piperacillin--tazobactam-drug-combination and Chest-Pain

The syndrome of Boerhaave is a rare affection, corresponding to a spontaneous rupture of the oesophagus, the prognosis of which depends on the precocity of cares. Clinically, it is characterized by a set of three: efforts of vomitings, thoracic pain and subcutaneous emphysema. We report the first case of spontaneous rupture of the oesophagus in a 3-month pregnant woman, further to incoercible vomiting. The excellent clinical tolerance of the patient has allowed a medical care with strict monitoring, parenteral food and adapted antibiotic therapy. The surgery as a matter of urgency, usually indicated in this pathology, was not realized in this context of pregnancy. The obstetric and neonatal future was favorable. We discuss the diagnostic difficulties, the modalities of cares as well as the prognosis of such a pathology.

Topics: Adult; Anti-Bacterial Agents; Chest Pain; Esophageal Perforation; Female; Humans; Parenteral Nutrition; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pregnancy; Pregnancy Complications; Subcutaneous Emphysema; Vomiting

Topics: Antifungal Agents; Aspergillus niger; Chest Pain; Diabetes Mellitus, Type 2; Empyema, Pleural; Female; Hemoglobin A; Humans; Middle Aged; Piperacillin, Tazobactam Drug Combination; Streptococcus agalactiae; Tomography, X-Ray Computed; Vancomycin; Voriconazole

A broncholith is defined as the presence of calcified material within a bronchus or within a cavity communicating with a bronchus. It is most frequently caused by Histoplasmosis or tuberculosis (TB) spp. Bronchial distortion, irritation and erosion by broncholiths can cause bronchiectasis, recurrent pneumonias and haemoptysis. We present a case of recurrent pneumonia due to a broncholith, which resolved conservatively with antibiotics. Owing to recurrent fevers and post obstructive pneumonias, a lobectomy or rigid bronchoscopic removal were considered but the patient was deemed not to be a candidate for general anaesthesia due to her comorbidities. Broncholiths are an uncommon cause of bronchiectasis and recurrent pneumonias. However, the wide range of symptoms and low clinical suspicion are the main reasons why a diagnosis can be delayed. Various treatment options are available and the choice of therapy should be made depending on the broncholith's size, mobility, location and local surgical expertise.

Topics: Anti-Bacterial Agents; Bronchial Diseases; Bronchiectasis; Bronchoalveolar Lavage; Chest Pain; Dyspnea; Female; Fever; Humans; Lithiasis; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Recurrence; Treatment Outcome; Vancomycin