Pneumothoraces are not an uncommon finding in the newborn period. Recurrent pneumothoraces can be associated with complications of prematurity or use of ventilators but can be seen in rapidly progressive cystic lung disease. We report a case of recurrent pneumothoraces in an infant with the rapidly progressive cystic disease in the setting of an absent right pulmonary artery. The patient ultimately underwent pneumonectomy for definitive management of the recurrent unilateral pneumothoraces.
Welcome to Annals of Global Health,Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. The journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. Its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment. The latest journal impact factor is 3.64.Annals of Global Health is supported by the Program for Global Public Health and the Common Good at Boston College. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health. Authors of articles accepted for publication in Annals of Global Health will be asked to pay an Article Publication Charge (APC) to cover publication costs. This charge can normally be sourced from your funder or institution. We are committed to supporting authors from all countries to publish their work in Annals of Global Health regardless of national income level, and to achieve this goal, we waive the Article Publication Charge for manuscripts where all authors are from low-income or lower-middle-income countries (as defined by the World Bank). From time to time, Annals of Global Health publishes Special Collections, a series of articles organized around a common theme in global health. Recent Special Collections have included “Strengthening Women’s Leadership in Global Health”, “Decolonizing Global Health Education”, and “Capacity Building for Global Health Leadership Training”. Global health workers interested in developing a Special Collection are strongly encouraged to contact the Managing Editor in advance to discuss the project.
The following is a concise review of the Pediatric Pulmonary Medicine Core reviewing pediatric pulmonary infections, diagnostic assays, and imaging techniques presented at the 2021 American Thoracic Society Core Curriculum. Molecular methods have revolutionized microbiology. We highlight the need to collect appropriate samples for detection of specific pathogens or for panels and understand the limitations of the assays. Considerable progress has been made in imaging modalities for detecting pediatric pulmonary infections. Specifically, lung ultrasound and lung magnetic resonance imaging are promising radiation-free diagnostic tools, with results comparable with their radiation-exposing counterparts, for the evaluation and management of pulmonary infections. Clinicians caring for children with pulmonary disease should ensure that patients at risk for nontuberculous mycobacteria disease are identified and receive appropriate nontuberculous mycobacteria screening, monitoring, and treatment. Children with coronavirus disease (COVID-19) typically present with mild symptoms, but some may develop severe disease. Treatment is mainly supportive care, and most patients make a full recovery. Anticipatory guidance and appropriate counseling from pediatricians on social distancing and diagnostic testing remain vital to curbing the pandemic. The pediatric immunocompromised patient is at risk for invasive and opportunistic pulmonary infections. Prompt recognition of predisposing risk factors, combined with knowledge of clinical characteristics of microbial pathogens, can assist in the diagnosis and treatment of specific bacterial, viral, or fungal diseases.
Background Pericardial effusion (PE) is associated with obstructive sleep apnea (OSA) in adults but has not been described in children.We present a unique case of PE in a pediatric patient with severe OSA and pulmonary arterial hypertension (PAH).Case Report A 2-year old female with moderate persistent asthma, obesity, and snoring underwent polysomnography.The study showed severe OSA with oxygen saturations in the 40s within a half-hour of sleep.The apnea-hypopnea index was 123.The study was aborted, and the patient was transferred to the intensive care unit.She underwent tonsillectomy and adenoidectomy and discharged on room air.Repeat polysomnography was ordered, but patient did not present for outpatient follow-up.Two years later, the now 4-year old patient presented to the emergency department with dyspnea.Initial asthma therapies were unsuccessful.A chest x-ray showed new cardiomegaly and echocardiogram showed circumferential PE (Figure 1).Clinical Course The patient was admitted to the cardiac intensive care unit and underwent emergent pericardiocentesis with drain placement.Over 1200mL of serosanguinous fluid was removed.A thorough infectious, oncologic, and autoimmune work-up was obtained; except for a weakly positive ANA titer (1:320), all results were negative.The patient improved following drainage but continued to have dyspnea and hypoxia, worse during sleep.CT chest and cardiac MRI showed an enlarged pulmonary artery, septal flattening, and enlarged right heart structures.Cardiac catheterization confirmed PAH with elevated mean pulmonary artery pressures.Patient underwent repeat polysomnography and required initiation of BiPAP due to hypoxia and hypercapnia.She was also discharged on bosentan and sildenafil.Discussion OSA has been associated with cardiovascular complications such as PAH in children.Additional findings in adults include ischemic heart disease and arrhythmias.Pericardial effusion has been noted in over one-third of adults with OSA, and is correlated with obesity, PAH, severity of OSA, and duration of desaturations.PE is a relatively rare occurrence in children and is most commonly neoplastic, idiopathic, or autoimmune in etiology.There are no reports of PE caused by OSA in children.We present this as a possible diagnosis in a patient with PE, severe OSA, and newly diagnosed pulmonary hypertension.Repeat polysomnography after her initial surgery was indicated in this patient.However, this case was complicated by poor outpatient follow-up.Conclusion Pericardial effusion is common in adults with OSA but has not been described in children.This patient's underlying sleep issues may have contributed her cardiac pathology.
