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Volume : 8 Issue : 2 Year : 2025

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Respiratory Case Reports - Respir Case Rep: 8 (2)
Volume: 8  Issue: 2 - June 2019
CASE REPORT
1. Interstitial Lung Disease in Systemic Lupus Erythematosus
Gina Amanda, Prima Belia Fathana, Dianiati Kusumo Sutoyo
doi: 10.5505/respircase.2019.03779  Pages 40 - 43
Connective tissue disease (CTD) is one of the etiologies of known-cause interstitial lung disease (ILD) that is frequently found with systemic sclerosis, rheumatoid arthritis, mixed-CTD and Sjӧgren syndrome, but which occurs rarely in systemic lupus erythematosus (SLE) patients. A diagnosis of ILD in SLE can be challenging, as the physician should first exclude other pulmonary involvements, including airway disorders, pulmonary infection and vascular abnormality. The management of ILD in SLE and other CTDs patients includes corticosteroid and other immunosuppressive medications. Here we report on two ILD in SLE cases: in one case, ILD was the first sign of SLE; and in the other, ILD appeared after the diagnosis of SLE had been established.

2. A Rare Presentation of Pulmonary Embolism: Cement Embolism after Vertebroplasty
Özge Oral Tapan, Utku Tapan, Funda Dinç Elibol
doi: 10.5505/respircase.2019.31549  Pages 44 - 48
Vertebroplasty is a minimally invasive method for the treatment of painful vertebrae fractures. Cement embolism, as a rare complication of this method, is usually asymptomatic and does not require treatment. Anticoagulant therapy or surgical embolectomy is recommended when symptomatic. We present here a case of pulmonary cement embolism who presented with chest pain and shortness of breath 5 days after vertebroplasty for a thoracic vertebrae fracture, and who had undergone anticoagulant treatment.

3. Tracheoesophageal Fistula Secondary to Tuberculosis: A Case Report
Mutlu Onur Güçsav, Mine Gayaf, Nimet Aksel, Kenan Can Ceylan, Dursun Alizoroğlu
doi: 10.5505/respircase.2019.96658  Pages 49 - 53
A tracheoesophageal fistula (TEF) is a pathological connection between the trachea and esophagus. Infectious diseases rarely lead to TEF, and tuberculosis is the most common cause of TEF among all infectious causes. A 78-year-old male patient under examination for esophageal malignancy at the gastroenterology service, and who was expected to undergo an endoscopic biopsy, was diagnosed with aspiration pneumonia after complaints of dyspnea and coughing after liquid intake, and was transferred to chest diseases clinic. TEF was identified from a bronchoscopy. Mycobacterium tuberculosis DNA was isolated during a bronchial aspiration. An endoscopic biopsy, performed after esophageal malignancy was suspected, gave the result of a granulomatous reaction. The patient was diagnosed with tuberculosis-induced TEF. Anti-tuberculosis treatment was initiated, and a tracheal Y stent was fitted. In this article we present a rare case in which a TEF emerged secondary to tuberculosis, and suggest that tuberculosis may be a cause of TEF. It is advised that before starting invasive surgical TEF treatment, it is essential to take the necessary precautions.

4. A severe Case of Hypercalcemia due to Pulmonary Tuberculosis Reactivation
Şule Gül, Ali Çetinkaya, Yağmur Başhan, Mehmet Atilla Uysal
doi: 10.5505/respircase.2019.98598  Pages 54 - 57
A 42-year-old female patient who was treated for pulmonary tuberculosis three years ago was admitted to our clinic with complaints of muscle weakness. On chest radiography, a diffuse cavitary lesion and nodular infiltration of the right lung was detected. Sputum acid-fast bacilli were positive, and the patient was diagnosed with pulmonary reactivation tuberculosis. Severe hypercalcemia was observed in the laboratory, and treatment for hypercalcemia was started alongside tuberculosis treatment. The case was presented to literature due to its rarity.

5. Tracheal Infection due to Corynebacterium striatum in a Female Patient: A Case Report
Panagiota Xaplanteri, Efstratios N. Koletsis, Christos Prokakis, Iris Spiliopoulou, Dimitrios Dougenis, Fevronia Kolonitsiou
doi: 10.5505/respircase.2019.23600  Pages 58 - 61
Nondiphtherial corynebacteria commonly colonize as normal flora on human skin and mucous membranes, and represent an emerging opportunistic pathogen for immunocompromised or critically ill patients. Corynebacterium striatum has seldom been reported as a human pathogen. Here we present the case of a 62-year-old Caucasian female patient who was previously hospitalized in the Intensive Care Unit, and who attended the emergency department with worsening dyspnea and inspiratory wheezing. The findings of a thorough examination, laboratory tests and imaging were consistent with tracheal stenosis, inflammation related to a previous tracheostomy and a submerged thyroid goiter. A multi-drug resistant C. striatum stain was isolated. The patient was treated with a subtotal thyroidectomy, tracheal resection and tigecycline. Postoperative recovery was complicated by a trauma infection treated with open drainage and antibiotics, and after a long recovery period, the patient was discharged home without further complications.

