Vancomycın resıstant enterococcus bacteremıa ın a patıent wıth Pneumocystis jiroveci pneumonıa, granulocystıc sarcoma and acute respıratory dıstress syndrome

In this case report we aimed to present a patient with granulocytic sarcomaa, neutropenic fever, ARDS and Pneumocystis jirovecii pneumoniae that was hospitalized in our intensive care unit. The patient recovered and  then developed vancomycin resistant enterococci (VRE) bacteremia due to port catheter during follow up. The patient had risk factors for VRE bacteremia and he was administered linezolide without removing the catheter. He was discharged with recovery.Key words: Granulocystic sarcoma, Pneumocystis jiroveci pneumoniae, vancomycin resistant enterococci, (VRE

Diagnostic Yield of Bronchoscopy with C-Arm Scopy in Cases without Endobronchial Lesion

WOS: 000376567100007Aim: Fiberoptic bronchoscopy (FOB) is widely used in the diagnosis and treatment of pulmonary diseases. FOB sensitivity is generally low in tumors localized in the outer third of the lung. Diagnosis of peripheral pulmonary lesions can be difficult; however, the use of computed tomography (CT)-, fluoroscopy- or ultrasonography (USG)-guided surgery increases the diagnostic rates. In this study we aimed to compare the diagnostic values of C-arm fluoroscopy-guided bronchoscopic lavage, brushing, and biopsy samples obtained in cases where radiological masses or parenchymal lesions were detected, but endobronchial pathology was not found. Material and Method: In this prospective observational study, bronchoscopy was performed to the patients who had a mass lesion or parenchymal infiltration on chest radiogram and who had no endobronchial lesion, the diagnostic results of the bronchoscopic lavage, brush and biopsy specimens have been compared where C-arm scopy guided the procedures. Results: 60 patients (45 male) with a mean age 61.5 +/- 9.6 were enrolled into the study. The lesions were mostly located in the right upper lobe. 45 patients had peripheral mass lesion, 17 patients had noduler lesion where consolidation or infiltration were present in 18 patients. The diagnostic yield of the bronchoscopic biopsy was 36%, brushing 20% and 21% for the bronchoscopic lavage. Overall diagnostic yield with all bronchoscopic methods was 45%. In lesions with a diameter of <3 cm, bronchoscopic brushing was significantly ineffective. There was not any severe complication due to these procedures. Discussion: The C-arm scopy guided bronchoscopic biopsy was much more valuable in the diagnosis of peripheral lesions

A rare tumor of the lung: Pulmonary sclerosing hemangioma (pneumocytoma)

WOS: 000316163200016PubMed ID: 23290153A 67-year-old woman was referred to our department for further evaluation of her abnormal, chest radiogram. Thorax computed tomography revealed a well-circumscribed, round mass in the middle lobe of the right lung. A thoracotomy was performed and pulmonary sclerosing hemangioma was diagnosed. We herein present a rare tumor of the lung. (C) 2012 Elsevier Ltd. All rights reserved

The factors affecting noninvasive mechanical ventilation failure in COPD exacerbations

WOS: 000300203500014Aim: To evaluate causes of noninvasive mechanical ventilation (NIMV) failure. The rate of NIMV failure in respiratory failure due to chronic obstructive pulmonary disease (COPD) exacerbations was reported as 5%-40%. Materials and methods: The necessity of endotracheal intubation was accepted as NIMV failure. The causes of NIMV failure were assessed in 54 patients (45 males; mean age: 67.7 +/- 11.0 years) treated with NIMV because of COPD exacerbations and respiratory failure in an intensive care unit (ICU). Results: There was NIMV failure in 20 patients (37.0%). The rates of hospital-acquired pneumonia and in-hospital mortality were higher (P = 0.003 and P = 0.002, respectively) and the duration of ICU stay was longer (P < 0.0001) in patients with NIMV failure. On admission, arterial pH, serum albumin, and Glasgow Coma Scale levels were lower (P = 0.032, P = 0.024, and P = 0.013, respectively) in the NIMV failure group. Arterial pH was lower (P = 0.039) and respiratory rate was higher (P = 0.010) after 1 h, and the PaO2/FiO2 rate was lower (P = 0.017) and respiratory and heart rates were higher (P = 0.002 and P = 0.020, respectively) after 3 h in the NIMV failure group. Conclusion: The present data strongly suggest that baseline and follow-up clinical and arterial blood gas evaluations can give important clues about NIMV failure in COPD exacerbations