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01 511B Saleh A 5000 Clinical Case Puzzlers---2016 ...
01 511B Saleh A 5000 Clinical Case Puzzlers---2016, Pulmonary Infections CMS bav1.pptx - 2
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Pdf Summary
This article discusses two cases of pulmonary infections and provides clinical approach guidelines for diagnosing and managing such infections. The first case involves a 39-year-old male with a history of smoking and end-stage renal disease. He presents with fevers, chest pain, and lower quadrant pain. The patient's laboratory and radiology findings lead to a diagnosis of angioinvasive mucormycosis. The article emphasizes the importance of recognizing uncommon manifestations of common diseases. Treatment for mucormycosis involves surgical debridement and IV Amphotericin B.<br /><br />The second case involves a 31-year-old male from India who is asymptomatic but has abnormal imaging findings. Further investigations reveal a cyst in the left upper and left lower lung. This is diagnosed as pulmonary echinococcosis, which is commonly discovered incidentally but can have serious consequences if the cyst ruptures. Treatment involves complete surgical removal and prolonged anti-helminthic treatment.<br /><br />The article provides clinical pearls for approaching patients with pulmonary infections, including the importance of the patient's history, physical examination, location of infection, and extrapulmonary examination. It also emphasizes the use of old chest X-rays in diagnosis. The article concludes with lessons learned from the cases, such as the fact that mucor prefers an acidic environment and the need to consider echinococcosis in patients with appropriate history.
Keywords
pulmonary infections
clinical approach guidelines
angioinvasive mucormycosis
surgical debridement
IV Amphotericin B
pulmonary echinococcosis
cyst
complete surgical removal
anti-helminthic treatment
lessons learned
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American College of Chest Physicians
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