1
|
Rossi S, Volpi F, Castellana R, Pancani R, Dente F, Gaeta R, Carrozzi L, Neri E, Romei C. A case report of unusual recurrent bronchopneumonia infections in Mounier-Kuhn syndrome. Radiol Case Rep 2024; 19:2525-2530. [PMID: 38585395 PMCID: PMC10997801 DOI: 10.1016/j.radcr.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Mounier-Kuhn syndrome is a rare airway disease characterized by tracheal and bronchial dilatation, primarily affecting middle-aged men. We present a case of Mounier-Kuhn syndrome in a 40-year-old man with a history of recurrent respiratory infections since adolescence. The diagnostic journey involved a multidisciplinary approach incorporating clinical evaluation, radiological imaging, and bronchoscopy. Computed tomography findings, including maximum intensity projection reconstructions and 3D rendering, facilitated the diagnosis by revealing significant airway dilation and associated abnormalities. Treatment primarily focused on supportive measures, including antibiotic therapy and respiratory physiotherapy. This case underscores the importance of considering Mounier-Kuhn syndrome in patients with recurrent respiratory infections and highlights the role of advanced imaging techniques in diagnosis.
Collapse
Affiliation(s)
- Sara Rossi
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Federica Volpi
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | | | - Roberta Pancani
- Department of Surgery, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Federico Dente
- Department of Surgery, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Roberta Gaeta
- Pneumology Unit, Pisa University Hospital, Pisa, Italy
| | | | - Emanuele Neri
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Chiara Romei
- Department of Diagnostic Imaging, Radiology Unit, Pisa University Hospital, Pisa, Italy
| |
Collapse
|
2
|
Suliman AM, Alamin MA, Hamza MM. Tracheobronchomegaly (Mounier-Kuhn syndrome) and Bronchiectasis as rare manifestations of Homocystinuria. Respir Med Case Rep 2023; 42:101808. [PMID: 36655006 PMCID: PMC9841048 DOI: 10.1016/j.rmcr.2023.101808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Homocystinuria (HCU) is a rare autosomal recessive inherited disorder usually diagnosed in childhood. It is characterized by a deficiency of the enzyme that converts homocysteine to cystathionine. The accumulation of homocysteine leads to abnormalities in the ocular, skeletal, cardiovascular, and central nervous systems. HCU shares several clinical features with Marfan syndrome; however, respiratory system involvement in HCU is uncommon and rarely reported. Bronchiectasis has been previously reported in a few cases of HCU, and it was attributed mainly to fibrillin deficiency. This case describes a young girl diagnosed with classical HCU since childhood who presented with a chronic productive cough and was initially misdiagnosed as bronchial Asthma. However, upon further evaluation, she was eventually diagnosed with tracheobronchomegaly (TBM), or Mounier-Kuhn Syndrome, and bronchiectasis based on the computed tomography (CT) scan of chest findings. To our knowledge, this is the first reported case of TBM and bronchiectasis in HCU. We believe that fibrillin degeneration may be the key to understanding this unusual association in HCU.
Collapse
|
3
|
Xiong J, Zhou Q, Li Y, Sun Y, Zhang Y. Unexpected curious cause of serious air leakage after endotracheal intubation: A case report of tracheobronchomegaly and literature review. Front Surg 2022; 9:961186. [PMID: 36081585 PMCID: PMC9445417 DOI: 10.3389/fsurg.2022.961186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTracheobronchomegaly (TBM) is a rare disease with enlarged trachea and mainstem bronchi, which might not be diagnosed preoperatively because of patient’s nonsymptoms or clinicians’ overlook. These patients would be at fatal risk after general anesthesia endotracheal intubation due to severe peritubal leakage. This case may provide a helpful and informative resource for anesthesiologists and other clinicians, especially those managing patients’ airways.Clinical featureWe presented a patient undergoing elective scoliosis orthopedics who was postoperatively diagnosed with TBM. After general anesthesia endotracheal intubation, difficulty in maintaining ventilation with obvious peri-cuff air leakage made this rare disease to be suspected. The peritubal leakage was resolved by relocating the endotracheal tube to the subglottic area. Fortunately, there were no air leakage and postoperative complications.ConclusionAnesthesiologists should keep the possibility of the unpredicted anatomic abnormal respiratory tract in mind, such as TBM.
