This study evaluated 330 elderly patients, including both inpatients and outpatients, to investigate the frequency, morphology, and distribution of tracheobronchial calcification using computed tomography, as well as its association with cardiovascular calcification. Tracheobronchial calcification was found to be more common in female patients and was frequently accompanied by respiratory complications such as airway deformation, mucus plugging, atelectasis, and aspiration pneumonia. Calcifications of the aorta and coronary arteries were also commonly observed in conjunction. These findings suggest that tracheobronchial calcification may influence respiratory function, complicate perioperative airway management, and contribute to the development of cardiovascular diseases. In an aging society, awareness of the clinical implications of tracheobronchial calcification will be increasingly important for comprehensive care of the elderly.

A 72-year-old woman presented with dyspnea and was referred to our hospital after being diagnosed with pneumonia at a previous clinic. Imaging revealed bilateral pneumonia, and she was admitted to the intensive care unit due to respiratory failure. A nasopharyngeal swab tested positive for human metapneumovirus (hMPV) by multiplex PCR and rapid antigen testing. Sputum culture yielded no significant bacterial pathogens, and a diagnosis of severe pneumonia caused by hMPV was made. The patient improved with steroid pulse therapy and supportive care under mechanical ventilation. Reports of severe community-acquired pneumonia due to hMPV in adults are rare, and we report this valuable case.

Re-expansion pulmonary edema (RPE), caused by spontaneous pneumothorax, is a complication that can lead to death in severe cases, and rapid lung re-expansion has been reported as a risk factor for developing this complication. We experienced a case of RPE due to uncontrolled subcutaneous emphysema, which occurred after clamping a large-diameter drain despite attempts to slowly inflate the lung. On the other hand, a different patient with a small-diameter drain developed RPE after surgery because the lung did not expand sufficiently. Since it is often difficult to obtain appropriate lung re-expansion at the intended rate, it is important to always be prepared for the occurrence of severe RPE when treating patients with spontaneous pneumothorax, and to avoid missing the opportunity to perform tracheal intubation when treating cases who demonstrate RPE.