1
|
Jarrah A, Sweidan HB, Alratroot A, Esber Z. Rapidly progressive empyema in the setting of vaping in an otherwise healthy patient. BMJ Case Rep 2023; 16:e255876. [PMID: 38129087 DOI: 10.1136/bcr-2023-255876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Vaping is defined as inhaling and exhaling vapour that is a product of heating a liquid or wax-like material. Electronic cigarettes (e-cigarettes) have become a popular method of smoking in the last decade and are advertised as an alternative to conventional smoking. Since the increase in e-cigarette use, various lung injury patterns have started to appear among users. Recent studies have shown an increased susceptibility to respiratory tract infections among e-cigarette/vaping product users. We present a case of pneumonia caused by Pseudomonas fluorescens complicated by rapidly developing empyema in an otherwise healthy patient.
Collapse
Affiliation(s)
- Abdullah Jarrah
- Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
- Internal Medicine, DMC Sinai-Grace Hospital, Detroit, Michigan, USA
| | - Hisham Botrus Sweidan
- Internal Medicine, DMC Sinai-Grace Hospital, Detroit, Michigan, USA
- Internal Medicine, DMC Sinai-Grace Hospital, Farmington, Michigan, USA
| | - Ahmad Alratroot
- Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Zahia Esber
- Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| |
Collapse
|
2
|
Abstract
The coronavirus disease 19 (COVID-19) is a highly transmittable viral infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 utilizes metallocarboxyl peptidase angiotensin receptor (ACE) 2 to gain entry into human cells. Activation of several proteases facilitates the interaction of viral spike proteins (S1) and ACE2 receptor. This leads to cleavage of host ACE2 receptors. ACE2 activity counterbalances the angiotensin II effect, its loss may lead to elevated angiotensin II levels with modulation of platelet function, size and activity. COVID-19 disease encompasses a spectrum of systemic involvement far beyond respiratory failure alone. Several features of this disease, including the etiology of acute kidney injury (AKI) and the hypercoagulable state, remain poorly understood. Here, we show that there is a high incidence of AKI (81%) in the critically ill adults with COVID-19 in the setting of elevated D-dimer, elevated ferritin, C reactive protein (CRP) and lactate dehydrogenase (LDH) levels. Strikingly, there were unique features of platelets in these patients, including larger, more granular platelets and a higher mean platelet volume (MPV). There was a significant correlation between measured D-dimer levels and MVP; but a negative correlation between MPV and glomerular filtration rates (GFR) in critically ill cohort. Our data suggest that activated platelets may play a role in renal failure and possibly hypercoagulability status in COVID19 patients.
Collapse
Affiliation(s)
- Muhanad Taha
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA
| | - Dahlia Sano
- Department of Internal Medicine, Division Hematology and Oncology; Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA
| | - Samer Hanoudi
- Department of Computer Science, Wayne State University , Detroit, MI, USA
| | - Zahia Esber
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA
| | - Morvarid Elahi
- Department of Pathology, Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA
| | - Ali Gabali
- Division of Infectious Diseases, Wayne State University , Detroit, MI, USA
| | - Teena Chopra
- Division of Infectious Diseases, Wayne State University , Detroit, MI, USA
| | - Sorin Draghici
- Department of Computer Science, Wayne State University , Detroit, MI, USA
| | - Lobelia Samavati
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine , Detroit, MI, USA
| |
Collapse
|
3
|
Ammar A, Esber Z, Bali SD, Waggoner G, Khan R. Sarcoidosis-Like Granulomatous Lymphadenopathy Mistaken for Neoplastic Disease on Positron Emission Tomography. J Investig Med High Impact Case Rep 2019; 7:2324709619892724. [PMID: 31808363 PMCID: PMC6900677 DOI: 10.1177/2324709619892724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This is a rare case of sarcoidosis-like granulomatous lymphadenopathy that was
initially mistaken for a neoplastic process due to the degree of hypermetabolic
changes observed on positron emission tomography (PET) scan. Sarcoid-like
granulomatous pulmonary disease is a disorder that has been described in WTC
(World Trade Center) Rescue Workers, and also known as post 9/11 sarcoidosis. We
present an interesting case of a man who presented with several months of
progressive dyspnea and was later discovered to have significant bilateral hilar
adenopathy, which was PET avid. Even more interesting, this patient’s symptoms
completely resolved without the use of systemic steroids or immune suppressants.
This is a condition that requires awareness in order to avoid repeating
unnecessary tests of performing interventions on a benign condition that may
resolve on its own.
Collapse
|
4
|
Esber Z, Esquinas AM, Soubani AO. Weaning outcome of solid cancer patients requiring mechanical ventilation in the ICU: Other factors to explore. J Formos Med Assoc 2019; 118:1676-1677. [PMID: 31474512 DOI: 10.1016/j.jfma.2019.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Zahia Esber
- División of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
| | | | - Ayman O Soubani
- División of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
5
|
Esber Z, Schwarze E, Critchfield J, Soubani AO. Serial transarterial embolization for the management of unresectable malignant pulmonary hemangiopericytoma: A case report and review of the literature. Respir Med Case Rep 2019; 28:100920. [PMID: 31453082 PMCID: PMC6704372 DOI: 10.1016/j.rmcr.2019.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/26/2022] Open
Abstract
Hemangiopericytomas (HPC) are perivascular neoplasms that are rarely encountered as primary lung malignancy. Surgical resection remains the mainstay therapy of HPC. A 37-year old African American female initially presented with fatigue, chest pain and palpitations. Chest radiography showed a well-circumscribed large heterogeneous vascular mass of the right hemithorax. She underwent a CT-guided biopsy of the thoracic mass and was diagnosed with low-grade pulmonary hemangiopericytoma. High tumor vascularity burden and liver metastases precluded her from being a surgical candidate. Three years ago, she referred to our facility seeking further management. She did not tolerate systemic chemotherapy. Alternatively, she had been successfully managed with serial transarterial embolization and oral angiogenesis inhibitor to date. This therapeutic approach can be further explored for long term control of unresectable pulmonary HPC.
Collapse
Affiliation(s)
- Zahia Esber
- Wayne State University School of Medicine, Division of Pulmonary and Critical Care Medicine, USA
| | | | - Jeffery Critchfield
- Wayne State University, School of Medicine/Karmanos Cancer Center, Department of Interventional Radiology, USA
| | - Ayman O Soubani
- Wayne State University, School of Medicine Division of Pulmonary and Critical Care Medicine, USA
| |
Collapse
|
6
|
Albaddawi E, Esber Z, Wright J, Khan A. High Use Rate of Chest Imaging in Hospitalized Patients and Its Dramatic Increase With Length of Stay. Chest 2017. [DOI: 10.1016/j.chest.2017.08.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Esber Z, Barbour S, Stansberry J. Pulmonary Kaposi Sarcoma: A Cryptic Angiosarcomatous Malignancy With Fatal Outcome. Chest 2017. [DOI: 10.1016/j.chest.2017.08.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
8
|
Esber Z, Bengtson H, Jones T, Weatherly M, Vollenweider M, Khan R, Rohde K. A Novel Rapid Diagnostic Tool for Detection and Differentiation of Nontuberculous Mycobacteria (NTM). Chest 2017. [DOI: 10.1016/j.chest.2017.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
9
|
Esber Z, Jacobson S, Turner RB, Bowman MC. Comparison of Treatment Outcomes between Minocycline, Trimethoprim-Sulfamethoxazole (TMP/SMX) and Fluoroquinolone (FQ) Monotherapy for Stenotrophomonas maltophilia Infections. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|