- |||||||||| ceftriaxone / Generic mfg., doxycycline / Generic mfg.
LEPTOSPIROSIS: A CAUSE OF MULTIORGAN FAILURE IN NYC (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5230;
While it most commonly causes asymptomatic illness, it has the potential to cause life-threatening multiorgan failure. If there is high clinical suspicion for leptospirosis, appropriate therapies should be initiated prior to laboratory confirmation.
- |||||||||| UNVEILING THE UNEXPECTED: FATAL ENCOUNTER WITH BORDETELLA BRONCHISEPTICA AND CANDIDA KRUSEI AFTER POST-INFLUENZA PNEUMONIA IN AN IMMUNOCOMPETENT HOST (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5155;
Following completion of the Oseltamivir course, sputum production continued and new infiltrative changes on chest radiography raised suspicion of post-viral pneumonia prompting initiation of intravenous antibiotics (Rocephin and Doxycycline) for seven days...Cultures from bronchial washings revealed growth of Bordetella bronchiseptica and Candida krusei, subsequently treated with Meropenem and Caspofungin... This raises questions regarding the potential sources of infection, including zoonotic transmission or nosocomial acquisition secondary to prolonged hospital stay after influenza pneumonia.
- |||||||||| Cytovene (ganciclovir) / Roche, Rituxan (rituximab) / Roche
HSV PNEUMONITIS: THE COVID MASQUERADER (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5148;
HSV Pneumonitis can be easily overlooked as a superinfection in COVID pneumonia, and may cause life-threatening pneumonitis. Clinicians should be aware of the risk of viral superinfection especially in immunocompromised patients with COVID pneumonia.
- |||||||||| HIDDEN THREAT UNVEILED: A TALE OF DISCOVERY AND TREATMENT OF PULMONARY HYDATID CYST (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5106;
She was treated with Augmentin, doxycycline for PID, and ivermectin...Due to the theoretical risk of teratogenicity in the first trimester with albendazole, the patient opted to terminate the pregnancy... Clinicians should maintain a high index of suspicion for PHC in at-risk patients and promptly employ serological testing for confirmation.
- |||||||||| RECOGNIZING ACUTE INTERSTITIAL PNEUMONIA AS CULTURE NEGATIVE ARDS (Convention Center 258 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4922;
Earlier mechanical ventilation allows for more diagnostic and therapeutic options such as lung biopsy, ECMO, and lung transplant. Use of steroids and immunosuppressive therapies are presently debated.
- |||||||||| Cresemba (isavuconazonium sulfate) / Astellas, Basilea
PERICARDITIS: A RARE PRESENTATION IN A PATIENT WITH DISSEMINATED HISTOPLASMOSIS: A CASE REPORT (Convention Center Exhibit Hall: Rapid Fire Area 2A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4842;
In cases where pericarditis does not respond to NSAIDs and steroids, it is important to conduct a comprehensive evaluation, which should encompass investigations for viral, bacterial, and fungal causes. We suggest that histoplasmosis infection be considered among the potential diagnoses for individuals with acute pericarditis, especially in regions where the disease is prevalent.
- |||||||||| doxycycline / Generic mfg., azithromycin / Generic mfg.
HEAD, SHOULDERS, LUNGS, AND TOES: A CASE OF ANTISYNTHETASE SYNDROME (Convention Center Exhibit Hall: Rapid Fire Area 3D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4722;
She was given doxycycline with no improvement...She was treated with azithromycin without further relief of her symptoms... The main learning points of this case are 1) considering autoimmune myositis in workup of idiopathic interstitial pneumonia and 2) screening for other anti-ARS antibodies when anti-Jo-1 antibodies are negative but a high clinical suspicion for IIM remains.
