Mohammed Abdalla

Tunneled indwelling pleural catheters (IPCs) are frequently used to palliate symptomatic dyspnea due to recurrent pleural effusions. The drainage valve of IPCs is an important component of the catheter as fracture of the valve leads to malfunctioning of the IPCs. Replacement of the catheter includes risks such as pain, infection, pneumothorax, and procedure cost. We report two cases of malfunctioning tunneled IPC drainage valves repaired by our noninvasive method and discuss the need for a repair kit and a standardized approach to this repair in case of nonavailability of repair kits.

Urinothorax is a rare cause of pleural effusion, which is seen in patients with obstructive uropathy, blunt trauma, or ureteric injury during abdominal surgical procedures. Clinical symptoms may include dyspnea, chest pain, cough, fever, abdominal pain, and decreased urine output. Diagnosis is made by thoracentesis, which would reveal fluid with a urine-like odor, and pleural fluid analysis, which would show if fluid is transudative in nature with a pH lower than 7.30. Pleural fluid to serum creatine ratio of more than 1 is diagnostic for this condition. In our case, the patient underwent percutaneous nephrolithotripsy with a stent placement three days before presentation to the hospital. She was diagnosed with urinothorax, which led to further investigations, and she was found to have persistent hydronephrosis. Her condition improved after her underlying hydronephrosis was addressed with stent placement. She was discharged home in stable condition.

Nodular sarcoidosis is a rare form of pulmonary sarcoidosis comprising 4% of lung involvement in this disease. It usually affects African American women with a mean age of 35 years. It presents with constitutional symptoms associated with chest imaging findings of multiple or solitary lung nodules. In our case we present a 38-year-old woman who had chronic productive cough associated with fever and dyspnea for 1 month. She had course of antibiotics without improvement in her symptoms. Chest imaging showed multiple nodules measuring up to 7.5 cm in size. Lung biopsy was obtained and histopathology revealed non-caseating granulomas consistent with sarcoidosis. Angiotensin-converting enzyme levels were elevated. She received systemic steroids and the nodules resolved on follow-up imaging. J Med Cases. 2019;10(2):46-48 doi: https://doi.org/10.14740/jmc3246

Effect of Troponin I Elevation on Duration of Mechanical Ventilation and Length of Intensive Care Unit Stay in Patients With Sepsis

BACKGROUND:Lung mucoepidermoid carcinoma is a form of non-small cell lung carcinoma that originates from the submucosal glands of the tracheobronchial tree; it is rare and causes 0.1% to 0.2% of lung malignancies. In this article, we report on an occ...