Mycobacterium abscessus infections in lung transplant recipients: 15-year experience from a single institution.

Purpose: To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR).

Methods: We retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001 to 2015 to identify patients with M. abscessus or Mycobacterium chelonae/abscessus infection before or after transplantation.

Nontuberculous mycobacterial pulmonary infections.

Pulmonary infections due to nontuberculous mycobacteria (NTM) are increasingly recognized worldwide. Although over 150 different species of NTM have been described, pulmonary infections are most commonly due to Mycobacterium avium complex (MAC), Mycobacterium kansasii, and Mycobacterium abscessus. The identification of these organisms in pulmonary specimens does not always equate with active infection; supportive radiographic and clinical findings are needed to establish the diagnosis.

The history of surgery for pulmonary tuberculosis.

Thoracic surgical procedures evolved from surgical management of tuberculosis; lung resections, muscle flaps, and thoracoscopy all began with efforts to control the disease. The discovery of antituberculosis drugs in 1944 to 1946 made sanatorium therapy and collapse therapy in all its forms obsolete and changed thoracic surgery dramatically. Currently, management of tuberculosis is primarily medical, and surgery has a minimal role.

How an aspirin, a throat swab from a chicken, and four Guinea pigs changed thoracic surgery.

The development of antituberculous drugs changed thoracic surgery and also markedly lowered the morbidity and mortality of a disease that had epidemic proportions. This article summarizes aspects from 3 important articles that led to the discovery of these drugs.

Traumatic bronchial rupture and platypnea-orthodeoxia.

A patient with blunt trauma and traumatic bronchial rupture and lung collapse had prominent symptoms of platypnea-orthodeoxia syndrome. These symptoms were relieved by bronchial repair. The syndrome is rarely seen and is usually associated with a patent foramen ovale or atrial septal defect.

Retrocardiac herniation of atelectatic lung into the opposite chest.

A 64-year-old man with a history of esophageal adenocarcinoma status postneoadjuvant therapy underwent esophagogastrectomy. Postoperatively he was found with increasing dyspnea and oxygen requirements. Computed tomography of the chest showed retrocardiac herniation of atelectatic lung into the contralateral hemithorax.

Phrenic nerve palsy and Parsonage-Turner syndrome.

This report describes 2 symptomatic patients with phrenic nerve palsy due to Parsonage-Turner syndrome who were managed by diaphragmatic plication. The characteristics of the underlying syndrome are defined.

Extended stent usage for persistent esophageal leak: should there be limits?

A patient with a spontaneous esophageal perforation was unsuccessfully managed elsewhere by repeated stent placement. Because of inability to remove the stents and persistent empyema, staged procedures of esophagectomy and later restoration of gastrointestinal continuity were necessary.

Minimally invasive endoscopic staging of suspected lung cancer.

Context: In patients with suspected lung cancer, the presence of mediastinal lymph node metastasis is a critical determinant of therapy and prognosis. Invasive staging with pathologic confirmation is recommended. Many methods for staging exist; mediastinoscopy, an invasive procedure requiring general anesthesia, is currently regarded as the diagnostic standard.

Transaortic fine-needle aspiration of centrally located lung cancer under endoscopic ultrasound guidance: the final frontier.

We describe endoscopic ultrasound guided fine-needle aspiration of a mass adjacent to the descending thoracic aorta, which was performed without complication.

Cervical sympathetic neuralgia arising from a schwannoma.

We describe an unusual case of neuropathic pain of the left face and shoulder accompanied by ipsilateral hyperhidrosis caused by a schwannoma of the cervical sympathetic chain. Additional signs of associated sympathetic hyperactivity included left-sided lacrimation, conjunctival injection, and nasal congestion. Autonomic testing demonstrated signs of increased vasomotor and sudomotor activity in the left palm.

Jejunopexy for selectively placed fluoroscopically guided percutaneous jejunal feeding tubes.

Prophylactic placement of feeding jejunostomy tubes in patients undergoing esophagectomy or gastrectomy continues to be a common practice. The aim of jejunostomy is to maintain nutrition, especially with an anastomotic leak. Frequently total or supplemental nutrition through a jejunostomy is not required, rendering prophylactic placement unnecessary.

Thoracoscopic extracardiac obliteration of the left atrial appendage for stroke risk reduction in atrial fibrillation.

Objectives: We evaluated left atrial appendage obliteration in high-risk patients with atrial fibrillation (AF).

Background: Left atrial appendage thrombosis and embolization is the principal mechanism of stroke in AF. Anticoagulation is underutilized and often contraindicated.