Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and death worldwide. COPD exacerbation is usually treated with antibiotics, systemic corticosteroids, and inhaled bronchodilators. We present a case of recurrent COPD exacerbation that was treated repeatedly with standard therapy. Dynamic expiratory computed tomography of the chest was done, which revealed concomitant tracheomalacia. COPD and tracheomalacia may coexist during recurrent exacerbations of COPD, and delayed diagnosis can be associated with severe comorbidities. Ordering the appropriate imaging may aid in the correct diagnosis and facilitate appropriate management.
Intramuscular progesterone has been reported to be infrequently associated with acute eosinophilic pneumonia in patients who have recently undergone in vitro fertilization. A 27-year-old female at 5 weeks gestation after in vitro fertilization presented with cough, fever, dyspnea, bilateral infiltrates, and eosinophilia. All infectious, neoplastic, and autoimmune evaluations were negative. She gradually improved with supportive care. This case demonstrates that progesterone in sesame seed oil may be an inciting agent for eosinophilic pneumonia and that removal of this agent may be sufficient for recovery in mild cases.
Aspirin remains one of the most common agents involved in both accidental and intentional overdose. The availability of enhanced elimination and early hemodialysis has been known to reduce the number of deaths from salicylate poisoning. We present the case of an intentional aspirin overdose with enteric-coated preparation that had continuously rising salicylate levels despite treatment with bicarbonate drip, continuous dialysis and activated charcoal.
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