RESUMEN
Background: Dengue is one of the most rapidly spreading arboviral infections in the world. Ultrasound is well established in abdomino-thoracic evaluation of patients with dengue infection. The aim of this study was to explore the role of ultrasound in predicting occurrence of severe infection in dengue patients and in predicting deterioration in patients with nonsevere dengue. Methods: The serologically proven dengue patients who reported to hospital during the study period were divided into three categories based on the dengue infection severity score. Ultrasound findings of abdomen and chest in these patients were noted in the initial, as well as follow-up scans and inferences drawn. Results: 61% belonged to the category of Dengue Fever, 35% were in Dengue Hemorrhagic Fever category, and 4% had Dengue Shock Syndrome. Positive ultrasound findings were seen to be significantly higher in patients with severe dengue. Logistic regression analysis revealed the presence of pericholecystic fluid to be significantly associated with the severe disease, while the presence of gall bladder wall edema, ascites, and any ultrasound finding were significantly associated with the disease progression. The odds of a patient with severe dengue having gall bladder wall edema, ascites, or any ultrasound finding were 2.74, 2.04, and 2.619 times, respectively. Conclusion: Our study indicates that positive findings on ultrasound are significantly higher in severe dengue and also that ultrasound can be reliably used to identify the patients with nonsevere dengue who are likely to progress to severe dengue.
RESUMEN
BACKGROUND: Pulmonary and pleural involvement is fairly common in patients with lymphoma, especially in the setting of progressive or recurrent disease. Pleuropulmonary involvement in lymphoma may occur as a single pattern or as a combination of multiple patterns which can often mimic unrelated pathologies. METHODS: Review of our institutional database from 01 Jan 2015 to 04 Oct 2017 revealed 90 patients with pulmonary and/or pleural lesions attributable to lymphoma. These lesions were classified into various categories, and the pattern of involvement was evaluated. RESULTS: Pulmonary involvement was seen in 17.6% of patients with Hodgkin lymphoma (HL) and in 10.5% of patients with non-Hodgkin lymphoma (NHL), whereas pleural involvement was seen in 6.5% of patients with NHL. Almost all the patients in our study had findings belonging to multiple categories. Pulmonary involvement in patients with HL was seen in the form of nodules (51.6%), masses (51.6%), and direct extension from a mediastinal/hilar mass (45.2%). Patients with NHL had pulmonary involvement in the form of nodules (42.4%), direct extension from a mediastinal/hilar mass (25.4%), pulmonary masses (18.6%), and interstitial pattern (2.4%). Pleural thickening (61.5%), masses (30.8%), and effusion (15.4%) were the three patterns of pleural involvement. CONCLUSION: Nodules and masses were the two commonest patterns of pulmonary involvement in patients with HL, whereas nodules were the commonest pattern noted in patients with NHL. Pulmonary masses were seen more commonly in patients with HL than in those with NHL. Pleural involvement was seen exclusively in patients with NHL.