A 31-Year-Old HIV-Positive Business Traveller With Cough, Shortness of Breath and Night Sweats

2022 ◽  
pp. 61-63
Author(s):  
Robert F. Miller
Keyword(s):  
Hiv Positive ◽  
Shortness Of Breath ◽  
Night Sweats ◽  
Business Traveller

scholarly journals 1373. Clinical Presentation, Demographics, and Outcomes of Cases of Tuberculosis (TB) at Princess Margaret Hospital, Nassau, The Bahamas 2014–2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S498-S498
Author(s):  
Javardo McIntosh ◽  
Nikkiah Forbes ◽  
Kevin Moss ◽  
M Anthony C Frankson
Keyword(s):  
Risk Factors ◽  
Retrospective Chart Review ◽  
Risk Groups ◽  
World Health ◽  
Contact Tracing ◽  
Hiv Positive ◽  
The Bahamas ◽  
Princess Margaret Hospital ◽  
Migrant Populations ◽  
Night Sweats

Abstract Background Tuberculosis (TB) is one of the oldest diseases known to man, yet the world health organization reports that Tuberculosis is one of the top 10 causes of death worldwide. There are various factors that have made the eradication of tuberculosis in the Bahamas difficult such as high rates of HIV infection and immigrants migrating from countries with high TB prevalence. In understanding the epidemiology and risk factors of TB cases in the Bahamas, the development of protocols can improve screening procedures and decrease disease burden. Methods A retrospective chart review of cases of Tuberculosis diagnosed at the Princess Margaret Hospital, Nassau, Bahamas. 189 cases of active tuberculosis diagnosed between 2014–2016 and all cases were evaluated for demographics, risk factors, clinical manifestation, method of diagnosis, symptoms, and treatment outcomes. Results Of the 189 cases of notified tuberculosis between 2014 and 2016, 46 cases were reported in 2014, 60 cases in 2015 and 83 cases in 2016. The mean age was 37.96 (±18.20) years old. 164 (86.8%) presented with symptoms, 19 (10.1%) of cases were diagnosed by routine screening and 6 (3.2%) of cases were diagnosed by contact tracing. 109 (59.9%) were HIV negative and 73 (40.1%) were HIV positive. 144 (76.2%) presented with cough, 84 (44.7%) weight-loss, 80 (42.3%) fever, 44 (23.3%) night sweats, 43 (22.8%) chills, 32 (16.9%) fatigue, and 25 (13.2%) hemoptysis. 126(66.7%) completed the full course of antibiotic therapy, 29(15.3%) patients expired before completing treatment and 18(9.5%) of patients defaulted. Conclusion HIV is a major risk factor for Tuberculosis in the Bahamas and it is advised that all patients diagnosed with TB be tested for HIV. We also advise screening HIV-positive patients for TB. Screening other high-risk groups such as migrant populations would also benefit to reduce the amount of latent TB cases which may progress to active TB. Disclosures All authors: No reported disclosures.

scholarly journals Missed opportunities for tuberculosis investigation in a municipal hospital in Ghana: evidence from patient exit interviews

2020 ◽  
Author(s):  
Joyce B Der ◽  
Daniel J Grint ◽  
Clement T Narh ◽  
Frank Bonsu ◽  
Alison D Grant
Keyword(s):  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Symptom Duration ◽  
Hiv Status ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Tb Treatment ◽  
Symptom Screening ◽  
Night Sweats

