Dating it complicated issue 69
Our case series outlines the evaluation and management of 3 soldiers exposed to mustard gas during Operation Iraqi Freedom, and reviews the long-term complications of SM exposure.
Previous literature has reported delayed pulmonary effects to include COPD, bronchiectasis, asthma, airway narrowing, and pulmonary fibrosis.
Delayed pulmonary complications are typically exacerbated over time in regards to both severity and frequency.
In most cases of mild sulfur mustard pulmonary toxicity, much of the patients’ evaluation is unrevealing with regards to a pathophysiologic explanation for persistent respiratory complaints.
He was also on atorvastatin for hyperlipidemia for many years. High-resolution chest computed tomography showed extra-luminal gas inferomedial to the right mainstem bronchus and patchy consolidation (Figure 1).
Flexible bronchoscopy showed a protruding surgical staple at the clean-looking anastomotic line confirming partial airway dehiscence Shennib grade 2a (Figure 2).
Exposure can result in cutaneous, ophthalmic, and pulmonary toxicity along with systemic effects to include bone marrow toxicity.
We present a case series of three US soldiers who were inadvertently exposed to SM vapor and liquid after detonating a cache of Iraqi munitions.
Her dyspnea had been present for 2 years and had been progressive.She also reported dry coughing with no history of fever, weight loss, hemoptysis, chest pain, or night sweats.Medical therapy for her proliferative histiocytic condition included etanercept, methotrexate, and prednisone with clearance of the skin lesions at the time of her pulmonary evaluation.Histology showed no evidence of cellular rejection but instead chronic inflammatory infiltrate of the airway with increased eosinophils and organizing pneumonia consistent with an infection or drug reaction.Cultures from bronchoalveolar lavage and lung tissue were negative for viral or fungal infection.