- |||||||||| NAVIGATING THE UNCHARTED WATERS: PULMONARY NOCARDIOSIS IN IMMUNOCOMPROMISED POPULATION (Convention Center Exhibit Hall: Rapid Fire Area 1D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4568;
The patient was started on doxycycline oral and meropenem IV with significant improvement in cough and shortness of breath... This case highlights that pulmonary nocardiosis should be kept in the differential of pulmonary disease in the immunocompromised patient, as early identification and proper treatment are crucial to reduce morbidity and mortality.
- |||||||||| doxycycline / Generic mfg., meropenem / Generic mfg.
LEMIERRE SYNDROME: CONSEQUENCES OF GRAM-NEGATIVE BACTEREMIA IN A PREVIOUSLY HEALTHY YOUNG ADULT (Convention Center Exhibit Hall: Rapid Fire Area 3A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4512;
Septic shock remains a dangerous pathologic process despite advances in evaluation, diagnosis and treatment. Providers must not only be aware of the direct risks of sepsis, but also the nuances of care for virulent pathogens and their potential complications.
- |||||||||| PASTEURELLA CANIS CAVITARY PNEUMONIA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3536;
Empiric ceftriaxone was started for community acquired pneumonia...He was started on amoxicillin-clavulanate twice daily for 4weeks for treatment of pulmonary cavitary infection... Pasteurella canis infection should be considered in the differential diagnosis of cavitary lesions especially in patients with exposure to dogs.
- |||||||||| NORTH? SOUTH? EAST? WEST?...SO CONFUSED (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3535;
Most patients, who are infected with WNV, have an indolent course or mild symptoms with recovery. Less commonly, patients can have a more severe course of meningitis/encephalitis, with acute flaccid paralysis with detrimental outcomes.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health
HYPERAMMONEMIA: A RARE BUT FATAL PHENOMENON FOLLOWING LUNG TRANSPLANTATION (Convention Center Exhibit Hall: Poster Area 5) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3067;
Early recognition and treatment are crucial in improving survival and preventing neurological sequela. This can be achieved by checking serial ammonia levels following lung transplantation.
- |||||||||| NEUROSARCOIDOSIS: A CLINICAL CASE REPORT (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2995;
Sarcoidosis is a multisystem disease with the most common manifestation of pulmonary involvement. Neursarcoidosis is a rare sub manifestation that can present with signs of headaches and blurry vision that should be treated with corticosteroids/DMARDs.
- |||||||||| progesterone / Generic mfg., doxycycline / Generic mfg.
DYSPNEA WITH MENSTRUATION: THE UNUSUAL CASE OF CATAMENIAL PNEUMOTHORAX (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2824;
Thoracic surgery was consulted and she underwent right-sided Video-assisted thoracoscopic surgery (VATS), mechanical and chemical pleurodesis with doxycycline and chest tube placement...She was referred to gynecology for hormonal contraceptives and was started on progesterone contraceptives with an improvement of her pleuritic chest pains that seem to occur around her menstruation cycles... It is important to have catamenial pneumothorax as an important differential in recurrent SPT in young women with diverse clinical presentations for timely management.
- |||||||||| ceftriaxone / Generic mfg., doxycycline / Generic mfg.
MALIGNANT PLEURAL MESOTHELIOMA: RARE CASE WITHOUT OCCUPATIONAL EXPOSURE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2796;
Despite advancements in treatment modalities, atypical malignant mesothelioma carries a poor prognosis and resistance to conventional therapies (3). Further investigation into alternative risk factors or genetic predispositions is crucial for improving our understanding of this disease and developing more effective treatment strategies.
- |||||||||| BLOOD SUCKER: A CASE OF ANAPLASMOSIS HIDING IN PLAIN SIGHT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2696;
It is essential to have a high index of suspicion and perform a detailed history and physical when developing a differential for TP. With early diagnostics including peripheral smear and serologies, anaplasmosis can be accurately treated to prevent life-threatening complications.
- |||||||||| Jardiance (empagliflozin) / Eli Lilly, Boehringer Ingelheim
RICKETTSIA RICKETTSII-INDUCED HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS: A COMPLEX IMMUNOLOGICAL INTERPLAY (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2617;
She was treated with an insulin infusion, intravenous fluids, intravenous vancomycin, cefepime, and metronidazole.CT abdomen revealed mild splenomegaly but was otherwise unremarkable...She was started on intravenous doxycycline to address potential tick-borne illnesses... This case highlights Rickettsia rickettsii-induced HLH, illustrating its diagnostic challenges and emphasizing the need for further understanding of its pathophysiology and treatment strategies.
- |||||||||| cefepime hydrochloride / Generic mfg., doxycycline / Generic mfg., tetracycline / Generic mfg.
THE NOT-SO-COMMON CULPRIT: ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY CHLAMYDIA PSITTACI: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2520;
She was started on IV cefepime...Patient was started on doxycycline and her condition improved and was subsequently extubated... Psittacosis is an infrequent cause of pneumonia and is not routinely tested in pneumonia diagnostic panels, therefore may be underestimated, especially in critically ill patients hence making timely diagnosis and management vital so as to reduce the use of unnecessary antibacterial drugs, hospitalization costs, and minimize the progression of disease process.
- |||||||||| ceftriaxone / Generic mfg., doxycycline / Generic mfg.
DIAGNOSTIC CHALLENGES IN REACTIVE ARTHRITIS: A CASE WITH GONOCOCCAL URETHRITIS, E. HISTOLYTICA, AND HIV (Convention Center Exhibit Hall: Poster Area 1) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2399;
This case highlights multiple etiologies of reactive arthritis including Gonococcal Urethritis, newly diagnosed HIV infection, and gastroenteritis due to E. Histolytica infection. For clinicians it is important to evaluate other possible etiologies and concomitant genetic and autoimmune testing as it may dictate the treatment regimen to prevent recurrence and progression of the disease.
- |||||||||| A COMPLEX CASE OF PROGRESSIVE PNEUMONIA IN A RENAL TRANSPLANT RECIPIENT (Convention Center 253 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2240;
Empirical treatment with doxycycline and augmentin proved ineffective...Despite zosyn and vancomycin treatment, her condition deteriorated...Susceptibilities demonstrated resistance to amikacin, tobramycin, trimethropin-sulfamethoxazole, and imipenem...Reviewing prior case reports, N. wallacei has a predilection for disseminating to the brain. Therefore, diagnosing Nocardia early can make the difference in preventing a fatal outcome.
- |||||||||| doxycycline / Generic mfg., azithromycin / Generic mfg., atovaquone / Generic mfg.
TAKOTSUBO CARDIOMYOPATHY AS A RARE COMPLICATION OF SEVERE BABESIOSIS (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1990;
To our knowledge, very few Babesia-related stress cardiomyopathy cases exist. Further research should be conducted for a better understanding of the pathophysiology and association between Babesiosis and Takotsubo cardiomyopathy.
- |||||||||| doxycycline / Generic mfg.
DOXYCYCLINE AS A NIDUS FOR ACUTE PANCREATITIS? (Convention Center Exhibit Hall: Rapid Fire Area 2A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1949;
Physicians should have a high index of suspicion for DIP in patients who develop GI symptoms after doxycycline administration. It is necessary to conduct new epidemiological studies to explore this uncommon connection further.
- |||||||||| Rituxan (rituximab) / Roche
FROM TICK BITE TO HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS: A CASE REPORT (Convention Center Exhibit Hall: Rapid Fire Area 2A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1944;
In conclusion, this case offers valuable insights into a rare but lethal disease. Therefore, clinicians must maintain a high index of suspicion to identify this disease.
- |||||||||| dexamethasone / Generic mfg., doxycycline / Generic mfg.
HLH SECONDARY TO EHRLICHIOSIS IN A LUNG TRANSPLANT RECIPIENT (Convention Center Exhibit Hall: Rapid Fire Area 4D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1771;
The patient received 7 days of dexamethasone 10mg/m2 and completed a 14-day course of doxycycline. Physicians should consider HLH in their differential when caring for an immunocompromised patient with multi-organ damage, as prompt diagnosis and treatment is essential in preventing morbidity and mortality.
- |||||||||| doxycycline / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
GASPING FOR ANSWERS: A CASE REPORT OF ACUTE MYELOID LEUKEMIA PRESENTING WITH DYSPNEA (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1708;
Clinicians should consider AML in the differential diagnosis of dyspnea, particularly in the absence of typical infectious features. Timely recognition and appropriate management are crucial for improving outcomes.
- |||||||||| doxycycline / Generic mfg., apixaban / Generic mfg.
A MITRAL VALVE REPLACED THAT LED TO A RARE CASE: MRSA EMPYEMA NECESSITANS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1647;
It is crucial for clinicians to acknowledge the potential emergence of MRSA empyema necesitans subsequent to mitral valve replacement, emphasizing the importance of early detection for optimal treatment. Management requires proactive source control interventions that can include decortication, drainage, thoracostomy, debridement, and antibiotic therapy.
- |||||||||| FOXES IN LAMB'S WOOL: A CASE OF LUNG ADENOCARCINOMA MASQUERADING AS RECURRENT PNEUMONIA (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1577;
A chest X-ray showed consolidation in the right lower lobe, leading to a presumptive diagnosis of community-acquired pneumonia and treatment with levofloxacin, providing partial relief...She was admitted for pneumonia that failed outpatient treatment and was managed with Zosyn and vancomycin, then transitioned to cefdinir and doxycycline, resulting in improved symptoms... This case features the importance of integrating clinical and radiographic findings to conduct a thorough workup in patients presenting with "recurrent pneumonia." This highlights the need to revisit diagnoses when treatments do not align with anticipated responses, emphasizing a thorough diagnostic strategy.
- |||||||||| Ocrevus (ocrelizumab) / Roche
OCRELIZUMAB-INDUCED DIFFUSE CRYPTOGENIC ORGANIZING PNEUMONIA (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1499;
Further research is needed to elucidate the mechanisms underlying such adverse events and to guide appropriate patient management strategies. Healthcare providers should remain vigilant for respiratory symptoms in patients receiving ocrelizumab and consider thorough pulmonary evaluation in cases of unexplained respiratory distress.
- |||||||||| prednisone / Generic mfg., doxycycline / Generic mfg., pirfenidone / Generic mfg.
WHEN RADIOLOGIC ABNORMALITIES BECOME INTERSTITIAL LUNG DISEASE IN LUNG CANCER (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1493;
There is limited data on many cancer-directed therapies in ILD patients, and additional research is needed on minimally invasive, chemotherapeutic, and immunotherapy options. Further exploration of the role of antifibrotics during cancer treatment is needed.
- |||||||||| Bosulif (bosutinib) / Pfizer
BUT COULD IT BE THE TKI? (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1467;
INTRODUCTION: Dasatinib is a tyrosine kinase inhibitor (TKI) that treats CML by targeting the Bcr-Abl oncoprotein...The patient is given ceftriaxone, doxycycline, and solumedrol...Oncology repeated Bcr-Abl testing and the patient's CML regimen was changed to bosutinib, a TKI believed to have fewer pulmonary toxicities... Providers should maintain a high index of suspicion for TKI-related lung injury and perhaps lower thresholds to preform BAL for individuals taking TKI presenting with respiratory complaints as this may change oncologic management by either withholding or changing TKIs.
- |||||||||| Mycobutin (rifabutin) / Pfizer, Lupin
SEPTIC SHOCK FROM DISSEMINATED NONTUBERCULOUS MYCOBACTERIUM (NTM) INFECTION IN A NON-HIV IMMUNOSUPPRESSED PATIENT: WHEN TO START EMPIRIC ANTIMYCOBACTERIAL THERAPY? (Convention Center Exhibit Hall: Rapid Fire Area 2A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1452;
CASE PRESENTATION: A 56-year-old woman with a history of systemic lupus erythematous with glomerulonephritis on chronic steroids and mycophenolate mofetil (MMF) presented with dyspnea and a one-month history of painful skin rash.Patient was afebrile with an oxygen saturation of 97% on room air upon admission...Empiric therapy for NTM was initiated with ciprofloxacin, meropenem, and doxycycline...She had a prolonged hospitalization with anti-mycobacterial treatment including rifabutin, ciprofloxacin, and clarithromycin... Although randomized studies of empiric therapy for disseminated NTM are lacking, a pragmatic approach of initiating a macrolide, rifamycin, quinolone, aminoglycoside and a carbapenem with close monitoring for toxicity and drug interactions may be warranted in persons with suspected disseminated disease.
- |||||||||| UNVEILING THE UNCOMMON: STENOTROPHOMONAS MALTOPHILIA-INDUCED DIFFUSE ALVEOLAR HEMORRHAGE (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1428;
The patient was then treated with DDAVP, inhaled tranexamic acid every eight hours, and prothrombin complex concentrate after the diagnosis of DAH was confirmed...Consequently, the patient was started on Minocycline and Levaquin... Our case underscores the importance of considering rare pathogens such as Stenotrophomonas in the etiology of DAH.
- |||||||||| MORE THAN JUST THE FLU: MYOPERICARDITIS AND MYOSITIS IN THE ICU (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1406;
Overall, influenza-associated myopericarditis and myositis are rare complications of this common infection, occurring in a minuscule percentage of cases. They are important but rare complications of influenza and should be recognized promptly to allow for optimal medical management.
- |||||||||| UNILATERAL PROPTOSIS AS AN INITIAL PRESENTATION OF RHINO ORBITAL AND PULMONARY MUCORMYCOSIS: A CHALLENGING DIAGNOSIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1404;
Timely recognition, interdisciplinary collaboration, and prompt initiation of appropriate antifungal therapy are crucial for improved outcomes. Awareness of the potential complications and a high index of suspicion should be maintained in at-risk populations, especially in the presence of unusual symptoms or findings, such as unilateral proptosis and necrotic eschar
- |||||||||| CAVITARY PNEUMONIA AND EMPYEMA IN A CHRONIC MARIJUANA USER (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1254;
The risk of bacterial pneumonia caused by inhaled oral flora is not well documented but can lead to severe infections requiring ICU-level care and even surgical intervention. It is important to take a thorough social history to identify risk factors that could easily be overlooked in order to prevent recurrent infections.
- |||||||||| benzylpenicillin / Generic mfg., doxycycline / Generic mfg.
PULMONARY SYPHILIS: AN UNEXPECTED FINDING IN AN ASYMPTOMATIC GENTLEMAN (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1251;
Initially, treatment of latent syphilis was planned with 3 weeks of intramuscular penicillin G at the public health department...Given doxycycline's appropriate coverage of pulmonary syphilis, the patient was discharged with follow-up with pulmonology and infectious disease... This case underscores the importance of recognizing that, despite an unclear exposure history or lack of significant respiratory symptoms, secondary syphilis should still be considered a possibility in the presence of cavitary lung nodules.
- |||||||||| SECOND TIME'S THE CHARM: PULMONARY NOCARDIOSIS IN AN IMMUNOCOMPETENT PATIENT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1218;
She had been diagnosed with several URI and bronchitis episodes and was treated with multiple 5-day courses of antibiotics including augmentin, azithromycin, cefdinir, doxycycline, and levofloxacin...She is currently on bactrim and follows with pulmonology and infectious disease outpatient... Our case highlights the importance of considering atypical infections including Nocardia in the differential for refractory cough in an immunocompetent patient.
- |||||||||| A RARE CAUSE OF 'CONSUMPTION' (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1205;
Non-caseating granulomas do not always represent sarcoidosis or inflammatory etiologies. Clinicians should maintain a high index of suspicion for infectious etiologies especially when there is clinical and radiological improvement following appropriate antibiotic therapy.
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