Abstract Background We assessed coverage of symptom screening and sputum testing for tuberculosis (TB) in hospital outpatient clinics in Ghana. Methods In a cross-sectional study, we enrolled adults (≥18 years) exiting the clinics reporting ≥1 TB symptom (cough, fever, night sweats or weight loss). Participants reporting a cough ≥2 weeks or a cough of any duration plus ≥2 other TB symptoms (per national criteria) and those self-reporting HIV-positive status were asked to give sputum for testing with Xpert MTB/RIF. Results We enrolled 581 participants (median age 33 years [IQR: 24–48], 510/581 [87.8%] female). The most common symptoms were fever (348, 59.9%), chest pain (282, 48.5%) and cough (270, 46.5%). 386/581 participants (66.4%) reported symptoms to a healthcare worker, of which 157/386 (40.7%) were eligible for a sputum test per national criteria. Only 31/157 (19.7%) had a sputum test requested. Thirty-two additional participants gave sputum among 41 eligible based on positive HIV status. In multivariable analysis, symptom duration ≥2 weeks (adjusted odds ratio [aOR] 6.99, 95% confidence interval [CI] 2.08–23.51) and previous TB treatment (aOR: 6.25, 95% CI: 2.24–17.48) were the strongest predictors of having a sputum test requested. 6/189 (3.2%) sputum samples had a positive Xpert MTB/RIF result. Conclusion Opportunities for early identification of people with TB are being missed in health facilities in Ghana.

scholarly journals Acute Stridor and Respiratory Failure due to Retrosternal Subglottic Stenosis of Unknown Origin

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Tharindu Vithanage ◽  
Gerben Keijzers ◽  
Nicola Jane Willis ◽  
Tara Cochrane ◽  
Linda Smith
Keyword(s):  
Respiratory Failure ◽  
Multidisciplinary Approach ◽  
Unknown Origin ◽  
Subglottic Stenosis ◽  
Upper Respiratory Tract ◽  
Shortness Of Breath ◽  
Oral Antibiotics ◽  
Night Sweats ◽  
Upper Respiratory ◽  
Tone Of Voice

Respiratory failure due to subglottic stenosis is a rare but serious condition. A 22-year-old male presented to the emergency department (ED) with shortness of breath, stridor, and change in tone of voice. The patient did not complain of B-symptoms (fever, weight loss, and night sweats). In the week before this presentation, he was diagnosed with an upper respiratory tract infection with associated bronchospasm and discharged on oral antibiotics and inhaled salbutamol without effect. He developed hypercapnic respiratory failure in the ED after a coughing episode. A normal nasopharyngoscopic examination and a subtle mediastinal abnormality on chest radiograph lead to a working diagnosis of retrosternal subglottic obstruction. The complexities of his airway management and suggestions for multidisciplinary approach are discussed.

scholarly journals A CASE REPORT ON ISOLATED HEMATURIA WITH ANEMIA DUE TO SCHISTOSOMA HAEMATOBIUM

2017 ◽  
Vol 9 (10) ◽  
pp. 251
Author(s):  
Sagar Pamu ◽  
Lakshmi Thakkalapally ◽  
Balakrishna Vuyyala
Keyword(s):  
Schistosoma Haematobium ◽  
Urine Analysis ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
North African ◽  
Medication History ◽  
African Patient ◽  
Chief Complaints ◽  
Night Sweats ◽  
Rbc Count

An unsual case in India was reported with an Isolated Hematuria with Anemia due to Schistosoma Haematobium. A male North African patient aged with 22 years admitted in hospital in Hyderabad with chief complaints of hematuria with dysuria, fever with night sweats and shortness of breath during exercise. His skin appears as pale. His history known that he came to India for his academics. He has a habit of swimming in lake at his country. He has no known past medical history and medication history. His blood reports were found to be low hemoglobin levels and low RBC count. His urine analysis results with reddish colored erythrocytes and crystals with an absence of proteins and casts. Microscopic examination of urine detects Schistosoma Haematobium eggs by using repeated concentration techniques.

scholarly journals Q Fever: An Old but Still a Poorly Understood Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Hamidreza Honarmand
Keyword(s):  
Q Fever ◽  
Antibody Test ◽  
Raw Milk ◽  
Shortness Of Breath ◽  
Animal Products ◽  
Chronic Q Fever ◽  
Dairy Workers ◽  
Night Sweats ◽  
Laboratory Workers ◽  
Acute Q Fever

Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteriaCoxiella burnetii.The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.

