Acute hypoxemia due to lung collapse in COVID-19: the role of therapeutic bronchoscopy

Bronchoscopy is an aerosol-generating procedure and involves a high risk of transmission of SARS-CoV-2 to health care workers. There are very few indications for performing bronchoscopy in a patient with confirmed COVID-19. These include atelectasis, foreign body aspiration, and suspected superinfection in immunocompromised patients. Proper use of standard personal protective equipment is mandatory to reduce the risk of transmission to health care workers. In this article, we describe a case of acute lung collapse in a 16-year-old boy with cerebral palsy who was infected with COVID-19. This patient responded to therapeutic bronchoscopy and had complete resolution of lung collapse within 24 hours of the procedure

Candidate immunomodulators for COVID-19: Heat-killed Mycobacterium w and BCG vaccine

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Neck massage induced dural sinus thrombosis

Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage

Aortic atresia with normal sized left ventricle

Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date

Nasal route for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): An alternative modality in difficult oral bronchoscope insertion

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under moderate sedation through the oral approach. Oral insertion is performed owing to the larger size of the EBUS bronchoscope as well as the delicate and rigid distal end with an integrated ultrasound transducer assembly. Nasal route for EBUS scope insertion has been described as a feasible alternative. We herein report a patient wherein inability to introduce the EBUS bronchoscope through the mouth necessitated nasal insertion of the bronchoscope to successfully perform EBUS-TBNA. We discuss the relevant issues comparing the nasal and oral introduction of the EBUS bronchoscope

Intracranial blastomycosis mimicking high-grade neoplasm on magnetic resonance imaging and spectroscopy

We describe a case of posterior fossa blastomycosis in an immunocompetent patient that mimicked high-grade neoplasm on neuroimaging. Histological analysis confirmed blastomycosis. Because the neuroimaging characteristics of intracerebral blastomycosis can be confused for neoplasm, these lesions must be confirmed histologically before initiating aggressive treatment for presumptive high-grade neoplasm. To our knowledge, it is the first description of a neoplasm mimic on MRS in the setting of intracranial blastomycosis

Cryoprobe transbronchial lung biopsy: How we do it?

Transbronchial lung biopsy (TBLB) is commonly utilized for diagnosis of diffuse parenchymal lung diseases. TBLB has a high yield in granulomatous interstitial lung diseases like sarcoidosis, but small size of biopsies limits its utility in idiopathic interstitial pneumonia. Surgical lung biopsy provides large size tissue, but there is associated morbidity, longer hospital stay, the risk of air leak, and mortality. Cryoprobe-TBLB, a relatively newer diagnostic procedure, provides larger biopsies than TBLB that are usually crush artifact free and enable the pathologist to provide diagnosis with greater confidence. We describe our technique of performing cryoprobe-TBLB