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Journal Of Respiratory Diseases

Journal Of Respiratory Diseases

Actinomyces odontolyticus is
a rare cause of pleuropericardial
infection, with only 1 case
identified in the literature. In
that instance, the infection
was believed to be secondary
to gastric surgery. We present a
patient with pericarditis and
pericardial tamponade caused
by
A odontolyticus. The infection
occurred after an ultrasound-
guided subcarinal
bronchoscopic needle biopsy
performed for a suspicious mediastinal
mass found on a CT
scan of the chest. We describe
the case presentation, the microbiology
and treatment of A
odontolyticus infection, and
the classic features of pericarditis
and cardiac tamponade.

ABSTRACT: Patients with obstructive sleep apnea (OSA) are at increased
risk for motor vehicle crashes as a result of excessive
sleepiness. However, a number of factors complicate risk assessment.
For example, self-reported sleepiness and the severity
of OSA do not appear to be good predictors of accident risk.
Many persons with OSA do not accurately perceive their level
of drowsiness-self-reported sleepiness does not correlate well
with objective measures, such as results of the Multiple Sleep
Latency Test. Moreover, it is not clear whether objective tests
can reliably predict accident risk in the real world, as opposed
to during simulated driving. The indications for-and benefits
of-restricting driving in patients with OSA have not been established.
However, there is good evidence that the use of continuous
positive airway pressure significantly reduces the risk
of crashes in these patients. (J Respir Dis. 2008;29(12):459-464)

•Coccidioides species, the cause of coccidioidomycosis, are endemic to the desert soils of the southwestern United States as well as northern Mexico and limited areas of Central and South America. The organisms can become airborne with disruption of the soil, either through natural causes or activities of humans or animals. Nearly all Coccidioides infections are acquired through the inhalation of airborne arthroconidia (spores).

ABSTRACT: Flexible bronchoscopy was clinically introduced by
Shigeto Ikeda in 1968 and is now used widely for diagnostic
and therapeutic interventions. A combination of advancing
technology and ingenuity has fostered the development of an
expanded array of devices and applications. The newer video
bronchoscopes offer higher-resolution images than fiberoptic
bronchoscopes. The advantages of fiberoptic technology are
lower cost and greater technical ease of adapting to smallerdiameter
bronchoscopes. Hybrid bronchoscopes have an imaging
lens and fiberoptic bundles that transmit the viewing
image to a charge couple device (CCD) chip in the body of the
operator end of the bronchoscope. The digital image is transmitted
from the CCD chip to the external processor for viewing
on a monitor, for digital storage, or for printing. (J Respir Dis.
2008;29(11):423-428)

Endobronchial primary synovial
sarcoma is an extremely
rare pulmonary tumor. We report
the case of a 58-yearold
man who presented with
a right-sided endobronchial
mass, which was diagnosed as
primary synovial sarcoma on
the basis of histological appearance
and immunohistochemical
staining. To the best
of our knowledge, this is only
the third case report of endobronchial
primary synovial
sarcoma.

ABSTRACT: Pulmonary arterial hypertension (PAH) is an increasingly
recognized cause of dyspnea in elderly patients. The
initial workup typically includes electrocardiography, chest radiography,
echocardiography, and pulmonary function tests. If
echocardiography shows signs of PAH, the diagnosis should be
confirmed by right heart catheterization. Radiographic evidence
of long-standing PAH includes enlargement of the central
pulmonary arteries with abrupt narrowing of the more distal
branches, giving a "pruned-tree" appearance, and right ventricular
(RV) enlargement. The classic radiographic signs of RV
enlargement include increased transverse diameter of the
heart, elevation of the cardiac border on the posteroanterior
view, and narrowing or loss of the retrosternal airspace on the
lateral projection. (J Respir Dis. 2008;29(11):443-450)

We describe a patient with intravascular
pulmonary lymphoma
who presented with
progressive dyspnea and hypoxemia
with normal chest radiographic
findings. After an
unrevealing noninvasive evaluation,
a high-grade B-cell
intravascular lymphoma was
diagnosed by bronchoscopy
with transbronchial biopsy.
Treatment with a modified
CHOP regimen resulted in resolution
of the patient’s hypoxemia
and exercise limitation.
Although intravascular pulmonary
lymphoma rarely presents
with pulmonary symptoms,
it should be considered
in the differential diagnosis of
patients presenting with hypoxemia
and normal chest radiographic
findings.

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