3/1/2024 0 Comments Bagpipe player windows 10A HRCT follow-up scan from (day 73) of the thorax demonstrated regressive interstitial infiltrates bipulmonal, regressive ground glass opacities predominating in the right middle-lobe and unchanged markedly subpleural fibrotic changes on both lung fields ( Fig. These examinations were performed on day 0–4.Īn externally performed computed tomography of the thorax (day – 49) showed subpleural reticular bronchiectasis (DD fibrotic changes) and mosaic perfusion with nodular densities in the right upper lobe. There were no abnormal results in other blood analyses. Blood gas analysis breathing ambient air revealed the following results: pH = 7.41, pCO2 = 37.6 mmHg, pO2 = 67.5 mmHg, TLCO 23%, demonstrating a severe disorder of gas exchange. Microbiological examination of the BALF revealed no evidence of fungal growth, mycobacteria or disease-causing bacteria. Cytology of the bronchoalveolar lavage fluid (BALF) showed no malignant cells, a lymphocytosis of 17% was found with a CD4/CD8 quotient of 1:2.5 (normal: 0.7–2.8) and CD56-NK cells of 12.1% (normal: 5–29%). A bronchoscopy with bronchoalveolar lavage was performed. Transthoracic echocardiography and ECG were inconspicuous. The lung function test showed a moderate restrictive respiratory disorder: total lung capacity 4.18 L, 59% predicted, vital capacity 2.26 L, 57% predicted, FEV1 1.95 L, 68% and residual volume 1.92 L, predicted 68%. Oxygen saturation at rest was 97% with no dyspnea, after walking exercise significant drop of oxygen saturation to 91%, dyspnea of 3 on the Borg scale (range 0–10) and no muscular exhaustion. The six - minute walk distance was slightly reduced with 398 m. Apart from that, there were no abnormal results in physical examination. Physical examination yields in the auscultation of the lungs crackles. The patient was playing the bagpipe for 20 years. During his life he was a nonsmoker and worked in the office. His medical history revealed no previous pulmonary or autoimmune disease. A 79 - year old man presented to the pneumology outpatient department on (day 0) with a six months' history of exertional dyspnea and weight loss of seven kilograms.
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