary cavity.The differential diagnosis of a left lower lobe cavity in this young patient with a history of productive cough should include hiatal hernia, pulmonary abscess, bronchiectatic cyst and bronchopulmonary sequestration. Hiatal hernia should be ruled out by barium swallow; acute pulmonary abscess by the lack of a history suggestive of a necrotizing pneumonia; bronchiectasis by bronchogram; and intralobar bronchopulmonary sequestration should be confirmed by aortography.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
2/31. 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 = 1keywords = cough (Clic here for more details about this article) |
3/31. A possible mechanism of primary ciliary dyskinesia: a case of a segmental defect in ciliary microtubules.We report here a 13-year-old woman with cough, sputum and fever. The patient had both chronic sinusitis and bronchitis. Chest X-ray and computed tomographic scan of the chest revealed mucous bronchial filling and bronchiectasia in bronchi of bilateral lower lobes, right middle lobe and left upper lobe. Aerosol inhalation scintigraphy with 99mTechnetium demonstrated delays of the discharged tracer. On the basis of these findings, primary ciliary dyskinesia was suggested. This was confirmed by the findings from nasal biopsy with transmission electron microscopy where all of the microtubules were segmentally defected near the basal body in the cilia. On the basis of these findings, we diagnosed the patient with primary ciliary dyskinesia which may be due, at least in part, to segmental defect of ciliary microtubules.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
4/31. Congenital broncho-oesophageal fistula associated with bronchiectasis in adults. Report of two cases and review of the literature.Congenital broncho-oesophageal fistula is a rare entity in adult patients. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking and even haemoptysis. Even rarer than its occurrence with the above-mentioned symptoms is its presentation with bronchiectasis. A congenital broncho-oesophageal fistula presenting with bronchiectasis in a 28-year-old male and 36-year-old female are described. In reported cases, symptoms of chronic recurrent pulmonary suppuration were initially attributed to alternative aetiologies. In both cases, with such an unusual presentation, the observation of the fistulous tract was coincidental. Surgical division of the fistula associated with lobectomy resulted in complete resolution of symptoms.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
5/31. Lady Windermere syndrome: middle lobe bronchiectasis and mycobacterium avium complex infection due to voluntary cough suppression.An 81-year-old woman who presented with middle lobe bronchiectasis and mycobacterium avium complex infection is described. She had a history of habitual suppression of cough, as in Lady Windermere syndrome. She was thin and had mild kyphoscoliosis but had no history of smoking or connective tissue disease. The middle lobe and lingula are predisposed to chronic inflammation because of their particular anatomic structures. Inability to clear the secretions from the airway due to voluntary cough suppression may predispose to bronchiectasis and M. avium complex infection.- - - - - - - - - - ranking = 6keywords = cough (Clic here for more details about this article) |
6/31. Mucoid impaction caused by monokaryotic mycelium of schizophyllum commune in association with bronchiectasis.A 51-year-old female was admitted to our hospital because of fever, cough, and hemoptysis. A chest radiograph showed a partial collapse of the left upper division and infected bullae in the left upper lobe. Bronchoscopic examination showed thick mucous plugs in the left upper bronchus. The isolates of the plugs proved to be schizophyllum commune. Neither accumulation of eosinophils nor Charcot-Leyden crystals were present in the plugs. Mild ectatic changes of the left upper bronchus had been observed 17 years previously. We describe the first case of mucoid impaction, which was independent of the immunological reactions, caused by S. commune in association with bronchiectasis.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
7/31. Rapidly progressive bronchiectasis complicating ulcerative colitis in a child.patients with ulcerative colitis may have a presentation dominated by extraintestinal manifestations. These manifestations, particularly bronchiectasis, are very rarely seen in pediatric patients. A 13-year-old boy with ulcerative colitis who was diagnosed by colonic mucosa biopsy is presented. He developed unexplained productive cough after the appearance of colonic disease. He was treated and followed up at his primary care hospital with the sole diagnosis of ulcerative colitis, with little attention given to the chest symptoms. The relation of the bronchial involvement to the ulcerative colitis was not established until two years after the onset of disease. Thoracal computed tomography (CT) examination after this period showed evidence of bronchiectasis and pulmonary involvement. Despite prophylactic inhaled corticosteroid treatment, no clinical or radiographic improvement was observed and widespread bronchial destruction developed very rapidly. More effective treatment with oral steroids was probably necessary in this patient, if the early chest symptoms were related to the ulcerative colitis.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
8/31. Idiopathic progressive pulmonary fibrosis.Five patients with progressive fibrotic lung disease are described. The dominant symptom was slowly increasing dyspnoea, and cough and sputum were not prominent. Marked weight loss was also a feature. There was severe restrictive impairment of ventilation with normal arterial gas tensions. The changes were confined to the upper parts of the lung in some but others had more generalized disease. The duration has varied so far from two to 17 years. The lung changes are considered to be due to dense progressive fibrosis. Necropsy in two confirmed this. Histologically there was monotonous fibrosis with lymphoid collections and secondary bronchiectasis, a picture similar to that found in association with ankylosing spondylitis. None of these patients had joint disease. tuberculosis was excluded as a cause by exhaustive bacteriological tests and the failure of chemotherapy to stop deterioration. All other recognized types of infective and non-infective progressive lung fibrosis were also excluded, and this is not considered to be a variant of cryptogenic fibrosing alveolitis. Though these patients have many features in common they do not necessarily have the same pathogenesis. They are presented as an encouragement to further study.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
9/31. Bullae, bronchiectasis and nutritional emphysema in severe anorexia nervosa.STUDY OBJECTIVES: Pulmonary complications of anorexia nervosa are rarely documented. The case of a patient with anorexia nervosa and pulmonary disease is presented, a new quantitative computed tomography (CT) method for the detection of emphysema is employed, the literature is reviewed and the concept of 'nutritional' emphysema is discussed. RESULTS: The case of a 34-year-old, nonsmoking woman with long-standing severe anorexia nervosa who was evaluated for cough and progressive shortness of breath is reported. Pulmonary function testing showed a predominant restrictive pattern with a marked reduction in carbon monoxide transfer and respiratory muscle strength, and an elevated residual volume. Imaging revealed bullae and bronchiectasis, and quantitative analysis of the CT scan was consistent with mild, generalized emphysema. Bronchial washings grew pseudomonas aeruginosa. Known causes for bronchiectasis were excluded. A literature review disclosed few reported noninfectious pulmonary complications of anorexia nervosa. CONCLUSIONS: To the authors' knowledge, this is the first report of bullae and bronchiectasis in a patient with anorexia nervosa, and the CT analysis was consistent with mild emphysema. malnutrition has been associated with emphysematous changes in animals and may be the primary insult in the development of emphysema, bullae and bronchiectasis in the present patient.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
10/31. Current management of bronchiectasis: review and 3 case studies.bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.- - - - - - - - - - ranking = 1keywords = cough (Clic here for more details about this article) |
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