Papulonecrotic tuberculid in an HIV-positive patient

2007 ◽  
Vol 18 (9) ◽  
pp. 643-644 ◽  
Author(s):  
Victoria Akhras ◽  
Gill McCarthy
Keyword(s):  
Skin Biopsy ◽  
Immunological Response ◽  
Hiv Positive ◽  
Papular Eruption ◽  
The Face ◽  
Night Sweats ◽  
Focus Of Infection ◽  
History Of ◽  
Haematogenous Spread ◽  
Systemic Symptoms

We present a 33-year-old HIV-positive man who presented with a two-year history of a non-itchy papular eruption, associated with night sweats, headaches, poor memory and weight loss. On examination, he had erythematous papular lesions with necrotic centres on the face, arms and torso with no systemic abnormalities. A skin biopsy eventually led to the diagnosis of papulonecrotic tuberculid, and treatment with quadruple therapy resulted in resolution of his rash and systemic symptoms. Papulonecrotic tuberculid is thought to be a immunological response to Mycobacterium bacillus components in a previously sensitized patient following haematogenous spread from a focus of infection elsewhere. Cultures from the skin are typically negative and there are no acid-fast bacilli seen, but mycobacterial DNA can be detected using polymerase chain reaction. This case is an example of the paradoxical activation of the immune system seen in patients with HIV. It highlights the importance of skin biopsy in patients with unexplained systemic symptoms and a rash, as the differential diagnosis can be wide in HIV.

scholarly journals Clinical Reasoning: Myokymia, Dysautonomia, and Uveitis Researching a Common Denominator

2020 ◽  
Vol 3 (1) ◽  
pp. 22-24
Author(s):  
Mikhail M ◽  
Maurice C
Keyword(s):  
Avascular Necrosis ◽  
Limbic Encephalitis ◽  
Diabetes Type 2 ◽  
Common Denominator ◽  
Shortness Of Breath ◽  
Steroid Use ◽  
Night Sweats ◽  
History Of ◽  
Artery Disease

A 56-year old man, originally from Pakistan, presented with bilateral avascular necrosis of the hips on a background of emphysema, pulmonary fibrosis, coronary artery disease, diabetes type 2 and psoriasis. The cause of the avascular necrosis was unclear, with no recent trauma or steroid use. During his preoperative consultation, he presented dysautonomia requiring an inpatient investigation; the surgery was canceled. He reported a thirty-pound weight loss and a three-week history of night sweats and shortness of breath. While hospitalized, this gentleman presented subacute confusion and fluctuation of his sensorium, compatible with limbic encephalitis. Furthermore, he developed diffuse myokymia involving the axial and appendicular musculature, confirmed by EMG.

scholarly journals Tuberculosis among Health Care Workers

2019 ◽  
Vol 4 (9) ◽  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Close Contact ◽  
Risk Groups ◽  
Hiv Positive ◽  
Bacterial Disease ◽  
Infected People ◽  
Care Workers ◽  
Night Sweats ◽  
Latent Tb

Tuberculosis (TB) is a bacterial disease caused by Mycobacterium Tuberculosis. It spreads form one person to another through air. When infected people with TB cough, sneeze or spit, they propel the TB germs in the air. A person needs to inhale only a few of these germs to be infected. Evidence of TB has been reported in human remains dated thousands of years. About one quarter of the world’s population has latent TB, which means TB bacteria have infected people but are not (yet) ill with the disease and therefore cannot transmit the disease. Tb occurs in specific risk groups such as immigrants, HIV-positive patients, homeless patients, prisoners, and alcoholics. Health care workers, who face frequent occupational exposure, are at particularly high risk. When a person develops active TB, the symptoms (such as cough, fever, night sweats or weight loss) may be latent for many months. This can lead to delays in seeking care and transmission of the bacteria to others. People with active TB can infect 10-15 other people through close contact over the course of the course of a year. Without treatment, 45% of HIV- negative people with TB on average and nearly all HIV- positive people with TB will die. Transmission of tuberculosis (TB) in health care settings to both patients and health care workers has been reported from virtually every country of the world, regardless of local TB incidence. We are presenting the case of an asymptomatic 28- year-old Caucasian male from Europe who initially was being screened for TB for pre-employment purposes.

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