Progressive dysphagia of unknown etiology may still provide a diagnostic challenge despite an increase in the number and quality of investigations available. We describe a 64-year-old man who presented with progressive dysphagia and weight loss. Following a number of investigations, a diagnosis of diffuse esophageal leiomyomatosis was made and the patient was treated appropriately.
There is a growing body of literature on infection with nontuberculous mycobacteria (NTM) associated with heater chiller units in the cardiac surgery population. We report a pediatric case undergoing reoperation for early right ventricle-to-pulmonary artery conduit stenosis. A successful outcome was achieved following excision of the infected conduit and six-week antibiotic treatment. To our knowledge, there is only one other pediatric cardiac case reported in the literature. Similar to the recently reported cases of infection associated with Mycobacterium chimaera in predominately adult patients after cardiac bypass surgery, we hypothesize that water-containing devices such as the heater chiller unit and water blanket acted as a reservoir for other NTM. With increasing awareness of NTM, we analyzed the 2015-2016 culture data on our fleet of eight heater chiller units. We identified an association between persistent positive cultures and the connection of a water mattress to the heater chiller unit circuit. This led us to abandoning the use of the mattress in pediatric cardiac surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.