The Middle Lobe Syndrome: A Clinical Study

Albo, Robert J.; Grimes, Orville F.

doi:10.1378/chest.50.5.509

Cited by 22 publications

(12 citation statements)

References 2 publications

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“…Prompt diagnosis, administration of antibiotics and the avoidance of irritating agents, such as smoke, may be effective. However, abnormal shadows on chest radiography persist even when symptoms have disappeared [4, 5]. We did not notice any antibiotic and/or anti-inflammatory interactions between roxithromycin and the drugs administered to patient 1.…”

Section: Discussionmentioning

confidence: 93%

Improvement in Right Lung Atelectasis (Middle Lobe Syndrome) following Administration of Low-Dose Roxithromycin

Kawamura

Arai²,

Tani³

2001

Respiration

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Middle lobe syndrome is a distinct clinical entity characterized by right middle lobe atelectasis. Prompt diagnosis and initiation of medical therapy including the administration of antibiotics and the avoidance of irritating agents may be effective. However, abnormal shadows on chest radiography remain unchanged even when acute symptoms have disappeared, suggesting latent lesional inflammation or recurrence. We describe 2 cases of atelectasis in the middle lobe of the right lung which resolved completely after administration of low-dose roxithromycin. Thus, low-dose therapy with a macrolide could be of interest or some value in these cases, but it is too early to draw a definite conclusion.

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Section: Discussionmentioning

confidence: 93%

Improvement in Right Lung Atelectasis (Middle Lobe Syndrome) following Administration of Low-Dose Roxithromycin

Kawamura

Arai²,

Tani³

2001

Respiration

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“…in Japan. Although a surgical excision was effective on canine cases [7,14] and two human cases [45,46], the procedure was not suitable for case 2 and simultaneously produced a severe aggravation of both carcinoma and histoplasmosis. A background of immunosupression was suspected in case 2.…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology of canine histoplasmosis in Japan

Murata¹,

Sano²,

Ueda³

et al. 2007

Med Mycol

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A recent case of canine histoplasmosis, the first confirmed case of disseminated infection accompanied by carcinoma in Japan, was diagnosed by clinical characteristics, histopathological examination, chest radiographs, ocular fundoscopy and molecular biological data. The clinical manifestations were not limited to cutaneous symptoms but were referable to disseminated infection, similar to human autochthonous cases. The partial sequences of the internal transcribed spacer (ITS1/2) regions of the ribosomal DNA genes of this and other Japanese canine histoplasmosis strains were 99-100% identical to the sequence AB211551 derived from a human isolate in Thailand, and showed a close relationship to the sequences derived from Japanese autochthonous systemic and cutaneous human cases. The phylogenetic analysis of 97 sequences of the ITS1/2 region disclosed six genotypes. The genotypes derived from Japanese autochthonous human and dog cases belonged to the cluster consisting of Histoplasma capsulatum var. capsulatum and H. capsulatum var. farciminosum sequences, indicating that these varieties might cause not only cutaneous but also systemic histoplasmosis, regardless of their host species. The current status of the 3 varieties of Histoplasma capsulatum according to the host species remains a subject of further investigation.

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“…2) when performing particle simulations using the compound data of Tarsin et al 5 and Stein et al 6 The poor drug deposition results obtained by FRI explain why a combination of several inhaled compounds was needed to treat the asthma, as these zones were probably pharmacologically undertreated. Furthermore, a long-term non-ventilatory status of the right middle lobe could set 7 In a recent review, Groth and Andrade 8 concluded that diaphragmatic plication seems to be a promising surgical technique to improve ventilation in patients with diaphragmatic paralysis. Therefore, diaphragmatic plication was performed to place the paralyzed diaphragm in a position of maximal inspiration to relieve compression on the lung parenchyma and to allow its re-expansion.…”

Section: Patientmentioning

confidence: 99%

Functional Respiratory Imaging as a Tool to Personalize Respiratory Treatment in Patients With Unilateral Diaphragmatic Paralysis

Holsbeke

Leemans²,

Vos

et al. 2013

Respir Care

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A completely different treatment approach was chosen for 2 patients with unilateral diaphragmatic paralysis and complaints of dyspnea despite similar anatomic and physiologic abnormalities. These decisions were supported by results obtained by functional respiratory imaging (FRI). FRI generated functional information on lobar ventilation and local drug deposition. In the first patient, some lobes were poorly ventilated, and drug deposition simulation showed that some regions were undertreated. This patient underwent diaphragmatic plication to restore ventilation. In the second patient, all lobes were still ventilated. A conservative approach with regular follow-ups was chosen to wait for spontaneous recovery of the diaphragmatic function. Both patients improved subjectively and objectively. These cases demonstrate how novel medical imaging techniques such as FRI can be used to personalize respiratory treatment in patients with unilateral diaphragmatic paralysis.

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The Middle Lobe Syndrome: A Clinical Study

Cited by 22 publications

References 2 publications

Improvement in Right Lung Atelectasis (Middle Lobe Syndrome) following Administration of Low-Dose Roxithromycin

Improvement in Right Lung Atelectasis (Middle Lobe Syndrome) following Administration of Low-Dose Roxithromycin

Molecular epidemiology of canine histoplasmosis in Japan

Functional Respiratory Imaging as a Tool to Personalize Respiratory Treatment in Patients With Unilateral Diaphragmatic Paralysis

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