Daptomycin-induced acute eosinophilic pneumonia.

Introduction: Daptomycin is a cyclic lipopeptide antibiotic with activity against gram-positive organisms. With increasing use, acute eosinophilic pneumonia is a rare, but potentially fatal adverse drug reaction that requires prompt recognition. The authors present a definite case of daptomycin-induced acute eosinophilic pneumonia.

Tracheobronchial amyloidosis managed with multimodality therapies.

Amyloidosis is a systemic disease involving abnormal extracellular deposition of amyloid and autologous fibrillar protein material in β-pleated sheets. Accumulation of this abnormal protein leads to organ dysfunction, although respiratory tract involvement is rare. We present two cases of tracheobronchial amyloidosis successfully treated with surgery and radiation.

Systemic lupus-induced diffuse alveolar hemorrhage treated with extracorporeal membrane oxygenation: a case report and review of the literature.

Objectives: We report the case of a 28-year-old patient with systemic lupus erythematosus (SLE) with rapid onset of dyspnea and hemoptysis found to have diffuse alveolar hemorrhage (DAH) with refractory hypoxemia successfully treated with venovenous extracorporeal membrane oxygenation (ECMO). The discussion includes clinical presentation, diagnosis, management, outcome, and a review of the available adult literature on the use of ECMO in patients with DAH.

Design: Case report.

Restoring functional status: a long-term case report of severe lung and ventilatory muscle pump dysfunction involving recurrent bacterial pneumonias.

Background And Purpose: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person's functional status even after multiple years of mechanical ventilation dependency.

Case Description: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home.

Clozapine-induced peripheral and pleural fluid eosinophilia.

Objective: To present a case of clozapine-induced peripheral and pleural fluid eosinophilia (PFE).

Case Summary: A 28-year-old man who was taking clozapine for bipolar disorder presented with a 2-week history of increasing shortness of breath. A large right-sided pleural effusion was identified, and eosinophilia was noted in peripheral and pleural fluid.

Severe pulmonary toxicity after azathioprine/6-mercaptopurine initiation for the treatment of inflammatory bowel disease.

Azathioprine and 6-mercaptopurine (6-MP) are effective in inflammatory bowel disease (IBD). However, between 10% and 29% of patients treated with these drugs are forced to stop therapy due to side effects. Pulmonary toxicity due to azathioprine/6-MP has been reported infrequently.

Risk factors for bronchiolitis obliterans in allogeneic hematopoietic stem-cell transplantation for leukemia.

Study Objectives: Reported risk factors for bronchiolitis obliterans (BO) in allogeneic hematopoietic stem-cell transplant recipients come from modest-sized studies and are limited to experiences of single institutions. We sought to identify risk factors for BO using data from the International Bone Marrow Transplant Registry.

Methods: Registry data on 6,275 adult patients with leukemia who received human leukocyte antigen-identical sibling transplants from 1989 to 1997 and survived at least 100 days after transplantation were evaluated for the study.

Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients.

Background: Chest computed tomographic (CT) scanning is used frequently to evaluate symptomatic patients for pulmonary embolus (PE). The incidence of PE diagnosed by helical CT scanning in asymptomatic patients is unknown.

Methods: Asymptomatic trauma patients with an Injury Severity Score > or = 9 were studied with contrast-enhanced helical CT images of the chest, pelvis, and lower extremities.

Subsequent pulmonary embolism: risk after a negative helical CT pulmonary angiogram--prospective comparison with scintigraphy.

Purpose: To determine whether a helical computed tomographic (CT) scan that is negative for pulmonary embolism (PE) is a sufficiently reliable criterion to safely withhold anticoagulation therapy.

Materials And Methods: Patients with negative helical CT scans were prospectively compared with patients with negative or low-probability scintigrams. In a 460-bed university hospital and clinic, 1,015 adult patients underwent either scintigraphy or helical CT for possible PE for 25 months.

Spiral computed tomography in the evaluation of pulmonary embolism.

Determining the presence or absence of thromboembolic disease can often be problematic. Traditional diagnostic algorithms are reviewed and discussed. Spiral CT technology allows a relatively noninvasive visualization of the pulmonary vasculature and is a promising new diagnostic modality for acute and chronic thromboembolic disease.

Functional and oximetric assessment of patients after lung reduction surgery.

Objective: The goal of this study was to clarify the issue of functional oxygen requirement by regimented exercise oximetry in patients undergoing lung reduction surgery.

Methods: Thirty-seven patients underwent lung reduction surgery and were followed up for at least 3 months. Patients routinely completed a 6-week program of cardiopulmonary rehabilitation.

Self-selected walking velocity for functional ambulation in patients with end-stage emphysema.

Purpose: Considerable attention has been given to ambulation and dyspnea in the population with chronic obstructive pulmonary disease; however, previous studies leave the question of what constitutes functional ambulation in this population unanswered. This article examines ambulation for functional independence in the community for patients with-end-stage emphysema based on their self-selected walking velocity (SSWV) during a 6-minute walk (6 MW) and a timed get up and go (GUG) test.

Methods: Fifty-nine patients (28 women, 31 men; mean age of 65.

Pulmonary function changes in long-term survivors of bone marrow transplantation.

Purpose: This study was undertaken to evaluate long-term pulmonary function changes in patients undergoing bone marrow transplantation (BMT), to assess their clinical significance, and to identify factors influencing these changes.

Methods And Materials: Pulmonary function tests (PFT) were evaluated before and after BMT in 111 adult patients undergoing BMT between 1985 and 1991. Forced expiratory volume at 1 s (FEV1), forced vital capacity (FVC), diffusing capacity (DLCO), and total lung capacity (TLC) were evaluated.