A 78-Year-Old Man With Repeated Dyspnea and Neutrophilia in Peripheral Blood and BAL.

Abstract:

CASE PRESENTATION:A 78-year-old man with asthma and COPD presented with shortness of breath, cough, and severe malaise for 4 days. Upon arrival, the patient was conscious and body temperature was 37.5°C. Arterial oxygen saturation (Spo2) was 80% on room air. Laboratory data demonstrated a WBC count of 17,400/μL (89.5% neutrophils) and C-reactive protein of 5.00 mg/dL. CT scan of chest revealed scattered ground-glass in the upper right lobe and thickening of the bronchial wall. Based on these findings, acute bronchopneumonia was diagnosed and antibacterial therapy was started. The day after admission, the patient's general condition and shortness of breath had gradually improved. We treated and observed him carefully for 10 days in the hospital on antibacterial therapy because of his underlying comorbidities (asthma and COPD) and his ongoing hypoxemia. Three days after discharge, the patient re-presented with shortness of breath, hypoxemia, and loss of appetite. The patient was hospitalized for a second time.

journal_name

Chest

journal_title

Chest

authors

Nakamatsu E,Morita T,Morishima A,Tagawa H,Furukawa M,Matsushita M,Yamane H

doi

10.1016/j.chest.2019.07.034

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

e17-e20

issue

1

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(19)33745-6

journal_volume

157

pub_type

杂志文章

相关文献

CHEST文献大全
  • Pitolisant for Residual Excessive Daytime Sleepiness in OSA Patients Adhering to CPAP: A Randomized Trial.

    abstract:BACKGROUND:Excessive daytime sleepiness (EDS) in individuals with OSA syndrome persisting despite good adherence to CPAP is a disabling condition. Pitolisant is a selective histamine H3-receptor antagonist with wake-promoting effects. RESEARCH QUESTION:Is pitolisant effective and safe for reducing daytime sleepiness i...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2020.09.281

    authors: Pépin JL,Georgiev O,Tiholov R,Attali V,Verbraecken J,Buyse B,Partinen M,Fietze I,Belev G,Dokic D,Tamisier R,Lévy P,Lecomte I,Lecomte JM,Schwartz JC,Dauvilliers Y,HAROSA I Study Group.

    更新日期:2020-10-26 00:00:00

  • Heparin added to cardioplegic solution inhibits tumor necrosis factor-alpha production and attenuates myocardial ischemic-reperfusion injury.

    abstract:OBJECTIVES:Tumor necrosis factor (TNF)-alpha is known to be a proinflammatory cytokine that has a pronounced negative inotropic effect and plays an important role in ischemic-reperfusion injury. METHODS:Twenty isolated rat hearts were randomly divided equally into two groups (heparin and non-heparin) and were perfused...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.3.1805

    authors: Pevni D,Frolkis I,Shapira I,Schwartz D,Yuhas Y,Schwartz IF,Chernichovski T,Uretzky G

    更新日期:2005-09-01 00:00:00

  • Transition from exercise to rest. Ventilatory and arterial blood gas responses.

    abstract::The mechanisms leading to rapid changes in arterial blood gas values soon after exercise ends have not been well established. To further study these phenomena, we exercised seven normal male volunteers to exhaustion on a cycle ergometer with a 25-W/min ramped protocol measuring arterial blood gas values, and breath-by...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.5.1145

    authors: O'Neill AV,Johnson DC

    更新日期:1991-05-01 00:00:00

  • Almitrine decreases the distensibility of the large pulmonary arteries in man.

    abstract::Almitrine improves blood gas values in patients with COPD, primarily through better ventilation-perfusion matching. The improvement comes largely from a vasomotor effect of the drug. The vasomotor mechanism is unknown. We suspected that decreased distensibility of the large pulmonary arteries was one probable effect o...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.96.3.572

    authors: Herve P,Musset D,Simonneau G,Wagner W Jr,Duroux P

    更新日期:1989-09-01 00:00:00

  • Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock?: a critical appraisal.

    abstract::Etomidate is commonly used for the facilitation of endotracheal intubation. While etomidate possesses multiple qualities that are beneficial in hemodynamically unstable patients who require a sedative or amnestic, its potential to negatively impact corticosteroid production is well-documented. Given the frequency of r...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.127.3.1031

    authors: Jackson WL Jr

    更新日期:2005-03-01 00:00:00

  • The clinical profile of unresolved pulmonary embolism.

