Late Presentation of Pulmonary Aplasia in Adulthood: A Report of a Rare Case.

Aplasia of the lung is an uncommon congenital anomaly that can resemble several common illnesses radiologically and presents as an opaque hemithorax with ipsilateral displacement of the mediastinum. This case scenario involves a young woman who has been experiencing recurrent pulmonary tract infections and worsening dyspnea since childhood, presenting as pneumonic consolidation on a chest X-ray. The case explores the importance of lung scans, CT pulmonary angiography, and bronchoscopy to elicit the absence of lung parenchyma on one side.

Kikuchi-Fujimoto Disease: A Rare Presentation in a Young Male.

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare benign condition characterized by cervical lymphadenopathy and constitutional symptoms mimicking tuberculosis. We present the case of a 22-year-old male who presented with fever, dry cough, loss of appetite, multiple joint pains for 15 days, and loss of weight for one month. Physical examination revealed palpable cervical, occipital, axillary, and inguinal lymphadenopathy, and laboratory investigations were within normal limits except for raised erythrocyte sedimentation rate (ESR). Contrast-enhanced computed tomography (CECT) showed mediastinal lymphadenopathy with no pleuroparenchymal abnormality of the lung. Excision biopsy of a cervical lymph node confirmed necrotizing lymphadenitis consistent with KFD. The patient was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, resulting in the resolution of symptoms and regression of lymphadenopathy. This case signifies the importance of considering KFD in the differential diagnosis of lymphadenopathy and highlights the significance of histopathological evaluation for accurate diagnosis and management guidance.

Invasive Pulmonary Aspergillosis in an Immunocompetent Patient: An Atypical Presentation.

Invasive pulmonary aspergillosis (IPA) is a severe fungal infection primarily affecting immunocompromised individuals. However, rare cases of IPA in immunocompetent patients have been reported, presenting diagnostic and therapeutic challenges. Here, we present a case of a 41-year-old immunocompetent male who presented with fever, cough with mucoid expectoration, and breathlessness. Despite the absence of traditional risk factors, imaging and laboratory findings led to the diagnosis of IPA. Prompt initiation of antifungal therapy resulted in clinical improvement. This case highlights the importance of considering IPA in the differential diagnosis of respiratory symptoms, even in immunocompetent individuals.

Multiple Myeloma Presenting With Bronchopneumonia: A Case Report.

Multiple myeloma is a disease of the plasma cells of the bone marrow, resulting in the proliferation and release of the monoclonal protein, which further causes end-organ damage. We report an unusual presentation of multiple myeloma, thereby insisting on the need for the treating physician to be aware of the various presentations that can be encountered in regular practice. It is often difficult to diagnose, and the diagnosis is usually made at a late stage of the disease. Even though uncurable, with recent advances, a proper regimen, newer chemotherapeutic agents, and stem cell transplantation, the disease can be brought into remission.

Outcome of COVID-19 infection and the impact of COVID-19 vaccination in chronic kidney disease patients: A single-center study.

Introduction: Chronic kidney disease (CKD) patients have increased vulnerability to infections including Covid-19. There is limited availability of antiviral in CKD patients. All guidelines have prioritized vaccinations for CKD patients. The variability in immunogenic response is multifactorial in CKD group. We have tried to analyze the outcome of Covid-19 infection and the impact of COVID-19 vaccination [COVAXIN / COVISHIELD] in our cohort. Materials Methods and Statistical Analysis: In a retrospective observational study, 73 cases of Covid-19 positive CKD patients were selected, who were managed as per MOFHW guidelines. The data of first laboratory values and radiological findings were evaluated. Their treatment outcome and stay during hospitalization were studied. All data were later analyzed using STATA 16.1 software. Results: In this study, 73 cases of CKD with Covid-19 were included. There were 38 patients who were vaccinated with at least one dose of the Covid-19 vaccine, while there were 35 patients who were unvaccinated. Out of 38 patients, 20 were vaccinated with 2 doses of Covid-19 while 18 received only one dose. The unvaccinated group was having more hypoxia and raised inflammatory markers, and had more lung involvement [i.e. higher CT severity value] [p value for CTSS-0.0765]. There was a higher mortality rate observed in the unvaccinated group [i.e-65.71%] than the vaccinated group [39.47%] [p-value 0.0249]. Dialysis was needed in 57.50% of the study population either due to failure of conservative management for renal failure or due to maintenance dialysis. The mean duration of hospitalization was 11.47 days with a mortality rate of 52% which is much higher than the reported average data in CKD patients. Conclusion: Vaccination seems to be very helpful in combating the adverse effect of Covid-19 in CKD patients. It also reduces mortality significantly in Covid-19 infected CKD patients.

Résumé Introduction: Il existe une différence entre les sexes dans les caractéristiques démographiques, cliniques et les résultats des patients atteints d'IRA associée à une chirurgie cardiaque et vasculaire. Méthodes: Cette étude rétrospective a eu un total de 88 participants pour lesquels les données socio-démographiques, cliniques et de laboratoire (électrolytes sériques, numération globulaire complète, analyse d'urine et volume d'urine, taux de créatinine et de filtration glomérulaire) des participants ont été prises avant et après l'opération. jours 1, 7 et 30. Résultats: Au total, 88 participants (66 hommes et 22 femmes) ont été étudiés. Les maladies des valves cardiaques étaient plus fréquentes chez les femmes que chez les hommes. L'âge moyen des participants était de 65,9 ± 6,9 ans, avec des hommes de 65,1 ± 7,6 ans et des femmes de 68,3 ± 8,4 ans, P = 0,02. Avant la chirurgie, une proportion significativement plus élevée de femmes avaient un dysfonctionnement rénal par rapport aux hommes, P = 0,003. La chirurgie valvulaire et le pontage coronarien étaient les chirurgies les plus courantes. La proportion de chirurgies d'urgence et d'admissions de moins de 7 jours était significativement plus élevée chez les femmes que chez les hommes, P = 0,04 et P = 0,02 respectivement. La récupération complète de l'IRA était significativement plus élevée chez les hommes, car la récupération partielle et la mort étaient significativement plus faibles chez eux, P = 0,02. Sur les 35 (39,8%) qui ont été dialysés, 85,7% se sont complètement rétablis, 5,7% sont devenus dépendants de la dialyse tandis que 8,6% sont décédés. Conclusion: Les hommes atteints d'IRA étaient plus jeunes que les femmes. Les chirurgies valvulaires étaient les plus courantes. Le dysfonctionnement rénal de base et l'âge avancé étaient des facteurs de risque d'IRA. Après l'opération, l'IRA était plus fréquente chez les hommes qui étaient plus susceptibles de récupérer une fonction rénale complète. L'optimisation de la préparation des patients pourrait réduire l'incidence de CVS-AKI. Mots-clés: Chirurgie cardiaque et vasculaire associée insuffisance rénale aiguë, dialyse, récupération de la fonction rénale, chirurgie valvulaire.