A 62-Year-Old Woman With Wheezing, Respiratory Failure, and an Abnormal CT Scan.

Abstract:

CASE PRESENTATION:A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. She received a 5-day course of azithromycin, with partial improvement of her symptoms. The patient returned home 1 week prior to admission, reporting worsening dyspnea, chest pressure, cough, and fever. The patient was admitted to the medical ward, and treatment for unresolved pneumonia was begun with levofloxacin, an inhaled short-acting beta agonist, and oral prednisone. Despite this treatment, the patient experienced severe respiratory distress with audible wheezing as well as increased work of breathing. She was intubated for acute hypoxemic respiratory failure and transferred to the ICU.

journal_name

Chest

journal_title

Chest

authors

Hountras P,Cajigas H

doi

10.1016/j.chest.2017.04.168

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

e73-e76

issue

3

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(17)30811-5

journal_volume

152

pub_type

杂志文章

相关文献

CHEST文献大全
  • Performance of American Thoracic Society-recommended spirometry reference values in a multiethnic sample of adults: the multi-ethnic study of atherosclerosis (MESA) lung study.

    abstract:BACKGROUND:The American Thoracic Society recommends race-specific spirometric reference values from the National Health and Nutrition Survey (NHANES) III for clinical evaluation of pulmonary function in whites, African-Americans, and Mexican-Americans in the United States and a correction factor of 0.94 for Asian-Ameri...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.09-0919

    authors: Hankinson JL,Kawut SM,Shahar E,Smith LJ,Stukovsky KH,Barr RG

    更新日期:2010-01-01 00:00:00

  • Colonization of dental plaques: a reservoir of respiratory pathogens for hospital-acquired pneumonia in institutionalized elders.

    abstract:STUDY OBJECTIVES:Poor dental hygiene has been linked to respiratory pathogen colonization in residents of long-term care facilities. We sought to investigate the association between dental plaque (DP) colonization and lower respiratory tract infection in hospitalized institutionalized elders using molecular genotyping....

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.5.1575

    authors: El-Solh AA,Pietrantoni C,Bhat A,Okada M,Zambon J,Aquilina A,Berbary E

    更新日期:2004-11-01 00:00:00

  • Cancer genetics and cell and molecular biology. Is this the way forward?

    abstract::Lung cancer, the most prevalent cancer in the western world, is predominantly caused by smoking and thus perceived as a "self-inflicted" disease. Nevertheless, only 20% of smokers develop lung cancer. This review examines the concept of high-risk populations and screening. It looks at developments in the molecular epi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.5_supplement.125s

    authors: Smyth JF

    更新日期:1996-05-01 00:00:00

  • Physical development of surgically treated patients with primary spontaneous pneumothorax.

    abstract:STUDY OBJECTIVES:There have been many studies on the physical characteristics at the time of contraction of a primary spontaneous pneumothorax (PSP), but it has not been shown when and how such physical characteristics develop. These issues were investigated. PATIENTS AND DESIGN:Physical development of 27 male patient...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.116.4.899

    authors: Fujino S,Inoue S,Tezuka N,Hanaoka J,Sawai S,Ichinose M,Kontani K

    更新日期:1999-10-01 00:00:00

  • Increased serum calcitonin levels in bronchogenic cancer.

    abstract::A study of 26 men with bronchogenic cancer demonstrated high serum calcitonin levels in 62 percent (16). Levels were particularly high in patients with small-cell cancer and adenocarcinoma. Two varieties of hypercalcitonemia have been encountered: (1) ectopic hypercalcitonemia, in which the hormone is secreted by the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.69.4.495

    authors: Silva OL,Becker KL,Primack A,Doppman JL,Snider RH

    更新日期:1976-04-01 00:00:00

  • Treatment of a solitary pulmonary sarcoidosis mass by CT-guided direct intralesional injection of corticosteroid.

    abstract::A case is reported of 38-year-old woman with chest pain attributed to a left lung sarcoidosis mass. The mass failed to diminish and symptoms failed to resolve with systemic corticosteroid therapy. CT-guided direct intralesional transthoracic injection of dexamethasone resulted in resolution of the patient's symptoms a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.1.316

    authors: Judson MA,Uflacker R

    更新日期:2001-07-01 00:00:00

  • Detection of left ventricular diverticulum by cross-sectional echocardiography.