    abstract::Nearly all patients with pulmonary embolism (PE) have complete clinical and hemodynamic and at least near complete roentgenographic and angiographic resolution within four to six weeks of the acute event. To classify the syndrome of unresolved pulmonary embolism we reviewed our experience and that of the English liter...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.84.6.669

    authors: Benotti JR,Ockene IS,Alpert JS,Dalen JE

    更新日期:1983-12-01 00:00:00

  • Acute postbronchodilator changes in pulmonary function parameters in patients with chronic airways obstruction.

    abstract::Pulmonary function studies were performed before and after one-time administration of an inhaled bronchodilator to ascertain the relative diagnostic value of using FVC, FEF25-75%, static lung volumes, Raw, and/or sGaw measurements, in addition to the FEV1, to assess the reversibility of chronic airways obstruction in ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.3.541

    authors: Berger R,Smith D

    更新日期:1988-03-01 00:00:00

  • Captopril lowers coronary venous free radical concentration after direct current cardiac shocks.

    abstract:STUDY OBJECTIVES:Direct current (DC) shocks to the heart cause morphologic and functional myocardial damage. Previous studies have suggested that acute DC shock injury is free radical mediated and that the administration of antioxidant enzymes superoxide dismutase and catalase can reduce the level of DC shock-induced f...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.116.2.484

    authors: Pagan-Carlo LA,Garcia LA,Hutchison JL,Buettner GR,Kerber RE

    更新日期:1999-08-01 00:00:00

  • Association of SERPINE2 with asthma.

    abstract:BACKGROUND:The "Dutch hypothesis" suggests that asthma and COPD have common genetic determinants. The serpin peptidase inhibitor, clade E (nexin, plasminogen activator inhibitor type 1), member 2 (SERPINE2) gene previously has been associated with COPD. We sought to determine whether SERPINE2 is associated with asthma ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-2973

    authors: Himes BE,Klanderman B,Ziniti J,Senter-Sylvia J,Soto-Quiros ME,Avila L,Celedón JC,Lange C,Mariani TJ,Lasky-Su J,Hersh CP,Raby BA,Silverman EK,Weiss ST,DeMeo DL

    更新日期:2011-09-01 00:00:00

  • A simplified insertion technique for tracheobronchial silicone stents.

    abstract::In many patients with central airway obstruction due to extrinsic compression or malacia, insertion of tracheobronchial stents can provide effective and permanent relief. Of the various types of prostheses described, the silicone Dumon-Artemis stents (Medicore, Brussels, Belgium) are probably the most efficient. The u...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.2.520

    authors: Noppen M,Dhondt E,Meysman M,Monsieur I,Gepts E,Vincken WG

    更新日期:1994-08-01 00:00:00

  • Very early onset of acute amiodarone pulmonary toxicity presenting with hemoptysis.

    abstract::A case of amiodarone pulmonary toxicity (APT) occurring within days of the start of therapy and presenting with hemoptysis is reported. Both the very early onset and the presenting symptom are highly unusual in this entity. Implications in the diagnosis of APT are discussed. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.111.5.1446

    authors: Goldstein I,Topilsky M,Segev D,Isakov A,Heller I

    更新日期:1997-05-01 00:00:00

  • Clinical relevance of the interaction of theophylline with diltiazem or nifedipine.

    abstract::The results of previously published studies indicate that calcium channel blockers are capable of competitively inhibiting cytochrome P-450 activity in hepatic microsomes, the pathway of theophylline metabolism. In addition, case reports have suggested that theophylline serum concentrations change when a calcium chann...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.2.309

    authors: Christopher MA,Harman E,Hendeles L

    更新日期:1989-02-01 00:00:00

  • Cocaine-induced bradyarrhythmia: an unsuspected cause of syncope.

    abstract::Cocaine use is associated with adverse events in nearly every organ system. Cardiovascular complications include hemorrhagic and ischemic stroke, aortic dissection, cardiomyopathy, accelerated coronary artery disease, myocardial infarction, and sudden cardiac death. Syncope may be the presenting symptom in these condi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.117.1.275

    authors: Castro VJ,Nacht R

    更新日期:2000-01-01 00:00:00

  • Factitious methemoglobinemia caused by hyperlipemia.

    abstract::Hyperlipemia in an acyanotic patient with diabetic ketoacidosis, alcoholism, and pancreatitis produced a falsely elevated concentration of methemoglobin (19 percent) and a lower-than-expected oxygen saturation measured with an automated spectrophotometer (IL-282 CO-Oximeter). In addition, there was a "normal" hemoglob...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.86.1.84

    authors: Spurzem JR,Bonekat HW,Shigeoka JW

    更新日期:1984-07-01 00:00:00

  • Oral corticosteroids increase esophageal acid contact times in patients with stable asthma.

