RESUMEN
We report the case of a 41-year-old patient with no family history of sudden cardiac death. The patient presented with high fever and vomiting and was diagnosed with acute pyelonephritis. Screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was positive. An electrocardiogram (ECG) performed during a fever episode revealed a Brugada pattern. Fever can be a trigger for induction of the electrocardiographic Brugada pattern but it is still unknown if the cardiac involvement by coronavirus disease 2019 (COVID-19) can interfere with myocardial ion channels.
RESUMEN
Hypersensitivity pneumonitis is understood to be a delayed allergic reaction to the repeated exposure of a usually innocent inhaled agent, causing inflammatory damage to the pulmonary parenchyma, alveoli and terminal bronchioles. With ongoing exposure, it can cause respiratory compromise and pulmonary fibrosis. Recognizing the heterogeneity of the causative agents and the low incidence of the disease, we considered it important to report the case of a greenhouse worker who developed a Cladosporium sp. related hot-tub lung hypersensitivity pneumonitis. We believe it to be the first reported case of a greenhouse occupational hypersensitivity pneumonitis due to Cladosporium sp. LEARNING POINTS: Enquiring about environmental and occupational exposure during anamnesis is fundamental, particularly when addressing respiratory tract symptoms.The mainstay management of hypersensitivity pneumonitis is based on eviction of the offending agent and control of inflammation, currently with corticosteroids.Antigen source removal may entail important psychological, social and economic consequences for the patient and will need a multidisciplinary approach.
RESUMEN
Bilateral deep vein thrombosis (DVT) should prompt investigation for pro-thrombotic conditions and the exclusion of vascular compromise due to intrinsic and extrinsic factors. The authors present the case of a 47-year-old man admitted with bilateral DVT and diagnosed with inferior vena cava (IVC) infra-renal segment agenesis, and discuss the management of this rare condition. LEARNING POINTS: Bilateral deep vein thrombosis in young and otherwise healthy individuals should prompt investigation of the aetiology and risk factors in case life-long treatment and anticoagulation therapy is required.Although rare, anatomical variations and congenital malformations should be considered even in adult patients.Rare medical cases should prompt a multidisciplinary approach to investigation and treatment, as prognosis will depend on both therapeutic procedures and anticipation of complications.
