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Rescue therapy using an endobronchial valve and digital air leak monitoring in Invasive Pulmonary Aspergillosis.

Tsim S, Paton L, Nicholson F, Blyth KG - Respir Med Case Rep (2014)

Bottom Line: In this case report, we describe the utilisation of two recently developed technologies for the successful management of a persistent air leak (PAL) in a critically ill patient in whom cardiothoracic surgical intervention was not possible.We report the case of a young leukaemic woman with a PAL complicating Invasive Pulmonary Aspergillosis (IPA), who was effectively managed using an Endobronchial Valve, supplemented by objective, digital air leak data provided by a Thopaz(®) device (Medela, Switzerland).

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Southern General Hospital, Glasgow G51 4TF, United Kingdom.

ABSTRACT
In this case report, we describe the utilisation of two recently developed technologies for the successful management of a persistent air leak (PAL) in a critically ill patient in whom cardiothoracic surgical intervention was not possible. We report the case of a young leukaemic woman with a PAL complicating Invasive Pulmonary Aspergillosis (IPA), who was effectively managed using an Endobronchial Valve, supplemented by objective, digital air leak data provided by a Thopaz(®) device (Medela, Switzerland).

No MeSH data available.


Related in: MedlinePlus

Axial images from Thoracic Computed Tomography (CT) scans acquired in a 32-year old leukaemic patient with Invasive Pulmonary Aspergillosis (IPA). The selected images, which are from identical slice positions, demonstrate bilateral ground glass opacification on Day 21 ((a)) and new intrapulmonary fungal mass lesions, which had developed by the time of repeat scanning on Day 47 ((b)).
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fig1: Axial images from Thoracic Computed Tomography (CT) scans acquired in a 32-year old leukaemic patient with Invasive Pulmonary Aspergillosis (IPA). The selected images, which are from identical slice positions, demonstrate bilateral ground glass opacification on Day 21 ((a)) and new intrapulmonary fungal mass lesions, which had developed by the time of repeat scanning on Day 47 ((b)).

Mentions: A 32-year old female with Acute Promyelocytic Leukaemia (APML), previously treated by autogeneic haematopoietic stem cell transplantation (HSCT), presented with pancytopaenia and evidence of relapsed disease. She was started on IV Arsenic and All-trans Retinoic Acid (ATRA) as a bridge to allogeneic HSCT, but became pyrexial and increasingly oxygen-dependent. Serial chest radiographs followed by thoracic Computed Tomography (CT) scanning on Day 28 revealed progressive, extensive ground glass opacification (see Fig. 1(a)). Repeat CT imaging on Day 44 demonstrated additional intrapulmonary mass lesions (see Fig. 1(b)). Galactomannan titres (Aspergillus Antigen Index Value 0.89) and subsequent bronchial lavage and pleural fluid cultures would later confirm IPA secondary to Aspergillus Flavus.


Rescue therapy using an endobronchial valve and digital air leak monitoring in Invasive Pulmonary Aspergillosis.

Tsim S, Paton L, Nicholson F, Blyth KG - Respir Med Case Rep (2014)

Axial images from Thoracic Computed Tomography (CT) scans acquired in a 32-year old leukaemic patient with Invasive Pulmonary Aspergillosis (IPA). The selected images, which are from identical slice positions, demonstrate bilateral ground glass opacification on Day 21 ((a)) and new intrapulmonary fungal mass lesions, which had developed by the time of repeat scanning on Day 47 ((b)).
© Copyright Policy - CC BY-NC-SA
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356032&req=5

fig1: Axial images from Thoracic Computed Tomography (CT) scans acquired in a 32-year old leukaemic patient with Invasive Pulmonary Aspergillosis (IPA). The selected images, which are from identical slice positions, demonstrate bilateral ground glass opacification on Day 21 ((a)) and new intrapulmonary fungal mass lesions, which had developed by the time of repeat scanning on Day 47 ((b)).
Mentions: A 32-year old female with Acute Promyelocytic Leukaemia (APML), previously treated by autogeneic haematopoietic stem cell transplantation (HSCT), presented with pancytopaenia and evidence of relapsed disease. She was started on IV Arsenic and All-trans Retinoic Acid (ATRA) as a bridge to allogeneic HSCT, but became pyrexial and increasingly oxygen-dependent. Serial chest radiographs followed by thoracic Computed Tomography (CT) scanning on Day 28 revealed progressive, extensive ground glass opacification (see Fig. 1(a)). Repeat CT imaging on Day 44 demonstrated additional intrapulmonary mass lesions (see Fig. 1(b)). Galactomannan titres (Aspergillus Antigen Index Value 0.89) and subsequent bronchial lavage and pleural fluid cultures would later confirm IPA secondary to Aspergillus Flavus.

Bottom Line: In this case report, we describe the utilisation of two recently developed technologies for the successful management of a persistent air leak (PAL) in a critically ill patient in whom cardiothoracic surgical intervention was not possible.We report the case of a young leukaemic woman with a PAL complicating Invasive Pulmonary Aspergillosis (IPA), who was effectively managed using an Endobronchial Valve, supplemented by objective, digital air leak data provided by a Thopaz(®) device (Medela, Switzerland).

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Southern General Hospital, Glasgow G51 4TF, United Kingdom.

ABSTRACT
In this case report, we describe the utilisation of two recently developed technologies for the successful management of a persistent air leak (PAL) in a critically ill patient in whom cardiothoracic surgical intervention was not possible. We report the case of a young leukaemic woman with a PAL complicating Invasive Pulmonary Aspergillosis (IPA), who was effectively managed using an Endobronchial Valve, supplemented by objective, digital air leak data provided by a Thopaz(®) device (Medela, Switzerland).

No MeSH data available.


Related in: MedlinePlus