Acute COVID-19 usually lasts 4 weeks from the onset of symptoms. We report two cases of COVID-19-associated organising pneumonia (OP) occurring beyond 4 weeks from the acute onset of symptoms. Both tested positive for SARS reverse transcription–PCR 2 months before presentation with a resolution of respiratory symptoms. The first case presented with residual fatigue and worsening exertional dyspnoea. Chest CT revealed an OP pattern. The second case presented with worsening cough and new-onset pleuritic chest pain with persistent radiological consolidation. A transbronchial lung biopsy confirmed OP. Both patients responded well to 12 weeks of steroid therapy. This case illustrates the rare presentation of OP as a late sequela of COVID-19 and the good response to steroid therapy.
Liquid silicone (polydimethylsiloxane) is an inert material that is commonly used for cosmetic purpose. Silicone embolization syndrome (SES) can rapidly progress to pneumonitis as a consequence of the injection of nonmedical-grade liquid silicone. We describe a case of severe silicone pneumonitis complicated with acute respiratory distress syndrome and bilateral pneumothorax secondary to silicone gluteal augmentation. In this case report, we aim to discuss our experience and approach in managing an uncommon case of SES.
Based on available evidence, the COVID-19 virus is thought to spread through close contact and droplet transmission. However, some have debated that it could be airborne. Airborne transmission occurs when particles of less than 0.5 μm within droplets spread through exhaled air via a process called aerosolisation. These particles can remain in the air for long periods and can disseminate over distances further than 1 meter. In the context of COVID-19, airborne particles can occur during certain aerosolised-generating-procedures (AGP). WHO underlines the use of N95 respirators or equivalent as part of personal protective equipment (PPE) for healthcare workers (HCW) managing COVID-19 positive patients when aerosolised-generating-procedures (AGP) are being conducted.
This retrospective observational study describes the result of COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) in health care workers (HCW) wearing different form of personal protective equipment (PPE) who had had close contact with a confirmed COVID-19 patient during performing such procedures. All HCWs were quarantined for 14 days after the exposure. COVID-19 RT-PCR nasopharyngeal swabs were performed at different intervals. Little is known about the effectiveness of different types of personal protective equipment (PPE) for preventing SARS-CoV-2 in HCWs. We describe the clinical outcome of HCWs exposed to sudden acute respiratory infection patient before the diagnosis of COVID-19 was known.
The use of Cannabis sativa, also known as marijuana, is believed to have dated back to thousands of years B.C. More than 200 decades later, it remains a popular recreational psychoactive substance that can be smoked through a water pipe. We report a case of marijuana smoking via a “bong” device, which has resulted in severe Pseudomonas aeruginosa necrotizing pneumonia treated with conservative medical therapy. This case highlights the importance of recognizing that life‐threatening pneumonia can potentially be linked to marijuana and “bong” usage. Complicated cases should be considered for early surgical intervention.
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