European Journal of Clinical and Experimental Medicine T.22, z. 3 (2024)

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https://repozytorium.ur.edu.pl/handle/item/10842

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Benign endotracheal tumor (hamartoma) mimicking bronchial asthma
(Publishing Office of the University of Rzeszow, 2024-09) Kaziród, Tomasz; Tokarski, Sławomir; Kaznowska, Ewa; Rzeszutko-Grabowska, Magdalena
Introduction and aim. The most common benign tumor of the lung is hamartoma. In many cases, it is a spherical tumor, located peripherally, often without clinical symptoms. Predominantly it is found accidentally during radiological examination. In some cases the tumor reaches a significant size in the lung parenchyma or in the lumen of the bronchi or trachea. Then, symptoms such as cough, dyspnea, wheezing, less commonly hemoptysis, and chest pain may occur. In addition, tumors located endobronchial or endotracheal may cause recurrent pneumonia or mimic obstructive diseases of the lower respiratory tract such as chronic obstructive pulmonary disease, or bronchial asthma. We present the case of a patient with an endotracheal tumor mimicking bronchial asthma. Description of the case. A 53-year-old male was taking bronchodilators and inhaled steroids for several months. The baseline chest radiograph showed no abnormalities. Spirometry suggested an obstruction of respiratory flow in the central or upper airways. The lack of improvement after asthma treatment required an extension of the diagnosis. Computed tomography allowed accurate visualization of the tumor lesion of the trachea, which was significantly obstructing its lumen, and resection was carried out. Conclusion. Our case demonstrates that tracheal tumors can present symptoms similar to respiratory tract diseases. In unresolved cases, spirometry and computed tomography are helpful in proper diagnosis.
ST-segment elevation in anterior leads secondary to electric shock – a diagnostic dilemma
(Publishing Office of the University of Rzeszow, 2024-09) Muniraju, Anil Kumar; Rohila, Amit Kumar; Sharma, Ankur; Shekar, Rakesh Guna; Rodha, Mahaveer Singh
Introduction and aim. Electrical injuries can be life-threatening and prompt interventions can save lives. Cardiac complications like arrhythmias and sudden cardiac death are common after electric shock. Certain ECG abnormalities can persist after successfully reviving the patient which can mimic ST-Elevation occlusive myocardial infarction. This case report aims to inform the treating emergency physicians about this rare association of ST-Elevation in anterior leads after electric shock. Description of the case. After obtaining proper consent from the patient, we describe here an interesting case of a 19-year-old boy who was presented to the emergency room with cardiac arrest after sustaining electrical injury. The patient was revived after cardiopulmonary resuscitation; ECG, as well as echocardiographic findings, were consistent with ST-elevation myocardial infarction of the anterior wall. A diagnostic dilemma was there between occlusive and non-occlusive causes of this condition. A coronary angiogram and conservative management of the patient helped in decision making and he was discharged with a Glasgow coma scale of 15/15 after recovery. Conclusion. ST-Elevations in ECG can occur after electric shock injury and their cause is rarely due to occlusion of the coronaries. Hence thrombolysis in such cases is rarely needed and supportive management is required.
Acute myocarditis mimicking ST – elevation myocardial infarction in a young adult with pharyngitis – a case report
(Publishing Office of the University of Rzeszow, 2024-09) Christou, Andreas; Kaperonis, Alexandros; Veskoukis, Nikolaos
Introduction and aim. Acute myocarditis (AM) is a life-threatening inflammatory disease that manifests with a highly variable range of clinical symptoms, sometimes mimicking those of myocardial infarction. The aim of this report was to describe the diagnostic challenges of AM. Description of the case. A 22-years old male previously diagnosed with pharyngitis arrived in the emergency room (ER) with retrosternal chest pain. The electrocardiogram (ECG) showed ST elevation in inferior and posterior leads and reciprocal changes with ST depression in anterolateral leads. Laboratory tests revealed elevated cardiac enzymes and bedside echocardiogram (ECHO) revealed hypokinesis of the inferior wall. Initial diagnosis of ST elevation myocardial infarction (STEMI) was made. Coronary angiogram showed normal epicardial coronary arteries and cardiac magnetic resonance imaging (CMRI) revealed subepicardial late gadolinium enhancement (LGE). Conclusion. This case was proven challenging due to the unusual ECG and ECHO findings, mimicking inferoposterior STEMI. The need for available angiography and CMRI was mandatory for the final diagnosis of AM.
Lung abscess with pneumonia after SARS-CoV-2 infection – a case report
(Publishing Office of the University of Rzeszow, 2024-09) Borys, Renata; Szeliga, Ewa; Wojtuń, Kazimierz; Kużdżał, Adrian; Sawka, Karolina
Introduction and aim. Some patients after the SARS-CoV-2 infection may be at higher risk of consequent bacterial or fungal infections even if they have no risk factors (advanced age, obesity, metabolic diseases). A possible complication of SARS-CoV-2 infection is lung abscess with pneumonia what requires further examination and specialized treatment as well as the pulmonary rehabilitation. Description of the case. This report presents all stages of the diagnosis and treatment of lung abscess with pneumonia of male patient, aged 42 years in course of COVID-19. The article emphasizes the role of pulmonary rehabilitation in decreasing the number of postoperative pulmonary complications. Presented case report includes a description of a rehabilitation program conducted during the patient’s hospitalization. Conclusion. Lung abscess is a serious disease with an often unpredictable course, complications and an uncertain prognosis. However, most patients can be treated conservatively, and the priority in treatment is antibiotic therapy and physiotherapy treatments.
Wunderlich syndrome – report of a rare case with comments on clinical implications
(Publishing Office of the University of Rzeszow, 2024-09) Krowiak, Karolina; Krowiak, Anita; Rajda, Sebastian; Palak, Artur; Balawender, Krzysztof
Introduction and aim. Spontaneous renal hemorrhage, known as Wunderlich syndrome, is a rare clinical condition that occurs without any history of trauma. The most common causes of this syndrome are both benign and malignant renal tumors. The treatment strategy is determined based on the patient’s hemodynamic stability. Description of the case. We report a case where a patient was admitted to the emergency department experiencing persistent pain in the right flank for three days. A diagnosis of spontaneous renal hemorrhage, secondary to an angiomyolipoma, was established through CT imaging. In this case study, we detail the diagnostic process and management of a patient who, due to the absence of hemodynamic instability, did not require surgical intervention. Instead, the patient was monitored and managed with conservative treatment. Conclusion. This case highlights the importance of prompt diagnosis, implementation of appropriate treatment, and the relevance of active follow-up in hemodynamically stable patients receiving conservative treatment.

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