Spectrum of mycobacterial infections: tuberculosis and Mycobacterium other than tuberculosis in dialysis patients.
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BACKGROUND: Patients with end-stage renal disease are at high risk of mycobacterial infection. OBJECTIVES: To analyze the difficulties in reaching an accurate diagnosis of tuberculosis in dialysis patients. METHODS: We conducted a retrospective follow-up of patients who attended our peritoneal and hemodialysis units during the 10 year period 1995-2005. RESULTS: Our dialysis unit diagnosed 10 cases of tuberculosis caused by Mycobacterium tuberculosis and 9 cases of Mycobacterium other than tuberculosis. In the former group, five patients had Mycobacterium in the sputum, which was diagnosed by intraabdominal mass biopsy in one, culture of the gastric juices in one, and pleural fluid culture or pleural biopsy in three. One of these patients was suffering from pleural TB as well as Potts disease. Of the patients with Mycobacterium other than tuberculosis, five were diagnosed by sputum cultures, three by urine cultures and one in peritoneal fluid. Differences in treatment and outcome were also reviewed. CONCLUSIONS: The diagnosis of TB in dialysis patients should be approached with a high index of suspicion. It is clear that extensive diagnostic procedures are required to ensure an accurate diagnosis of the disease. Tuberculosis incurs a significant added burden due to the need for isolation of infected patients within the dialysis unit. Treatment of patients with Mycobacterium other than tuberculosis should be addressed individually. (+info)
Oesophageal gastro-intestinal stromal tumour presenting with rupture into pleural cavity.
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Gastro-intestinal stromal tumours are rarely found in the oesophagus and it is uncommon for these tumours to present with rupture. In this paper, we report a case where the tumour ruptured through the distal oesophagus. As a result, the patient underwent surgical tumour dissection. A histopathological examination of the tumour mass confirmed that it was a gastro-intestinal stromal tumour. In this report, we review the diagnosis, pathology, and treatment of a patient presenting with a ruptured oesophageal gastro-intestinal stromal tumour. (+info)
Hepatic hydrothorax occurring rapidly after manual abdominal compression.
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Hepatic hydrothorax is a relatively infrequent but potentially serious complication of liver cirrhosis that often causes respiratory dysfunction. Several hypotheses for the development of hepatic hydrothorax have been suggested to explain a transdiaphragmatic shift of ascitic fluid through small defects between the peritoneal cavity and the pleural space. However, the rapid development of hydrothorax within several hours is seldom encountered. In addition, the causal factors for rapid passage of ascitic fluid into the pleural cavity are unknown. This report describes a patient with liver cirrhosis who suffered rapid development of a hydrothorax after manual compression of the abdomen. (+info)
Emerging paradigms in the management of malignant pleural effusions.
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Video-assisted thoracoscopic removal of foreign bodies from the pleural cavity.
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Video-assisted thoracoscopy is a minimally invasive surgical technique. It is the procedure of choice for the treatment of certain lung and pleural diseases. It has been increasingly used in the acute phase of thoracic trauma. Another indication for its use, which is rarely described in the literature, is for the removal of retained intrathoracic foreign bodies. We report the cases of two hemodynamically stable gunshot victims in whom the bullet was removed from the pleural cavity through video-assisted thoracoscopy, thereby avoiding the need for thoracotomy. (+info)
Human parietal pleura present electrophysiology variations according to location in pleural cavity.
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