1/16. Atypical measles infections in leukaemic children on immunosuppressive treatment.One case of giant-cell pneumonia and two of encephalopathy, all due to measles infection in children in leukaemic remission on immunosuppressive treatment, were seen recently. The clinical syndromes were variable and atypical and the antibody responses unpredictable. Conventional doses of pooled immunoglobulin failed to protect the two children to whom it was given. Degeneration rather than inflammation seems to characterise the encephalopathy in immunosuppressed children infected with measles virus.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/16. "Unresolving pneumonia" as the main manifestation of atypical Kawasaki disease.Two cases of atypical Kawasaki disease (KD) manifested as persistent lobar lung consolidation, prolonged fever, and active inflammatory laboratory markers unresponsive to antibiotic treatment are reported. One of the children developed a giant coronary aneurysm. Atypical KD should be considered in the differential diagnosis of young children with prolonged fever and lobar consolidation unresponsive to antibiotics.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/16. Parainfluenza virus pneumonitis in an adult.Parainfluenza virus uncommonly causes fatal giant cell pneumonia in immunocompromised infants and children. To our knowledge, this is the first adult case of parainfluenza virus pneumonia. A 77-year-old woman who was diagnosed as having small-cell carcinoma of the lung underwent chemotherapy. She died of lung edema. Analysis of her serum showed antibodies to parainfluenza virus types 2 and 3 at titers of 1:64 and 1:128, respectively. The postmortem examination revealed giant cell pneumonia, in which giant cells and detached alveolar lining cells had intracytoplasmic inclusions. On electron microscopic examination, the intracytoplasmic inclusions contained fuzzy-form nucleocapsids.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
4/16. lung lesions in children with Crohn's disease presenting as nonresolving pneumonias and response to infliximab therapy.lung lesions in children with Crohn's disease are often difficult to diagnose and treat. We report here 3 children (aged 13, 14, and 17 years) on immunosuppressive therapy for previously diagnosed Crohn's disease who presented with nonresolving pneumonias. All 3 had unfavorable response to empiric antibiotics and had progression of lesions. Cultures of sputum and blood did not yield any organisms. Subsequent lung biopsies revealed noncaseating granulomas with giant cells in 2 subjects and bronchiolitis obliterans with organizing pneumonia in the third. All patients were treated with infliximab, a novel anti-tumor necrosis factor monoclonal antibody, and showed rapid clinical and radiologic response. We emphasize that a high index of suspicion for noninfectious etiologies needs to be maintained in patients with Crohn's disease who present with lung lesions to ensure timely intervention. Infliximab therapy seems to be effective and well tolerated in such patients.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/16. An aspergilloma in an echinococcal cyst cavity.Aspergilloma is a saprophytic infection which can colonize preexisting lung cavities. The most common underlying diseases are tuberculosis, sarcoidosis, cavitary lung cancer, etc. Although aspergilloma can also occur in operated hydatid cyst cavities, only a few cases have been reported in literature. A 32-year-old female patient underwent cystectomy for the diagnosis of perforated intraparenchymal giant hydatid cyst located in the right upper lobe, reaching down to the hilum. Capitonnage was not performed and it was observed that a residual cavity remained in the cystectomy area. The patient was discharged; however, during clinical and radiological follow-ups, it was found that the residual cyst cavity had expanded. As it was thought that one of the drainage bronchi in the cyst cavity could have opened, the patient was reoperated. During the operation, it was noted that purulent fluid and necrotic tissues were present in the cystic cavity. It was seen that the posterior upper lobe segment was consolidated and not ventilated. Contents of the cavity were removed and the posterior upper lobe segment was resected. Histopathological examination revealed that the tissue in the cavity was that of an aspergilloma, and that chronic organized pneumonia and diffuse interstitial fibrosis were present in the resected segment. Refraining from surgical obliteration (capitonnage) of cyst cavities in cases of giant hydatid cysts extending to the hilum can lead to opportunistic infections such as aspergilloma.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/16. decompression of giant bulla in acute pneumonia: surgical palliation prior to definitive management.Giant bullae can be complicated by respiratory tract infection in the setting of emphysema. Herein we describe a technique of palliative decompression of the bullae that gives time to treat acute pulmonary infection prior to definitive surgical treatment.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
7/16. Case of biliary lithiasis in an infant.The case of a 3-month-old premature infant deceased by massive hemorrhage from a giant hemangioma of the right thigh, exhibiting also biliary lithiasis, is discussed. The six dark-green-blackish faceted calculi contained by the gall bladder appear to be formed of biliary pigment and the consequence of repeated inflammatory hemolytic episodes in an immunodeficient infant.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/16. Congenital mumps pneumonia: a rare cause of neonatal respiratory distress.A case of a fullterm infant with severe neonatal respiratory distress due to mumps infection is reported. pregnancy was complicated by a self-limited febrile illness of the mother about two weeks before birth. Foetal heart rate patterns and delivery were normal. Immediately after birth the infant needed mechanical ventilation. bacterial infections, as well as congenital cardiac or pulmonary malformations were excluded. The infant showed serologic evidence of mumps infection: IgM antibodies to mumps virus were highly positive. He expired on the 9th day of life due to bilateral pneumothoraces and pneumopericardium. Post-mortem examination showed interstitial pneumonia with intra-alveolar multinucleated giant cells, suggesting viral disease. This case demonstrates, that mumps pneumonia should be included in the differential diagnosis of severe neonatal respiratory distress in fullterm neonates.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/16. Giant cell pneumonia in Letterer-Siwe disease.An 8 month-old girl suffered from letter-Siwe disease since one week after birth. During the chemotherapy, giant cell pneumonia caused by measles virus infection developed and led rapidly to her death. Histopathologically, alveolar spaces were lined by multi-nucleated giant cells with intranuclear and intracytoplasmic eosinophilic inclusion bodies. Electronmicroscopical examination of the lung revealed intranuclear inclusion bodies full of rod-shaped structures characteristic to paramyxoviruses, and irregular electron-dense materials compatible with nucleocapsid protein antigens in the cytoplasm. Additionally these giant cells were observed in the salivary glands, thyroid gland, thymus and lymph nodes. The measles virus antigen was detected immunohistochemically in these giant cells in the lungs and other organs. The specific antibody of measles virus is helpful to study the pathogenesis of giant cell pneumonia.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
10/16. Idiopathic cholesterol pneumonitis.The fiftieth case of idiopathic cholesterol pneumonitis (ICP) is presented and the 49 previously reported cases have been reviewed. This review draws attention to certain features which have not previously been emphasized, including marked male predominance, single lobe involvement, the distribution of the lesions, dense pleural fibrosis, smoking history and the close histological association between giant cells and disrupted elastic fibres of the alveolar walls. The clinical and radiological similarity between ICP and primary bronchogenic carcinoma is described. Various aetiology theories are discussed, and the similarity between ICP and spontaneous lipid pneumonia in the mongoose is noted; the hypothesis is put forward that ICP, like the mongoose pneumonia, is an expression of disordered production or disposal of excessive surfactant.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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