    abstract::This report describes the cross-sectional echocardiographic features of a left ventricular diverticulum. The echocardiographic findings are illustrated and discussed in relation to the diagnostic capabilities of this noninvasive imaging technique. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.69.4.544

    authors: Estevez CM,Weyman AE,Feigenbaum H

    更新日期:1976-04-01 00:00:00

  • Prolonged mechanical ventilation: review of care settings and an update on professional reimbursement.

    abstract::The goal of this article is to provide an update on recent changes to current procedural terminology codes used for billing physician services for mechanical ventilation in chronic care facilities. In addition to billing information, background data relevant to prolonged mechanical ventilation are reviewed. Topics cov...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0656

    authors: White AC,O'Connor HH,Kirby K

    更新日期:2008-02-01 00:00:00

  • Relationship of indices of inflammation and thrombogenesis to arrhythmia burden in paroxysmal atrial fibrillation.

    abstract:BACKGROUND:Atrial fibrillation (AF) is associated with a high risk of stroke. The contribution of arrhythmia to events is clear in sustained forms of AF, but in paroxysmal AF, presently available data have yet to identify what proportion of time spent in AF (ie, arrhythmia burden [AFB]) is of clinical relevance. We aim...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.09-1426

    authors: Watson T,Arya A,Sulke N,Lip GY

    更新日期:2010-04-01 00:00:00

  • Nonfebrile mitral valve endocarditis due to Neisseria subflava.

    abstract::Native valve endocarditis normally presents with fever and only later in its course demonstrates dysfunction of the affected valve. We describe a case of endocarditis due to Neisseria subflava, a Gram-negative diplococcal saprophyte of the oral cavity, which was unsuspected clinically and found unexpectedly during a m...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.109.1.280

    authors: Amsel BJ,Moulijn AC

    更新日期:1996-01-01 00:00:00

  • Single-breath nitrogen washout; effects of alterations of lung volumes and elastic recoil.

    abstract::Strapping of the chest causes decreased lung volumes and increased elastic recoil pressure. Such strapping was used in conjunction with single-breath nitrogen washout to study the effects of changes in these factors on the dynamics of the small airways. Studies consisted of simultaneous measurements of the quasistatic...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.76.1.83

    authors: Al-Bazzaz FJ

    更新日期:1979-07-01 00:00:00

  • Humidifier lung. An outbreak in office workers.

    abstract::Symptoms consistent with hypersensitivity pneumonitis (HP) occurred in 26 of 50 employees working in a localized area of a large factory. This area was served by a single heating-cooling unit utilizing a water humidification system. The illness consisted of flu-like symptoms with fever, chills, headache, cough, dyspne...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.77.2.183

    authors: Ganier M,Lieberman P,Fink J,Lockwood DG

    更新日期:1980-02-01 00:00:00

  • Left subclavian steal, interrupted aortic arch, complete transposition of the great vessels and single left ventricle.

    abstract::Congenital subclavian steal consists of atresia of the proximal end of the subclavian artery, while the blood supply to the distal portion of the subclavian artery originates from the circle of Willis. It should be suspected in complicated malformations of the heart associated with marked hypoplasia or interruption of...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.67.3.352

    authors: Garcia O,Wilkins R,Cunha D,Jesse MJ

    更新日期:1975-03-01 00:00:00

  • Evaluating prethrombotic state in lung cancer using molecular markers.

    abstract::Clotting abnormalities are well-recognized complications that occur with high frequency in patients suffering from underlying malignant diseases. New and highly sensitive molecular markers of hemostasis, thrombin-antithrombin III complex (TAT III), D-dimer fragments (DD), and plasmin-alpha 2-antiplasmin complex (PIC) ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.1.196

    authors: Gabazza EC,Taguchi O,Yamakami T,Machishi M,Ibata H,Suzuki S

    更新日期:1993-01-01 00:00:00

  • The recrudescent epidemic of retrolental fibroplasia.

    abstract::We are probably observing a recrudescent epidemic of RLF which has elicited surprisingly little attention from the medical community. Given present data, it is not unreasonable to conclude that there is a true epidemic and that its etiologic basis involves a population of infants with high susceptibility to oxygen tox...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.89.4.576

    authors: Robin ED,Burke CM

    更新日期:1986-04-01 00:00:00

  • Tracheoesophageal and aortoesophageal fistulae complicating corrosive esophagitis.

