women are more likely to be diagnosed with asthma and suffer greater morbidity than men. The physiologic mechanisms for these differences are not well understood. Understanding sex-related differences in asthma and providing patients with education geared toward these disparities are important in establishing effective, individualized asthma management strategies for all patients.

Glomus tumors are uncommon soft tissue tumors that usually occur in the hands or feet but rarely have been described to appear in the tracheobronchial tree. Tracheal glomus tumors present with symptoms including cough, dyspnea, and wheezing that may be mistaken for other pulmonary disorders. Imaging and pulmonary function testing can detect tracheal obstruction, but pathology is necessary to differentiate glomus tumors from other airway tumors. On pathology, glomus tumors are made up of glomus cells, blood vessels, and smooth muscle and are classified based on the predominant cell type. The differential for this tumor includes carcinoid tumors, paragangliomas, and hemangiomas, and immunohistochemical stains can be used to obtain the correct diagnosis. The most common modality for treatment of these tracheal tumors has been surgical resection. However, there have been reported cases of successful removal with rigid or flexible bronchoscopy. We present a case of a tracheal glomus tumor that was successfully resected using electrocautery snare during flexible bronchoscopy. Our case adds to the evidence that flexible bronchoscopy is a safe, less invasive approach to management of tracheal glomus tumors in select patients.

A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. A bronchoalveolar lavage sample was positive via PCR for adenovirus which we suspect exacerbated a pre-existing bacterial pneumonia and led to a severe and non-responsive respiratory failure. His serum adenovirus load was markedly elevated. Treatment was started once the diagnosis of disseminated adenovirus infection was made; however, at that time patient was suffering from refractory hypoxaemia, respiratory acidosis, right heart failure and septic shock. Despite maximal supportive measures our patient ultimately expired over the course of 6 days.

Summary Objective To evaluate whether asthma and airway hyper-responsiveness are associated with HIV infection. Methods We reviewed the literature on HIV-associated pulmonary diseases, pulmonary symptoms, and immune changes which may play a role in asthma. The information was analyzed comparing the pre-HAART era to the post-HAART era data. Results HIV-seropositive individuals commonly experience respiratory complaints yet it is unclear if the frequency of these complaints have changed with the initiation of HAART. Changes in pulmonary function testing and serum IgE are seen with HIV infection even in the post-HAART era. An increased prevalence of asthma among HIV-seropositive children treated with HAART has been reported. Conclusion The spectrum of HIV-associated pulmonary disease has changed with the introduction of HAART. Current data is limited to determine if asthma and airway hyper-responsiveness are more common among HIV-seropositive individuals treated with HAART.

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