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Related Concept Videos

Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Pneumonia I: Introduction01:30

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Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
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Pneumonia II: Pathophysiology01:29

Pneumonia II: Pathophysiology

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The pathophysiology of pneumonia involves the following steps:
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Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

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Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
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Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

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Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
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Pneumothorax-II01:27

Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Updated: Jun 27, 2025

A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation
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Hyperacute Radiation Pneumonitis after Severe irAE.

Yang Chou1,2, Wei-Kai Chuang3,4

  • 1Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan.

Diagnostics (Basel, Switzerland)
|April 26, 2024
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Summary

A patient with recurrent triple-negative breast cancer developed Pneumocystis pneumonia during treatment. Prompt diagnosis and treatment with TMP-SMX and steroids led to recovery, highlighting opportunistic infections in immunocompromised cancer patients.

Keywords:
breast cancerimmunotherapyradiotherapy

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Area of Science:

  • Oncology
  • Infectious Diseases
  • Pulmonology

Background:

  • Triple-negative breast cancer (TNBC) recurrence presents significant treatment challenges.
  • Immune checkpoint inhibitors (ICIs) like pembrolizumab are used in TNBC but can cause immune-related adverse events.
  • Patients with advanced cancer and those undergoing immunosuppressive therapy are at risk for opportunistic infections.

Purpose of the Study:

  • To report a case of Pneumocystis jiroveci pneumonia (PJP) in a patient with recurrent TNBC treated with ICIs and radiotherapy.
  • To highlight the importance of considering opportunistic infections in immunocompromised cancer patients presenting with respiratory symptoms.
  • To underscore the successful management of PJP in this complex clinical scenario.

Main Methods:

  • Case report of a 54-year-old woman with recurrent TNBC and bone metastases.
  • Treatment involved pembrolizumab, taxane, and radiotherapy.
  • Diagnosis of PJP was confirmed via bronchial lavage PCR.
  • Management included antibiotics (TMP-SMX) and glucocorticoids.

Main Results:

  • The patient experienced severe skin toxicity from pembrolizumab, leading to treatment discontinuation.
  • Radiotherapy for a sternum mass was complicated by dyspnea and fever, suggestive of PJP.
  • Pneumocystis jiroveci was identified in bronchial lavage.
  • Respiratory symptoms resolved with TMP-SMX and methylprednisolone.

Conclusions:

  • Opportunistic infections, such as PJP, can occur in patients with advanced cancer receiving immunotherapy and radiotherapy.
  • Early recognition and appropriate treatment of PJP are crucial for patient recovery.
  • Multidisciplinary management involving oncology, infectious disease, and pulmonology is essential for complex cases.