Rationale: Due to its nonspecific manifestations, pneumonic-type adenocarcinoma can be easily misdiagnosed as pneumonia, tuberculosis, or other diseases, especially in developing countries where many patients in the early stage refuse invasive examinations. Early recognition of pneumonic-type adenocarcinoma is essential. Patient concerns: We report a case of pneumonia lung adenocarcinoma diagnosed by frozen lung biopsy after death. Diagnoses: A 75-year-old male patient was admitted to the hospital on April 24, complaining of 5 months of recurrent coughing, expectoration, and panting, and his symptoms had been worsening over the past month. Interventions: After obtaining informed consent from the patient's family, transbronchial cryobiopsy was performed at the bedside. Outcomes: After a positive rescue, the patient died. Pathological examination indicated adenocarcinoma. Lessons: At present, surgery is still the first choice for the treatment of pneumonic lung cancer, and early diagnosis can remove the tumor as much as possible. Transbronchial cryobiopsy can be used for the collection of pathological samples, especially for the early diagnosis of pneumonic lung cancer.
Background: According to the data from the joint investigative team of the WHO and China, the fatality rate in Wuhan is 5.8%and 0.7% in the rest of China. Most of the patients who have died have had chronic diseases or advanced age, and patients with critical COVID-19 have the highest death rate. Patients with critical COVID-19 are the main focus of research on treatment. However, there are few reports on critical COVID-19 patients in China and worldwide. It will help other researchers and clinicians around the world for similar cases.Purpose: Coronavirus disease 2019 (COVID-19) is highly infectious and has a high fatality rate.This paper summarizes and analyses the clinical characteristics of patients with critical COVID-19 to improve clinicians' understanding of this disease. Methods: We selected 16 patients with critical COVID-19 who were treated in the ICU of a grade A hospital in Wuhan from February to March 2020. Then, we collected the clinical data and analysed their general conditions, clinical symptoms, blood tests, CT scans and treatments. Results: Patients with critical COVID-19 had comorbidities (87.5%), and the main symptoms were low or moderate fever (75%), cough and expectoration (68.75%), and multiple lesions in both lungs (100%). 2. Patients with critical COVID-19 were divided into the non-surviving and surviving groups, and the interleukin-6 (IL-6) level and CD4/CD8 ratio were significantly different (P<0.05). 3. On chest CT, multiple patchy lesions were observed in both lungs, mainly as patchy infected lesions, partial consolidation, ground-glass opacities, and interstitial changes. 4. There were 10 patients (62.5%) who survived and 6 (37.5%) who died. Conclusion: Critical COVID-19 is mainly characterized by low or moderate fever, cough and sputum and often occurs in people with chronic disease.Chest CT showed multiple patchy ground-glass opacities and consolidation. For critically ill patients, it is important to monitor interleukin-6 (IL-6) and CD4/CD8 ratio. Early treatment involves thymalfasin, immunoglobulin and other immune-enhancing treatments, and a large dose of ulinastatin can reduce plasma levels of inflammatory factors.
Background: For decades, Aeromonas daca has often been mistaken for Aeromonas hydrophila by phenotypic identification systems and shows obvious characteristics of virulence. The clinical data of patients with A. daca reported in China and elsewhere in the past 5 years were retrospectively analyzed to improve clinicians' understanding of the disease. Methods: The diagnosis and treatment of a patient who died of diffuse alveolar hemorrhage caused by A. daca in our hospital were reported. The CNKI, Wanfang and VIP databases were searched with "Aeromonas daca" as the keyword, and the PubMed database was searched with "Aeromonas dhakensis" as the keyword; these searchers covered publications from the last 5 years. The data reported in the literature from China and elsewhere were analyzed retrospectively. Results: The patient, a 26-year-old male with no underlying disease, was admitted to our hospital for 3 days because of cough, expectoration and shortness of breath. According to blood and lavage fluid cultures and next-generation sequencing (NGS), the patient was diagnosed with an A. daca infection. He soon deteriorated to a critical condition complicated with septic shock and died after active rescue treatment. A total of three relatively complete English-language studies were retrieved, yielding data on 3 patients in total. Conclusion: A. daca infection is lethal, and an accurate taxonomy can improve our understanding of the epidemiological distribution and virulence potential of this human pathogen. Third-generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. daca infection, and the best regimen is cefepime or fluoroquinolones.
Background: For decades, Aeromonas daca has often been mistaken for Aeromonas hydrophila by phenotypic identification systems and shows obvious characteristics of virulence. To our knowledge, a total of two English-language studies with relatively complete data were retrieved.Case presentation: The patient, a 26-year-old male with no underlying disease, was admitted to our hospital for 3 days because of cough, expectoration and shortness of breath. According to blood and lavage fluid cultures and next-generation sequencing (NGS), the patient was diagnosed with an A. daca infection. He soon deteriorated to a critical condition complicated with septic shock and died after active rescue treatment. Conclusions: A. daca infection is lethal, and an accurate taxonomy can improve our understanding of the epidemiological distribution and virulence potential of this human pathogen. Third-generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. daca infection, and the best regimen is cefepime or fluoroquinolones.
Background: For decades, Aeromonas daca has often been mistaken for Aeromonas hydrophila by phenotypic identification systems and shows obvious characteristics of virulence. To our knowledge, a total of two English-language studies with relatively complete data were retrieved.Case presentation: The patient, a 26-year-old male with no underlying disease, was admitted to our hospital for 3 days because of cough, expectoration and shortness of breath. According to blood and lavage fluid cultures and next-generation sequencing (NGS), the patient was diagnosed with an A. daca infection. He soon deteriorated to a critical condition complicated with septic shock and died after active rescue treatment. Conclusions: A. daca infection is lethal, and an accurate taxonomy can improve our understanding of the epidemiological distribution and virulence potential of this human pathogen. Third-generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. daca infection, and the best regimen is cefepime or fluoroquinolones.
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