    abstract:STUDY OBJECTIVES:The prevalence of gastroesophageal reflux disease (GERD) is higher in people with asthma than in control populations. Predisposing factors for GERD development may include asthma medications such as prednisone. The objective of this study was to determine whether prednisone alters GERD parameters in pe...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.121.2.625

    authors: Lazenby JP,Guzzo MR,Harding SM,Patterson PE,Johnson LF,Bradley LA

    更新日期:2002-02-01 00:00:00

  • Nonsurgical treatment of Histoplasma endocarditis involving a bioprosthetic valve.

    abstract::Endocardial involvement associated with disseminated histoplasmosis has been infrequently documented, especially among patients with prosthetic valves. The therapeutic approach to these patients is also not yet clearly defined. A 54-year-old man with prosthetic valve endocarditis due to histoplasmosis was successfully...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.99.1.253

    authors: Kanawaty DS,Stalker MJ,Munt PW

    更新日期:1991-01-01 00:00:00

  • Naloxone and naltrexone. Application in COPD.

    abstract::The narcotic antagonists naloxone and naltrexone were used as respiratory stimulants in two patients failing traditional medical therapy for COPD. Both patients demonstrated improvement while receiving the drugs, but developed respiratory failure when they were discontinued abruptly. In selected patients with COPD, na...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.1.217

    authors: Reents SB,Beck CA Jr

    更新日期:1988-01-01 00:00:00

  • Persistent Challenges in Pediatric Pulmonary Hypertension.

    abstract::Pulmonary hypertension and related pulmonary vascular diseases cause significant morbidities and high mortality and present many unique challenges toward improving outcomes in neonates, infants, and children. Differences between pediatric and adult disease are reflected in controversies regarding etiologies, classific...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2016.01.007

    authors: Hopper RK,Abman SH,Ivy DD

    更新日期:2016-07-01 00:00:00

  • Prostacyclin but not phentolamine increases oxygen consumption and skin microvascular blood flow in patients with sepsis and respiratory failure.

    abstract::Inadequate tissue oxygenation may occur in critically ill patients with sepsis despite an apparently adequate O2 transport (QO2), and this may contribute to the development of an O2 debt and also to multiple organ failure. It has been shown that increasing QO2 by infusing a vasodilator may reveal this O2 debt in septi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.6.1467

    authors: Pittet JF,Lacroix JS,Gunning K,Laverriere MC,Morel DR,Suter PM

    更新日期:1990-12-01 00:00:00

  • Evaluation of changes in forgoing life-sustaining treatment in Israeli ICU patients.

    abstract:INTRODUCTION:Over the last several years, there have been legal decisions and changes in medical directives concerning end-of-life decisions in Israel. METHODS:The data were compared to evaluate the changes in the frequency and types of forgoing of life-sustaining treatment (FLST) in patients who were admitted to the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.6.1969

    authors: Jakobson DJ,Eidelman LA,Worner TM,Oppenheim AE,Pizov R,Sprung CL

    更新日期:2004-12-01 00:00:00

  • Stability of blood gases in ice and at room temperature.

    abstract::Arterial blood samples from 75 patients were analyzed for PO2, PCO2, and pH at 0, 15, and 30 min. After the baseline analysis, 60 samples were kept in ice while 59 samples were left at room temperature. There was a statistically significant increase in the PO2 at 15 min and again at 30 min in both groups. There was a ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.4.1120

    authors: Liss HP,Payne CP Jr

    更新日期:1993-04-01 00:00:00

  • Interleukin-2 and soluble interleukin-2 receptor in bronchoalveolar lavage fluid from patients with bronchial asthma.

    abstract::To clarify the interrelation between interleukin-2 (IL-2) and soluble IL-2R receptor (sIL-2R), as products of T-cell activation in the bronchial tree of patients with bronchial asthma, we measured the concentration of IL-2, sIL-2R, and the cellular composition in bronchoalveolar lavage (BAL) fluid. We also measured ph...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.2.400

    authors: Park CS,Lee SM,Chung SW,Uh S,Kim HT,Kim YH

    更新日期:1994-08-01 00:00:00

  • Right chest electrocardiographic patterns in normal subjects.

