Biomedical subjects
Publications and source records attributed to W Rodriguez-Cintron.
A chronically immunosuppressed patient receiving oral steroid therapy had a cavitary lesion; both Histoplasma capsulatum and Cryptococcus neoformans were found in samples of respiratory secretions. C neoformans was also found in specimens taken from skin lesions and blood. This is the first reported instance of synchronous infection by these two fungi.
We report the second case of a right-to-left interatrial shunt due to a carcinoid tumor, which was successfully corrected by surgery. The patient had closure of a patent foramen ovale and tricuspid valve replacement. One and a half years after surgery, the patient had no symptoms related to heart disease.
Pulmonary complications of alpha 1-antitrypsin deficiency are most commonly manifested by panlobular emphysema. This report describes histologically proven bronchiectasis in a 21 year old man with massive haemoptysis and homozygous deficiency of alpha 1-antitrypsin. Neither panlobular emphysema nor cirrhosis of the liver were present. Bronchiectasis must be considered part of the spectrum of the pulmonary pathology that may be encountered in individuals with alpha 1-antitrypsin deficiency.
Coccidiomycosis is rarely associated with a pulmonary mycetoma. We report a patient with progressive cavitary coccidiomycosis, whose initial radiographic and clinical appearance simulated a mycetoma. Examination of the surgically resected lung showed necrotizing Coccidioides immitis granulomas with spherules and arthroconidialike structures, but no evidence of a mycetoma. We propose the term pulmonary coccidioidal pseudomycetoma as the best descriptor for this patient's clinical, radiographic, pathologic, and microbiologic presentation.