Pulmonary & Respiratory Medicine

Pulmonary interstitial emphysema in mechanically ventilated premature infants is a serious complication that is difficult to manage and is associated with a poor prognosis [1]. We describe a premature infant with respiratory insufficiency secondary to severe pulmonary interstitial emphysema that was managed with nasopharyngeal highfrequency oscillatory ventilation, as a non-invasive mode of ventilation. Our case report does not clearly differentiate whether the improvement in gas exchange and eventual resolution of PIE are attributable to the use of non-invasive HFOV or to the use more appropriate low frequency (7Hz) with the non-invasive approach. Further studies of NP-HFOV use in infants with PIE are needed to support our report Conclusion: NP-HFOV may be utilized in infants with PIE associated with compromised respiratory function. NPHFOV may decrease the chance of further pulmonary complications, including pneumonia and lung atelectasis, and facilitate care of sick infants while on NP-HFOV.

The Mycobacterium terrae complex, consisting of three saprophytic species, (M. terrae, M. nonchromogenicum, and M. triviale), they rarely cause diseases in immunocompetent people. There are few case reports of lung involvement by Mycobacterium terrae complex. We reported a 13 years old immunompetent girl with a cavitary opacity seen on chest imaging and bronchoscopy revealed an endobronchial lesion, sputum and tissue specimens revealed growth of Mycobacterium triviale. Our patient is unique as it is the first case reported in Saudi Arabia with this type of Mycobacteria, in addition there is no case reported in the literature with Mycobacterium triviale with endobronchial lesion, the patient treated with a combination of rifampicin, ciprofloxacin and ethambutol for six months, she showed good response with resolution of radiological abnormalities and she did not have relapse after one year of follow up.

Churg Straus syndrome is considered a systemic vasculitis in asthmatic patients with important diagnostic signs of hypereosinophilia, pulmonary infiltration, vasculitic skin lesions and nasal polyps and mononeuritis multiplex also supports this diagnosis. Here we present a patient with long history of asthma, polypectomy, abdominal pains and treatment by different brands of monteleukast.