    abstract::A 51-year-old man suffered third-degree caustic burns of the esophagus and proximal two-thirds of the stomach. A tracheoesophageal fistula developed, and surgery was performed to exclude the esophagus from gastrointestinal reflux and to divert the oral secretions. An uneventful postoperative course was interrupted on ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.70.4.549

    authors: Singh AK,Kothawla LK,Karlson KE

    更新日期:1976-10-01 00:00:00

  • Antimyosin scintigraphy for detection of myocarditis. Scintigraphic follow-up.

    abstract::To examine the value of antimyosin-indium 111 imaging in relation to endomyocardial biopsy in patients with suspected myocarditis, as well as the natural evolution of abnormal findings on the antimyosin scan, 12 patients with suspected myocarditis underwent endomyocardial biopsy and antimyosin scan. The heart-to-lung ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.5.1427

    authors: Lekakis J,Nanas J,Moustafellou A,Kostamis P,Moulopoulos S

    更新日期:1993-11-01 00:00:00

  • Reperfusion adequacy and functional recovery.

    abstract::Ischemic myocardium undergoes many physiologic changes, including alterations in contractile function, histologic condition, and oxygen utilization. Reperfusion of ischemic myocardium may reverse some of these changes; however, the level of reperfusion needed for adequate functional recovery, as opposed to myocyte sal...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.112.4.1075

    authors: Rohs TJ Jr,Benedict MB,Bolling SF

    更新日期:1997-10-01 00:00:00

  • In-hospital clinical and economic consequences of pulmonary wedge resections for cancer using video-assisted thoracoscopic techniques vs traditional open resections: a retrospective database analysis.

    abstract:OBJECTIVE:The objective of this study was to compare the safety, use, and cost profiles of open thoracotomy vs video-assisted thoracoscopic surgery (VATS) for wedge resection in lung cancer performed by thoracic surgeons in the United States. METHODS:The Premier database, which contains complete patient billing, hospi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-3013

    authors: Howington JA,Gunnarsson CL,Maddaus MA,McKenna RJ,Meyers BF,Miller D,Moore M,Rizzo JA,Swanson S

    更新日期:2012-02-01 00:00:00

  • Beliefs among pulmonologists and thoracic surgeons in the therapeutic approach to non-small cell lung cancer.

    abstract:STUDY OBJECTIVES:The physicians who initially evaluate patients with non-small cell lung cancer (NSCLC) strongly impact the course of therapy. Their beliefs in treatment and prognosis may contribute to practices of variable quality and appropriateness. We sought to better describe beliefs among pulmonologists and thora...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.1.129

    authors: Schroen AT,Detterbeck FC,Crawford R,Rivera MP,Socinski MA

    更新日期:2000-07-01 00:00:00

  • Detection and evaluation of asymptomatic myocarditis in schoolchildren: report of four cases.

    abstract:STUDY OBJECTIVE:Data on the prevalence of myocarditis in children are limited. Autopsy studies have shown that myocarditis is often undiagnosed. We attempted to investigate the clinical features of asymptomatic myocarditis in four schoolchildren detected during a mass ECG screening in schoolchildren. DESIGN AND SETTIN...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.116.2.340

    authors: Nakagawa M,Sato A,Okagawa H,Kondo M,Okuno M,Takamatsu T

    更新日期:1999-08-01 00:00:00

  • Promoter polymorphism G-50T of a human CYP2J2 epoxygenase gene is associated with common susceptibility to asthma.

    abstract:BACKGROUND:Cytochrome P-450 2J2 (CYP2J2) has recently been shown to be an important enzyme in the metabolism of epoxygenase-derived eicosanoids that play important functional roles in pulmonary physiology and may contribute to the pathogenesis of asthma. STUDY OBJECTIVE:The focus of our pilot study was to evaluate whe...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0371

    authors: Polonikov AV,Ivanov VP,Solodilova MA,Khoroshaya IV,Kozhuhov MA,Panfilov VI