Collapse
Affiliation(s)
- Jun Xiong
- Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
- Correspondence: Jun Xiong
| | - Quan Zhou
- Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Yu Li
- Department of Radiology, Jiangsu Province Hospital of Integration of Chinese and Western Medicine, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Yanyan Sun
- Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Yajun Zhang
- Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| |
Collapse
|
4
|
Srivali N, De Giacomi F. Mounier-Kuhn Syndrome: A Rare Cause of Recurrent Chest Infection. Arch Bronconeumol 2021; 57:655. [PMID: 35699051 DOI: 10.1016/j.arbr.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/30/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Narat Srivali
- Division of Pulmonary Medicine (NS), St. Agnes Hospital, Baltimore, MD 21229, USA; Respiratory Unit (FDG), Cremona Hospital, Cremona, Italy.
| | - Federica De Giacomi
- Division of Pulmonary Medicine (NS), St. Agnes Hospital, Baltimore, MD 21229, USA; Respiratory Unit (FDG), Cremona Hospital, Cremona, Italy
| |
Collapse
|
5
|
Satia I, Adatia A, Cusack RP, Greene JM, O'Byrne PM, Killian KJ, Johnston N. Influence of age, sex and respiratory viruses on the rates of emergency department visits and hospitalisations with respiratory tract infections, asthma and COPD. ERJ Open Res 2021; 7:00053-2021. [PMID: 34046485 PMCID: PMC8141702 DOI: 10.1183/23120541.00053-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/18/2021] [Indexed: 01/08/2023] Open
Abstract
Background The importance of age, sex and respiratory virus prevalence in emergency department (ED) visits and hospitalisations for respiratory tract infections (RTIs), asthma and COPD in a whole population over time is not well established. Methods This study retrospectively analysed data for daily ED visits and hospitalisations from 2003 to 2013 in Ontario, Canada and the daily number of virus positive tests. Daily numbers of ED visits and hospitalisations with RTIs, asthma and COPD listed as a primary diagnosis were collected from the Canadian Institute for Health Information. Virus data were obtained from the Respiratory Virus Detection Surveillance System. Multiple linear regression was used to assess the association of individual viruses with the daily rates. Results There were 4 365 578 ED visits and 321 719 (7.4%) admissions for RTIs, 817 141 ED visits and 260 665 (31.9%) admissions for COPD and 649 666 ED visits and 68 626 (10.6%) admissions for asthma. Respiratory syncytial virus and influenza A were associated with male ED visits, whereas human rhinovirus was associated with female ED visits for RTIs in preschool children. 19.2% of males, but only 7.2% of females were admitted. The correlation between the prevalence of each virus and ED visits and hospitalisations for asthma was weak, irrespective of age group and sex. Influenza A was most strongly associated with COPD ED visits and hospitalisations in males and females. Conclusions There are significant age and sex differences in the contribution of respiratory viruses to the number of ED visits and hospitalisations for RTIs, asthma and COPD. There are important age- and sex-related differences in the contribution of respiratory viruses to the number of ED visits and hospitalisations for respiratory tract infections, asthma and COPDhttps://bit.ly/39hrhIW
Collapse
Affiliation(s)
- Imran Satia
- Dept of Medicine, McMaster University, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada.,Division of Infection, Immunity and Respiratory Medicine, and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,These authors contributed equally
| | - Adil Adatia
- Dept of Medicine, McMaster University, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada.,These authors contributed equally
| | - Ruth P Cusack
- Dept of Medicine, McMaster University, Hamilton, Canada
| | | | - Paul M O'Byrne
- Dept of Medicine, McMaster University, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
| | | | - Neil Johnston
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
| |
Collapse
|
6
|
Srivali N, De Giacomi F. Mounier-Kuhn Syndrome: A Rare Cause of Recurrent Chest Infection. Arch Bronconeumol 2021; 57:S0300-2896(21)00026-0. [PMID: 33610401 DOI: 10.1016/j.arbres.2020.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Narat Srivali
- Division of Pulmonary Medicine (NS), St. Agnes Hospital, Baltimore, MD 21229, USA; Respiratory Unit (FDG), Cremona Hospital, Cremona, Italy.
| | - Federica De Giacomi
- Division of Pulmonary Medicine (NS), St. Agnes Hospital, Baltimore, MD 21229, USA; Respiratory Unit (FDG), Cremona Hospital, Cremona, Italy
| |
Collapse
|