Postpneumonectomy-like syndrome presenting in a patient with treated pulmonary tuberculosis: a case report

Postpneumonectomy syndrome is a rare condition that is characterized by dyspnea resulting from an extreme mediastinal shift and bronchial compression of the residual lung following surgical pneumonectomy. It is even rarer for this syndrome to present in patients without a history of prior lung surge...

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Bibliographic Details
Published in:Journal of medical case reports 2013-02, Vol.7 (1), p.40-40, Article 40
Main Authors: Kam, Jennifer C, Dieguez, Javier, Doraiswamy, Vikram, Alberaqdar, Enis, Ramchandran, Aparna, Adelman, Marc, Klukowicz, Alan J, Miller, Richard A
Format: Article
Language:English
Subjects:
Antitubercular agents
Care and treatment
Case Report
Case studies
CT imaging
Health aspects
Patient outcomes
Pneumonectomy
Pulmonary tuberculosis
Risk factors
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Summary:Postpneumonectomy syndrome is a rare condition that is characterized by dyspnea resulting from an extreme mediastinal shift and bronchial compression of the residual lung following surgical pneumonectomy. It is even rarer for this syndrome to present in patients without a history of prior lung surgery but induced by autopneumonectomy due to parenchymal disease, an entity termed 'postpneumonectomy-like syndrome'. We present a rare case of a 91-year-old Puerto Rican man presenting with progressively worsening dyspnea with a history of pulmonary tuberculosis diagnosed 40 years earlier who developed severe unilateral lung fibrosis. Plain X-ray and computed tomography scans confirmed the presence of postpneumonectomy-like syndrome secondary to his parenchymal lung destruction. The patient developed cor pulmonale due to his extensive lung disease and as a consequence was not a suitable candidate for surgical intervention. The patient was otherwise stable until he developed acute respiratory distress from an acute upper gastrointestinal bleed and died four days into his hospital course. We present a rare case of postpneumonectomy-like syndrome as sequelae of severe pulmonary parenchymal tuberculosis infection along with a review of literature, in the hopes of aiding clinicians to include the differential of postpneumonectomy-like syndrome in patients presenting with worsening dyspnea without a history of surgical lung resection.
ISSN:1752-1947
1752-1947
DOI:10.1186/1752-1947-7-40