6. Pituitary Metastasis in Squamous Cell Lung Carcinoma
Fatma Tokgoz Akyil, Emre Sedar SAYGILI, Belgit Talay, Mustafa Akyıl
doi: 10.5505/respircase.2019.05945  Pages 62 - 66
Metastases to the pituitary gland are extremely rare, and can be asymptomatic and easily overlooked in imaging. In this case report, a male patient diagnosed with a lung squamous cell carcinoma with asymptomatic pituitary metastasis is presented. A 70-year-old man was referred to our clinic with a right lower lobe mass identified in a thorax computed tomography. A bronchoscopic biopsy from the intermediate bronchus revealed a squamous cell carcinoma. Positron emission tomography imaging revealed increased metabolic activity in the lung mass; multiple mediastinal lymphadenopathies; liver and diffuse bone lesions along the left side of the pituitary gland. The patient's hormone panel was consistent with hyperprolactinemia and hypogonadotropic hypogonadism. Pituitary magnetic resonance imaging detected a deviation in the infundibulum and optic chiasm indentation with an 18 x 12 mm mass lesion. The patient was diagnosed with pituitary metastasis and radiotherapy was planned. The patient was unable to attend the follow-up and died within one month of diagnosis. Pituitary gland metastasis is extremely rare in lung cancer. It can be detected incidentally in imaging findings or from specific symptoms encountered during follow-up.

7. Lateral Thoracic Lung Herniation: A Rare Condition
Erkan Akar, Miktat Arif Haberal, Özlem Şengören Dikiş
doi: 10.5505/respircase.2019.27132  Pages 67 - 70
Lung herniation is described as the protrusion of lung tissue and pleura out of the thoracic cavity through an abnormal gap in the chest wall. We present a case with a rare lateral lung herniation. The patient was taken for urgent surgery and an anterolateral thoracotomy was carried out. Pursuant to rib and lung parenchyma repair, the herniation defect was closed without a prosthetic graft. The patient was discharged on the postoperative fifth day with full recovery. Although there is a lack of consensus on the timing of surgery, we are of the opinion that in blunt thorax trauma-induced symptomatic lung hernias, operating on the patient is appropriate as soon as a diagnosis is established should be advised.

8. Spontaneous Pneumomediastinum Following to a Generalized Tonic – Clonic Seizure
Cenk Balta
doi: 10.5505/respircase.2019.91886  Pages 71 - 73
Pneumomediastinum refers to the presence of air in the mediastinum. It is commonly occurs secondary to a perforation of respiratory or gastrointestinal system organs. Primary spontaneous pneumomediastinum is a rare and benign condition that can result from a peripheral pulmonary alveolar rupture. We present here a case of spontaneous pneumomediastinum that occurred following to a generalized tonic-clonic epileptic seizure.

9. Right Pulmonary Artery Agenesis and Right Pulmonary Hypoplasia, presenting with Bronchiolitis Symptoms
Tayfun Kermenli, Aslı Serter
doi: 10.5505/respircase.2019.49403  Pages 74 - 77
Unilateral pulmonary artery agenesis (UPAA) is a rare ailment, characterized by the absence of a unilateral pulmonary artery. UPAA may be associated with heart defects such as Tetralogy of Fallot, coarctation of the aorta, atrial septal defects and truncus arteriosus. The etiology has not been fully elucidated to date. Patients may present with signs of pulmonary hypertension during childhood, and symptoms of UPAA may not manifest until adulthood. A 33-year-old woman diagnosed at adulthood presented with symptoms of bronchiolitis. At the time of diagnosis, PA chest X-ray and Thorax CT images showed a right hypoplasic lung. Pulmonary hypertension and minimal tricuspid regurgitation were detected in a cardiac ultrasonography. For a diagnosis of UPAA, the patient's story, physical examination findings and imaging are used. The optimum imaging technique is pulmonary angiography. Clinical symptoms include exercise intolerance, hemoptysis and recurrent lower respiratory tract infections.

REVIEW ARTICLE
10. Humoral Immunodeficiency and Infection
Dilaver Taş, Ali İnal
doi: 10.5505/respircase.2019.27167  Pages 78 - 85
Infections are common in people with immunodeficiency, and these infections can be difficult to treat, and may lead to complications. Immunodeficiencies may be primary or secondary. Primary immunodeficiencies occur due to genetic defects, and directly impair the functions of the immune system, whereas secondary immunodeficiencies occur when individuals with a structurally normal immune system are affected by drugs, metabolic and structural disorders and various environmental factors, especially infections. In this review, immunodeficiencies will be discussed, and diagnosis and treatment methods will be put forward.

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