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Diagnostic and Therapeutic Endoscopy (1)
Infection and Drug Resistance (1)
Infection and drug resistance (1)
Yokoyama, Toshinobu (3)
Aizawa, Hisamichi (2)
Hirokawa, Masashi (2)
Imamura, Yutaka (1)
Ito, Yusuke (1)
Kaku, Yoichiro (1)
Koga, Chie (1)
Matsumoto, Keita (1)
Natori, Hiroki (1)
Sasaki, Jun (1)
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Toda, Reiko (1)
Tomioka, Ryusuke (1)
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A necrotic lung ball caused by co-infection with Candida and Streptococcus pneumoniae
Infection and Drug Resistance
A necrotic lung ball is a rare radiological feature that is sometimes seen in cases of pulmonary aspergillosis. This paper reports a rare occurrence of a necrotic lung ball in a young male caused by Candida and Streptococcus pneumoniae.
A 28-year-old male with pulmonary candidiasis was found to have a lung ball on computed tomography (CT) of the chest. The patient was treated with β-lactams and itraconazole and then fluconazole, which improved his condition (as found on a following chest CT scan) and serum β-D-glucan level. The necrotic lung ball was suspected to have been caused by coinfection with Candida and S. pneumoniae.
A necrotic lung ball can result from infection by Candida and/or S. pneumoniae, indicating that physicians should be aware that patients may still have a fungal infection of the lungs that could result in a lung ball, even when they do not have either Aspergillus antibodies or antigens.
lung ball; necrotic lung ball; Candida; Streptococcus pneumoniae
Respiratory failure caused by intrathoracic amoebiasis
Infection and drug resistance
A 41-year-old male was admitted to the hospital with symptoms of diarrhea, fever and rapidly progressive respiratory distress. A chest radiograph and computed tomography (CT) of the chest and the abdomen showed a large amount of right pleural effusion and a large liver abscess. The patient was thus diagnosed to have amoebic colitis, amoebic liver abscess and amoebic empyema complicated with an HIV infection. The patient demonstrated agranulocytosis caused by the administration of trimethoprim-sulfamethoxazole. However, the administration of granulocyte colony-stimulating factor made it possible for the patient to successfully recover from agranulocytosis, and he thereafter demonstrated a good clinical course.
amebiasis; amoebic empyema; HIV; agranulocytosis; trimethoprim-sulfamethoxazole
Medical Thoracoscopy Performed Using a Flexible Bronchoscope Inserted through a Chest Tube under Local Anesthesia
Diagnostic and Therapeutic Endoscopy
Background and Objectives. Many cases of pleural effusion can remain undiagnosed following thoracentesis. We evaluated our own technique for performing thoracoscopy under local anesthesia using a 32 Fr chest tube and a flexible fiberoptic bronchoscope without a rigid thoracoscope for the diagnosis, inspection, and management of patients with pleurisy. Methods. Seven patients with pleural effusion who underwent thoracoscopy under local anesthesia using a 32 Fr chest tube and a flexible fiberoptic bronchoscope were retrospectively studied. Results. Thoracoscopy was safely performed in the diagnosis and management of pleural effusion in all cases. The visualization of the pleura, diaphragm, and lung using this instrumentation was excellent in comparison to that normally obtained during surgical thoracoscopy. A forceps biopsy of the pleura or diaphragm could therefore be easily and effectively performed. Conclusion. This technique is considered to have clinical utility as a diagnostic tool for pleurisy; furthermore, this method is safe, effective and inexpensive, not only for surgeons but also for physicians.
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