    abstract::Right-sided chest lead ECGs (V3R to V6R) were recorded in 110 normal male subjects who were between the ages of 17 and 22 years old (mean, 17.9 years). The prevalence of the rS pattern decreased from V3R (89 percent) to V6R (37 percent). However, the opposite was the case for the rSr pattern (10 percent in V3R and 36 ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.3.572

    authors: Tan CC,Hiew TM,Chia BL

    更新日期:1990-03-01 00:00:00

  • Solid or partly solid solitary pulmonary nodules: their characterization using contrast wash-in and morphologic features at helical CT.

    abstract:BACKGROUND:Solitary pulmonary nodule (SPN) evaluation based on analyses of combined wash-in (WI) and washout (WO) values obtained by helical dynamic CT (HDCT) scanning is useful for malignant SPN characterization, because this method has higher specificity and accuracy than that based on analyses of WI values only. How...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.06-2526

    authors: Lee KS,Yi CA,Jeong SY,Jeong YJ,Kim S,Chung MJ,Kim HY,Kim YK,Lee KH

    更新日期:2007-05-01 00:00:00

  • Differences between low-molecular-weight and unfractionated heparin for venous thromboembolism prevention following ischemic stroke: a metaanalysis.

    abstract:BACKGROUND:Venous thromboembolism (VTE) remains a major cause of morbidity following stroke. The optimal form of pharmacologic prophylaxis following stroke is unknown. METHODS:We identified randomized trials comparing unfractionated heparin (UFH) to low-molecular-weight heparin (LMWH) for VTE prevention in ischemic st...

    journal_title:Chest

    pub_type: 杂志文章,meta分析

    doi:10.1378/chest.07-1826

    authors: Shorr AF,Jackson WL,Sherner JH,Moores LK

    更新日期:2008-01-01 00:00:00

  • Obstructing tracheal pulmonary Langerhans cell histiocytosis.

    abstract::Pulmonary Langerhans cell histiocytosis, also known as eosinophilic granuloma, is an uncommon interstitial lung disease. A solitary nodule, usually parenchymal, may rarely be the only manifestation of the disease. We describe a case of Langerhans cell histiocytosis presenting as an obstructing tracheal lesion in a 55-...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.2.1057

    authors: Fridlender ZG,Glazer M,Amir G,Berkman N

    更新日期:2005-08-01 00:00:00

  • Physician-diagnosed COPD global initiative for chronic obstructive lung disease stage IV in Ostersund, Sweden: Patient characteristics and estimated prevalence.

    abstract:BACKGROUND:The prevalence of COPD is estimated to 4 to 14%. According to the Global Initiative for Chronic Obstructive Lung Disease guidelines, COPD is divided into four stages. Patients with stage IV disease (very severe) have FEV1 < 30% of predicted values and/or respiratory insufficiency. The few studies that exist ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.130.3.666

    authors: Stenfors N

    更新日期:2006-09-01 00:00:00

  • Effect of a beta 2-agonist (broxaterol) on respiratory muscle strength and endurance in patients with COPD with irreversible airway obstruction.

    abstract::The effect of broxaterol, a new beta 2-agonist, on respiratory muscle endurance and strength was studied in a double-blind, placebo-controlled, randomized crossover clinical trial in 16 patients with chronic obstructive pulmonary disease (COPD) with irreversible airway obstruction (FEV1 = 57.1 percent of predicted). O...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.101.1.133

    authors: Nava S,Crotti P,Gurrieri G,Fracchia C,Rampulla C

    更新日期:1992-01-01 00:00:00

  • Bronchoscopic protected catheter brush for the diagnosis of pulmonary infections.

    abstract::A new bronchoscopic-protected catheter brush (BPCB), designed to obtain uncontaminated bronchial secretions, was studied in vitro and in vivo. The device was composed of a standard biopsy brush, protected by a single catheter and occluded with an agar plug. Ejection of the plug was obtained neither by advancing the br...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.93.4.746

    authors: Marquette CH,Ramon P,Courcol R,Wallaert B,Tonnel AB,Voisin C

    更新日期:1988-04-01 00:00:00

  • Persisting symptoms despite permanent pacing. Incidence, causes, and follow-up.

    abstract::Persisting symptoms, consisting of palpitations, dizziness, or syncope, were found in 49 of 570 consecutively followed patients (8.6 percent) with permanent pacemakers (PM). Among 540 patients with ventricular PM, 19 had syncope and 24 dizziness; among 30 patients with dual-chamber PM, five had palpitations and one di...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.85.2.207

    authors: Hoffman A,Jost M,Pfisterer M,Burkart F,Burckhardt D

    更新日期:1984-02-01 00:00:00