rifampin and Hemoptysis

The patient had received five courses of anti-tuberculosis treatment for recurrent tuberculosis. The drug sensitivity test results of the first three courses showed drug-sensitive pulmonary tuberculosis, and the fourth diagnosis was rifampin-resistant tuberculosis (RR-TB), complicated by chronic obstructive pulmonary disease, type Ⅱ respiratory failure, pulmonary heart disease, and heart failure (grade Ⅲ). The patient stopped taking the anti-tuberculosis drugs on his own in the eighth month of receiving the resistant treatment. After admission, the symptoms improved temporarily after receiving oxygen therapy, anti-infection, and anti-tuberculosis treatment. Because of hemoptysis, the patient underwent arterial embolization by catheterization, but a large amount of hemoptysis occurred shortly thereafter. Emergency left total lung resection and gauze packing for hemostasis were performed. After surgery, the patient's vital signs were maintained with mechanical ventilation and vasopressors. Forty-eight hours after surgery, the gauze was removed, and the patient underwent tracheotomy, enteral nutrition, and anti-tuberculosis treatment. After discharge, the patient underwent rehabilitative exercise and anti-resistant tuberculosis therapy. The patient's condition remained stable for more than six months of follow-up.. 本例患者因肺结核经历5次抗结核治疗，前3次药物敏感试验均显示为非耐药肺结核，第4次诊断为利福平耐药结核病（rifampin-resistant tuberculosis，RR-TB），合并慢性阻塞性肺疾病、Ⅱ型呼吸衰竭、肺源性心脏病及心功能不全（Ⅲ级），按照耐药结核病治疗方案8个月后患者自行停药。此次因咳喘、胸闷入院，经吸氧、抗感染、抗结核治疗后症状缓解，因咯血行经导管动脉栓塞术治疗，术后再发大咯血，急诊行胸膜外左全肺切除+胸腔纱布填塞止血术，术后呼吸机、血管活性药物维持生命体征，48 h后拔出纱布并气管切开、鼻饲营养、抗结核等治疗，出院后康复锻炼、口服耐药方案治疗，随访半年余病情平稳。.

Topics: Antitubercular Agents; Hemoptysis; Humans; Lung; Rifampin; Thoracic Diseases; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

Topics: Aged; Antitubercular Agents; Celiac Disease; Diarrhea; Diet, Gluten-Free; Drug Compounding; Drug Substitution; Drug Therapy, Combination; Ethambutol; Glutens; Hemoptysis; Humans; Isoniazid; Male; Metronidazole; Moxifloxacin; Pyrazinamide; Rifampin; Smoking; Tomography, X-Ray Computed; Tuberculosis, Pulmonary

Paragonimiasis is a food-borne zoonosis caused by a trematode of the genus Paragonimus(1,2). Infestation is rare in Spain, but the influx of people from endemic areas should make us keep this condition in the differential diagnosis of our patients(2,5). We report the case a patient from Ecuador and resident in Spain for 7 years with active pulmonary tuberculosis on arrival in Spain and later diagnosed with of pulmonary paragonimiasis due to persistent haemoptysis. The diagnosis was established by surgical lung specimen showing granulomas containing parasite eggs and the macroscopic view of the fluke within a lung cavity. Initial tuberculosis treatment and current treatment with praziquantel controlled both conditions.

Topics: Adult; Animals; Anthelmintics; Antitubercular Agents; Caulobacteraceae; Delayed Diagnosis; Ecuador; Ethambutol; Food Parasitology; Gram-Negative Bacterial Infections; Granuloma; Hemoptysis; Humans; Isoniazid; Lung Diseases, Parasitic; Male; Paragonimiasis; Pneumonia, Bacterial; Praziquantel; Pyrazinamide; Radiography; Rifampin; Spain; Tuberculosis, Pulmonary

We report a case of an aortobronchial fistula causing massive hemoptysis, which was managed by emergency stent grafting. Although this procedure was successful initially, the aortobronchial fistula appeared again 7 months later. Aneurysmectomy, followed by rifampicin-soaked gelatin sealed polyester graft replacement and omentopexy, was performed under cardiopulmonary bypass. The patient, a 73-year-old woman, had an uneventful postoperative course and the infection was eradicated.

Topics: Aged; Aneurysm, Infected; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Aortic Rupture; Blood Vessel Prosthesis; Bronchial Fistula; Cardiopulmonary Bypass; Endovascular Procedures; Enzyme Inhibitors; Female; Hemoptysis; Humans; Leprostatic Agents; Prognosis; Rifampin; Stents; Tomography, X-Ray Computed; Vascular Fistula

In the United Kingdom Mycobacterium kansasii is the most common pulmonary non-tuberculous mycobacteria to cause disease in the non-HIV positive population.. The clinical features, treatment, and outcome of 47 patients (13 women) of mean (SD) age 58 (17) years with culture positive pulmonary M kansasii infection were compared with those of 87 patients (23 women) of mean (SD) age 57 (16) years with culture positive pulmonary M tuberculosis infection by review of their clinical and laboratory records. Each patient with M kansasii infection was matched for age, sex, race and, where possible, year of diagnosis with two patients with M tuberculosis infection.. All those with M kansasii infection were of white race. Haemoptysis was more common in patients infected with M kansasii but they were less likely to present as a result of an incidental chest radiograph or symptoms other than those due to mycobacterial infection. Patients with M kansasii were also less likely to have a history of diabetes, but the frequency of previous chest disease and tuberculosis was similar. An alcohol intake of > 14 units/week was less frequent in those with M kansasii, but there were no significant differences in drug history, past and present smoking habit, occupational exposures, social class, or marital status. Patients with M kansasii received a longer total course of antimycobacterial therapy and, in particular, extended treatment with ethambutol and rifampicin was given. There was no significant difference in outcome between pulmonary M kansasii or M tuberculosis infection.. There are group differences between the clinical features of the two infections but, with the possible exception of diabetes and alcohol intake, these features are unlikely to be diagnostically helpful. Treatment of M kansasii infection with ethambutol, isoniazid, and rifampicin in these patients was as effective as standard regimens given to patients infected with M tuberculosis.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Cause of Death; Ethambutol; Female; Follow-Up Studies; Hemoptysis; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium Infections, Nontuberculous; Rifampin; Risk Factors; Survival Analysis; Time Factors; Treatment Outcome; Tuberculosis, Pulmonary

Topics: Adult; Aspergillosis; Hemoptysis; Humans; Isoniazid; Lung; Lung Diseases, Fungal; Male; Radiography; Rifampin; Tuberculosis, Pulmonary