Pulmonary Botryomycosis in a Patient with Down Syndrome

Pulmonary botryomycosis is a rare chronic, pyogranulomatous infection affecting the lung parenchyma. We describe here the clinical and histopathological findings of pulmonary botryomycosis reported for the first time in a Down syndrome female who required prolonged intensive care. This case has other different unique aspects. It is the first case to present with empyema, the second case involving the right lower lobe and the first case managed by decortication

Case Report Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube

Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement