Chickenpox and pneumothorax.

Chickenpox and pneumothorax. J G Barone, M R Todd, R Maise and J E Barone Chest 1990;98;514a-514 DOI 10.1378/chest.98.2.514a The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://chestjournal.chestpubs.org/content/98/2/514a.citation

Chest is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright1990by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder. (http://chestjournal.chestpubs.org/site/misc/reprints.xhtml) ISSN:0012-3692

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specimens

patients

from

patterns.

This

method

bronchoalveolar

lung

with seems

also

cancer

and

infiltrative

diffuse

to be helpful

for the

diagnosis

of

carcinoma.9

We concluded lung

the addition of BAL cytologic examinations in might occasionally increase the diagnostic yield ofbronchoscopy and spare some patients unnecessary invasive procedures.m0mm This diagnostic technique seems especially indicated in lung cancer with an infiltrative x-ray pattern. that

lesions

peripheral

Joaquim

M.D.,

Ph.D.;

lacier De Gracia,

M.D.;

Beilmunt,

Serafin Morales M.D.; RatnOn Oi’riols, M.D., and Natalie Hospital

Tallada, M.D., %lille Hebron, Barcelona,

Spain

REFERENCES FIGURE

1 Davis

WB,

JE.

Gadek

Detection of pulmonary Chest 1987; 91:787-90

bronchoalveolar

lymphoma

by

lavage. P, Cordier JF, Cellier CC, Pages J, Loire R, Brune Primary immunocytoma of the lung: the diagnostic value bronchoalveolar lavage. Thorax 1985; 40:542-43 Morales FM, Matthews JI. Diagnosis ofparenchymal Hodgkids disease using bronchoalveolar lavage. Chest 1987; 91:785-87

4 Miller KS, Sahn SA. Mycosis and diagnosed by bronchoalveolar

fungoides

presenting

lavage.

of

as ARDS

Radiographic

and

Chest 1986; 89:312-14 5 Zavadiova H. Comparison ofsputum and bronchoalveolar lavage examination in patients with cancer. Eleventh European Congress ofCytology, Sept 29-Oct 1, 1982; page 171 6 Sineway MJ, Francis PB, Honig EG, Boozer RM, Nassar VH. Bronchoalveolar lavage in the diagnosis of peripheral lung cancer. Am Rev Respir Dis 1984; 129:68 7 Karnofsky DA, Burchenal JH. In: McLeod, ed. Evaluation of pathologic

pulmonary

chemotherapeutic 1949 8 Baglin JY, Danel

J. Interest

manifestations.

agents. C, Carnot

York:

National

Institutes SC,

Springmeyer Bronchioloalveolar lavage. Chest

10 Turner-Warwick choalveolar 105-21

Columbia

University

J, Jaubert

F, Lacronique

of bronchoalveolar

tumors with normal ternational Conference 9

New

lavage

in the

fiberoptic bronchoscopic on BAL (abstract book). of Health, 1984; 29

Hackman

R,

carcinoma

JJ,

Carlson

diagnosed

F, Chr#{233}tien

by

examination. Columbia,

lavage

in

Autonoma

of lung In-

evidence

smokers

and

demonstrating alveoli

of pneumonia

apical

(A)

multinucleated giant cell (Hematoxylin and eosin, x 100)

JE.

or chronic

(Ibstructive

blebs

and

pleurodesis

was

done.

pulmonary

The

patient

on hospital day 20. Pathologic examination tissue demonstrated multinucleated giant Varicella

zoster

inflammatory

infection

tissue

produces

reaction.’

In

in 1989

was

ofthe excised cell infiltration

discharged

pulmonary (Fig).

a multinucleated our

patient,

giant

cell

inflammation

of a

bleb resulted in pneumothorax. To our knowledge, this complication ofchickenpox has never been documented. Ifa patient with chickenpox develops sudden shortness of breath or chest pain, a spontaneous pneumothorax should be ruled out by immediate chest x-ray examination. Clinical suspicion for pneumothorax should be

especially

high

if the

or has a previous

event and chickenpox.

need

to

should

be

patient

is a tall

history

of spontaneoims

aware

include

of this

it as yet

young

man,

elderly,

fatal

possible

pulmonary

complication

of

j G. Barone,

80:

M. R. Maine,

lung

M.D.;

a

pneumothorax.

potentially

another

of bron1986;

disease.

pulmonary

Physicians

de Barcelona,

bleb

pulmonary

Electrocardiogram was normal. A chest tube was inserted and placed to closed water sealed suction. Chest x-ray film showed full reexpansion of the right lung. An air leak was present and persisted after ten days (If continuous suction. On hospital day 1 1 , open thoracotomy with excision of

smoker

MD:

McClellan bronchoalveolar

1983; 83:278-79 ME, Haslam PL. Clinical applications lavage: an interim view. Br J Dis Chest

11 Bellmunt J. Bronchoalveolar cancer (thesis). Universidad

Press,

diagnosis

and

J.

2 Weynants

3

Excised

.

(arrow)

andj

R.

M.D.;

Todd,

M.D.;

E. Barone,

St. Francis

Medical

Trenton,

New

Hahnemann

M.D., Center,

Jersey;

and

University, Philadelphia

Chlckenpox

and Pneumothorax

REFERENCES

1 Weller

lb the Editor: woman with chickenpox chest pain and dyspnea.

she developed rapidly

and

crust

smoking

disease

from

the sudden Four days before admission, and a diffuse red macular rash. The

macules

presented

to papules,

with

vesicles,

and

herpes zoster. 1434 2 Watt AG. Spontaneous pneumothorax. tive admissions to Royal Perth Hospital.

N Engl

J Med 1983: 309;

were covered

28 the

per

mm.

The

characteristic

skin.

Bight

lung

field

breath

A review of 210 consecuMed J Aust 1978: 1; 186

pustules

There was no history of trauma, obstructive or previous dyspnea. She had a 10 pack/year

Pleural Fluid Acidosis in the Malignant Variant of Benign Pleural Mesothelioma

history.

Respirations chickenpox

fever, malaise progressed

formation.

pulmonary

Varicella

1362,

A 35-year.old onset of right rash

TH.

lesions sounds

of were

decreased, the remainder of the physical examination was normal. The only laboratory abnormality was a white blood cell count of 7.8 cJdl with 47 percent banded forms. Chest x-ray examination showed a 40 percent right tension pneumothorax. There was no radiographic

To the Editor:

Pleural effusions (BPM) are unusual,’ patient with a value

associated

with

benign

pletmral

mesothelioma

with the description offluid pH limited of 7.50. We wish to report a case where

514

Communications


to one pH

of

to the Editor

Chickenpox and pneumothorax. J G Barone, M R Todd, R Maise and J E Barone Chest 1990;98; 514a-514 DOI 10.1378/chest.98.2.514a This information is current as of December 31, 2011 Updated Information & Services Updated Information and services can be found at: http://chestjournal.chestpubs.org/content/98/2/514a.citation Permissions & Licensing Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.chestpubs.org/site/misc/reprints.xhtml Reprints Information about ordering reprints can be found online: http://www.chestpubs.org/site/misc/reprints.xhtml Citation Alerts Receive free e-mail alerts when new articles cite this article. To sign up, select the "Services" link to the right of the online article. Images in PowerPoint format Figures that appear in CHEST articles can be downloaded for teaching purposes in PowerPoint slide format. See any online figure for directions.
