TB or not TB?
27 y/o Egyptian Male presents with cc of progressive hemoptysis and weight loss while on treatment for TB. Imaging reveals a large LLL cavitary lesion with multiple heterogeneous peripheral cystic/cavitary lesions. What’s going on? Key topics covered: 1)Differential for hemoptysis; 2) treatment regimen in TB, MDR-TB & XDR-TB; 3) cystic versus cavitary lesions Current Concepts […]
Bronchiectasis
64 y.o. M with medical history significant for pulmonary T.B. (treated in the 1980s) presenting with hemoptysis, but without other symptoms consistent with reactivation T.B. Discussed other causes of hemoptysis, particularly bronchiectasis, which was prominent in the patient’s imaging. See the links below: Bronchiectasis Powerpoint from today Bronchiectasis Review – Chest. 2008 Oct;134(4):815-23. Asbestosis Review […]
Eosinophilia
Today’s resident report focused on the workup of peripheral eosinophilia and pulmonary infiltrates. The patient is a 41 yo F from Haiti presenting with repeated asthma exacerbations and 38% Eos on differential. Broad categories for the differential diagnosis are: Infectious (parasitic, fungal) Hematologic (hyper-eosinophil syndrome) Autoimmune (Churg-Strauss syndrome, eosinophilic pneumonia) Allergic Reaction/Hypersensitivity Reaction Here are […]
BiPap in COPD Exacerbations
Today’s morning report was about the use of BiPap in COP exacerbations. Here is a seminal paper from the NEJM re: BiPap use in COPD exacerbations. This was the first paper to show that non-invasive positive pressure ventilation had a morbidity and mortality benefit in patients with severe COPD exacerbations. And here is a link […]