    更新日期:2007-07-01 00:00:00

  • Clinical significance of a multiple biomarker assay in patients with lung cancer. A study with logistic regression analysis.

    abstract::The relative usefulness of a combination of some tumor markers, such as CEA, AFP, ferritin and NSE for the diagnosis of lung cancer was assessed by multiple logistic analysis. Serum concentration of these markers was determined in 68 patients with lung cancer (50 with NSCLC and 18 with SCLC, in 68 patients with benign...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.3.639

    authors: Lombardi C,Tassi GF,Pizzocolo G,Donato F

    更新日期:1990-03-01 00:00:00

  • Pain location, distribution, and intensity after cardiac surgery.

    abstract:STUDY OBJECTIVES:To study the location, distribution, and intensity of pain in a sample of adult cardiac surgery patients during their postoperative hospital stay. DESIGN:In a prospective study, pain location, distribution (number of pain areas per patient), and intensity (0 to 10 numerical rating scale) were document...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.2.391

    authors: Mueller XM,Tinguely F,Tevaearai HT,Revelly JP,Chioléro R,von Segesser LK

    更新日期:2000-08-01 00:00:00

  • The spectrum of building-related airway disorders: difficulty in retrospectively diagnosing building-related asthma.

    abstract:INTRODUCTION:The specific causes and mechanism(s) for asthma occurring among occupants of non-residential buildings with poor indoor air quality are not known, but allergic and nonallergic processes are possible explanations METHODS:Repeated indoor air quality measurements were made while employees were working in a b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.3.1720

    authors: Brooks SM,Spaul W,McCluskey JD

    更新日期:2005-09-01 00:00:00

  • Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients.

    abstract::To evaluate the morbidity associated with obstructve sleep apnea syndrome (OSAS), we undertook a seven-year follow-up study of 198 OSAS patients seen between 1972 and 1980. The patients had been submitted to tracheostomy (71 patients) or had received a weight-loss recommendation (127 patients). Despite a lower mean ap...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.1.27

    authors: Partinen M,Guilleminault C

    更新日期:1990-01-01 00:00:00

  • Relationship between pulmonary function and sleep-induced respiratory abnormalities.

    abstract::The relationships between pulmonary function and sleep-induced respiratory events were studied in 34 consecutive male patients with suspected sleep apnea syndrome. In view of the effects of obstructive airway disease on pulmonary volume and airway resistance (Raw), patients were divided into two groups, those with and...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.87.4.437

    authors: Onal E,Leech JA,Lopata M

    更新日期:1985-04-01 00:00:00

  • Long-term effects of nitrendipine on hemodynamics and oxygen transport in patients with cor pulmonale.

    abstract::Recent studies have suggested that vasodilators may acutely improve pulmonary hemodynamics in patients with chronic obstructive pulmonary disease and cor pulmonale, but the effects of long-term therapy have not been assessed. We evaluated the hemodynamic and gas exchange effects of nitrendipine, a calcium channel bloc...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.89.1.141

    authors: Rubin LJ,Moser K

    更新日期:1986-01-01 00:00:00

  • Ventilatory and cardiocirculatory exercise profiles in COPD: the role of pulmonary hypertension.

    abstract:BACKGROUND:Pulmonary hypertension (PH) is a well-recognized complication of COPD. The impact of PH on exercise tolerance is largely unknown. We evaluated and compared the circulatory and ventilatory profiles during exercise in patients with COPD without PH, with moderate PH, and with severe PH. METHODS:Forty-seven pat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.11-2798

    authors: Boerrigter BG,Bogaard HJ,Trip P,Groepenhoff H,Rietema H,Holverda S,Boonstra A,Postmus PE,Westerhof N,Vonk-Noordegraaf A

    更新日期:2012-11-01 00:00:00

  • Lung elastic recoil does not correlate with pulmonary hemodynamics in severe emphysema.

    abstract:BACKGROUND:It has been postulated that right ventricular (RV) function may improve after lung volume reduction surgery (LVRS) for severe emphysema due to improvement in lung elastic recoil. Improved lung elastic recoil after LVRS is hypothesized to "tether" open extraalveolar vessels, thereby leading to a decrease in p...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.07-0041

    authors: Falk JA,Martin UJ,Scharf S,Criner GJ

    更新日期:2007-11-01 00:00:00