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A 73-year-old woman was hospitalized for the treatment of anaplastic large-cell lymphoma. She complained of itchiness with a rash on her trunk and was diagnosed with chickenpox. Although she had no respiratory symptoms, chest high-resolution computed tomography (HRCT) performed on the same day showed multiple nodules with surrounding ground-glass attenuation (GGA) and consolidation (Picture). Bronchoscopy was performed to diagnose the lung involvement. The histopathological features of the specimens obtained via a transbronchial lung biopsy were nonspecific. An examination of the bronchoalveolar lavage (BAL) fluid demonstrated a total cell count of 229/μL, with the differential count showing 52% lymphocytes, 2% neutrophils, 1% eosinophils and 45% alveolar macrophages, while the ratio of CD4/8 was 1.75. Varicella-zoster viral DNA was detected in the BAL fluid (90×10 6 copy/mL), although no findings caused by other lung diseases were found. Therefore, the patient was diagnosed with primary varicella pneumonia.

Purpose] The aim of this study was to elucidate the usefulness of the 30-second chair stand test (CS-30) for evaluating the exercise capacity of patients with mild to moderate interstitial pneumonia (IP). [Subjects and Method] Nineteen consecutive patients who performed the 6-minute walk test (6MWT) and the CS-30 as evaluations in clinical practice were enrolled. The results of the 6MWT and CS-30 were compared.[Results] The number of chair stands significantly correlated with the 6-minute walk distance. It also showed significant correlations with the maximum heart rate, maximum respiratory rate, and maximum modified Borg dyspnea score, and these items' values were significantly lower in the CS-30. A significant correlation with minimum SpO2 was also found, and the decrease in SpO2 was significantly smaller in the CS-30. [Conclusion] The results suggest that CS-30 correlates well with 6MWT and can be performed with lower risk of desaturation in patients with mild to moderate IP. Key words: interstitial pneumonia (IP), 6-minute walk test (6MWT), 30-second chair stand test

Objective Predictors of the need to initiate noninvasive ventilation (NIV) in stable COPD outpatients with acute exacerbation of chronic obstructive pulmonary disease (COPD-AE) are insufficiently defined. The objective of this study was to investigate predictors of the need to initiate NIV in stable COPD-AE outpatients. Methods A total of 140 consecutive stable COPD outpatients who were hospitalized for COPD-AE for the first time were retrospectively examined. Demographic and clinical parameters measured in the stable state were evaluated, including data for arterial blood gases, the pulmonary function, body mass index and dyspnea scores. Results Of the 140 patients included, NIV was used in 32 (23%) patients. In a univariate Cox proportional hazards analysis, the baseline partial pressure of arterial carbon dioxide (PaCO2) (hazard ratio (HR), 1.14 per mmHg; 95% confidence interval (CI), 1.08-1.21) and forced expiratory volume in one second (FEV1)% predicted (HR, 1.03 per %; 95% CI, 1.01-1.05) were identified to be significant predictors. A multivariate logistic regression analysis showed only the PaCO2 (HR, 1.18 per mmHg; 95% CI, 1.12-1.26) to be a significant predictor. Conclusion Our results suggest that the PaCO2 measured in the stable state is an independent significant predictor of the need to initiate NIV in COPD-AE patients who are hospitalized for the first time.

statement has shown that patients with pulmonary Mycobacterium avium complex (MAC) disease who complete 10-12 months of negative cultures on therapy but then have either single or multiple positive MAC cultures are more likely to have reinfection with a new MAC strain.Case presentation: A 63-year-old woman was diagnosed with pulmonary disease caused by clarithromycin (CAM)-susceptible MAC. Before initiating chemotherapy using a four-drug regimen containing CAM, an investigation of the patient's residential bathroom was conducted and one of the M. avium isolates recovered from the bathtub inlet was found to be genetically identical to sputum-derived isolates by variable number tandem repeats analysis using M. avium tandem repeat loci (MATR-VNTR). A second investigation of the bathroom during chemotherapy showed no M. avium isolates, and five consecutive sputum cultures were negative for 12 months until chemotherapy was discontinued. A recurrence occurred 3 months after the end of chemotherapy (at age 65 years). A third investigation of the bathroom was performed and MATR-VNTR analysis revealed that the VNTR profile of the M. avium isolates recovered from the sputum at recurrence was identical to that of the isolates recovered from the sputum at initial diagnosis and the bathroom at the first investigation. Conclusion:The recurrence occurred due to endogenous reactivation of the initial M. avium isolate despite drug treatment for 12 months after sputum culture conversion. Further genetic analyses of MAC isolates recovered from patients and environments should be encouraged.