The First Reported Case of Elizabethkingia anophelis From Nepal.

Elizabethkingia anophelis, a gram-negative bacillus belonging to the Flavobacteriaceae family, is found in various environmental sources and has been associated with community and hospital outbreaks. Correct identification is crucial, guided by advanced genomic techniques, i.e., matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system with an updated database. The case fatality rate, ranging from 24 to 60%, underscores the need for timely recognition and appropriate management. Additionally, Elizabethkingia presents a challenge due to its recent discovery, misidentification history, and drug resistance. Here, we present a case of fatal infection in a 30-year-old male, who presented with pneumonia. It gradually progressed and ultimately proved fatal underscoring the virulence of the pathogen involved. It was a diagnostic challenge as it likely is the first reported instance of Elizabethkingia anophelis infection from Nepal.

Pleural Effusion: An Uncommon Manifestation of Hepatitis.

Hepatitis A virus infection is the commonest form of hepatitis in pediatric age group and common health problem in developing countries due to poor sanitation. The clinical spectrum of hepatitis A virus infection ranges from asymptomatic infection to fulminant hepatitis and the symptoms are primarily hepatobiliary or constitutional. Here, we present a case of 16 years old male who presented with complains of fever, vomiting, anorexia, right sided abdominal pain, shortness of breath and cough. On clinical examination, patient has hepatomegaly and decreased breath sounds on right sided mammary, infra- mammary and infra scapular region. Blood investigations showed aminotransferases while pleural effusion and ascites with thickened gall bladder were found in chest x-ray and abdominal ultrasonography respectively. In absence of others causes, pleural effusion can be a rare complication of hepatitis A. Thus, this complication should be kept in mind in endemic countries in clinically matching scenarios. Keywords: Acalculous cholecystitis; ascites; hepatitis A; pleural effusion.

Small Cell Lung Carcinoma with Pancoast Syndrome: A Case Report.

Small cell lung cancer mostly arises centrally in the large bronchi. The literature search revealed very limited cases of small cell lung cancer arising at the upper part of the pulmonary sulcus near the thoracic inlet as superior sulcus tumor and also manifesting with typical Pancoast syndrome. We report a case of a 71 years old male patient, presenting with features of Pancoast syndrome including Horner's syndrome with completed three cycles of chemotherapy resulting in partial response which concludes that small cell lung carcinoma has to be considered despite the clinical findings like pancoast syndrome.

Mesothelioma with Nonbacterial Thrombotic Endocarditis: A Case Report.

Non-bacterial thrombotic endocarditis is a rare condition characterized by noninfectious vegetation on cardiac valves which are often associated with malignancy. It often presents with features of embolism rather than cardiac failure. These are usually seen in autoimmune conditions, disseminated intravascular coagulation, malignancy of gut and lung but has also been reported in other malignancies as well. This entity is rare but one must have a clinical suspicion of the disease especially in a patient suffering from malignancy presenting with the embolic phenomenon. In this report, we are presenting a case of non-bacterial thrombotic endocarditis in an inpatient with pleural mesothelioma, a rare malignant neoplasm arising from pleura in a 35 years old mason, and a rare association as well.

Bronchoscopic visualization of a cavity in entirety: an unusual finding.

It is unusual to be able to visualize an entire cavity with such clarity.

Rare Cause of Tension Pneumothorax: Hydatid Disease of Lung: A Case Report.

Lung is the second most common site of hydatid disease, after liver. Pleural involvement of hydatid disease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst into the pleural space. When a patient presents with tension pneumothorax, zoonotic infections, especially hydatid disease of the lung, also has to be considered especially in areas with high burden of the disease. We report a 31 years male patient presenting with tension pneumothorax due to rupture of hydatid cyst of lung.