RESUMEN
Gross electrolytes disturbances including hypokalemia, hypomagnesaemia, and hypocalcaemia have been reported in tuberculosis patients who have been treated with capreomycin.1-3 Capreomycin is recommended in the treatment of M. tuberculosis isolates resistant to kanamycin at baseline in multi drug resistant tuberculosis patients (MDR - TB) and treatment of extensively drug resistant tuberculosis (XDR-TB) under programmatic management of drug resistant tuberculosis (PMDT) in India.4 We report a case of tetany in a extensively drug resistant tuberculosis (XDR-TB) patient treated with capreomycin. She developed hypokalemia after 7 weeks of administration of injection capreomycin intramuscularly daily in dose of 750 mg. Hypokalemia was refractory to intravenous potassium replacement therapy. At 12 weeks during the treatment she developed tetany and hypocalcaemia. Hypomagnesaemia was also associated with hypocalcaemia and hypokalemia. Normal level of serum potassium and calcium were achieved with correction of hypomagnesaemia.
Asunto(s)
Antibióticos Antituberculosos/uso terapéutico , Capreomicina/uso terapéutico , Tuberculosis Extensivamente Resistente a Drogas , Mycobacterium tuberculosis , Tetania/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos , Antituberculosos , Femenino , Humanos , India , Pruebas de Sensibilidad MicrobianaRESUMEN
Idopathic pulmonary artery aneurysm (PAA) is a rare lesion. Clinical experience with this condition is limited and current knowledge is mainly derived from autopsy findings. We report a patient who came to us with complaints of chest pain, breathlessness on exertion and pedal oedema and was diagnosed to have PAA.
Asunto(s)
Aneurisma/diagnóstico , Isquemia Miocárdica/diagnóstico , Arteria Pulmonar/diagnóstico por imagen , Antagonistas Adrenérgicos beta/uso terapéutico , Diagnóstico Diferencial , Diuréticos/uso terapéutico , Quimioterapia Combinada , Ecocardiografía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Negativa del Paciente al TratamientoRESUMEN
Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated inflammatory disease caused by hypersensitivity to Aspergillus fumigatus. A wide spectrum of plain radiographic appearances has been described in ABPA, though none are pathognomonic of ABPA. The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions. However, miliary nodules as a radiological presentation of ABPA are very rare and only one case has been reported in literature. It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.
RESUMEN
Tuberculosis (TB) is a disease as old as mankind, whereas in India the first case of Human Immunodeficiency Virus (HIV) was reported in 1986. HIV and TB are so closely connected that their relationship is often described as a co-epidemic. Aspergilloma (Fungal Ball, Mycetoma) represents a saprophytic growth of aspergillus that colonizes in the preformed cavities commonly due to pulmonary tuberculosis (PTB). We report a case of HIV, active pulmonary tuberculosis and aspergilloma occurring in the same patient. Despite our best efforts, we could not lay our hands on any similar case in the medical literature.
Asunto(s)
Infecciones por VIH/complicaciones , VIH/inmunología , Aspergilosis Pulmonar/complicaciones , Tuberculosis Pulmonar/complicaciones , Aspergillus/aislamiento & purificación , Líquido del Lavado Bronquioalveolar/microbiología , Broncoscopía , Diagnóstico Diferencial , Anticuerpos Anti-VIH/análisis , Infecciones por VIH/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Aspergilosis Pulmonar/diagnóstico , Radiografía Torácica , Tomografía Computarizada por Rayos X , Tuberculosis Pulmonar/diagnósticoRESUMEN
Opportunistic infections are common complications of advanced immuno-deficiency in individuals with Human Immunodeficiency Virus (HIV) infection. Following involvement of the lung, the central nervous system (CNS) is the second most commonly affected organ. We report two cases of concurrent cryptococcal meningitis and tuberculosis (TB) in HIV infected persons. A high suspicion of multiple opportunistic infections should be kept in mind in HIV seropositive individuals.