scholarly journals Rare Presentation of Pulmonary Embolism Associated with PCP in a 28-Year-Old Man who was not known to be infected with HIV Before

2020 ◽  
Vol 5 (7) ◽  
pp. 66-72
Author(s):  
Nasser Al-Shekaili ◽  
Ahmed Nada ◽  
Yousif A. Hamad
Keyword(s):  
Pulmonary Embolism ◽  
Opportunistic Infections ◽  
Pneumocystis Pneumonia ◽  
Hiv Positive ◽  
Rare Presentation ◽  
Case Presentation ◽  
Pulmonary Angiogram ◽  
Human Immunodeficiency Viruses ◽  
History Of ◽  
Suspected Pneumonia

Introduction Human Immunodeficiency Viruses (HIV) commonly presented with acute seroconversion symptoms or opportunistic infections from immunosuppression, but first presentation of HIV with pulmonary embolism associated with active Pneumocystis pneumonia (PCP) is very rare. Case presentation A 28-year-old man presented with history of fever and cough associated with dyspnoea over 8 weeks and gradually worsen till maximised 2 week prior to admission. he did not improved inspite of antibiotics for suspected pneumonia. Found to be HIV positive with opportunistic infection. Computed Tomography Pulmonary Angiogram (CTPA) confirmed the presence of pulmonary embolism. He was treated successfully with anticoagulants, steroids, and antibiotics . discharged on base of clinical and radiological improvement. Conclusion Pulmonary embolism can be the first presentation of a newly diagnosed with HIV patient. The similar features of both viral pneumonia and subacute pulmonary embolism can lead to delay diagnosis, especially in the era of covid-19 pandemic infection

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

Beware of cryptococcomas when treating Cryptococcal meningitis

2020 ◽  
Vol 10 (5) ◽  
pp. 183-184
Author(s):  
Rafael Ferreira Nascimento ◽  
Diogo Raposo André, ◽  
Fabiana Gouveia ◽  
Nancy Faria ◽  
Ana Paula Reis
Keyword(s):  
Immunocompromised Patient ◽  
Brain Mri ◽  
Hiv Positive ◽  
Rare Presentation ◽  
Neck Stiffness ◽  
Viral Loads ◽  
Hiv Rna ◽  
Neurological Exam ◽  
History Of ◽  
The Brain

Introduction: The authors describe a rare presentation of central nervous system cryptococcosis in an immunocompromised patient. Case description: An HIV-positive patient, with poor adherence to the treatment, presented with a seventeen days history of severe headache. On the neurological exam there was only evidence of neck stiffness, he had a CD4 count of 23 cells/μl and plasma HIV RNA viral loads of 364,000 copies/ml. Lumbar puncture revealed positive for cryptococcal antigen virus and so treatment with amphotericin B was started. During his admission the patient developed an expressive aphasia with visual hallucinations and the brain MRI revealed cerebral cryptococcomas. After 98 days of treatment general and neurological examination was normal and the patient was discharged home. Conclusion: This case highlights a rare and severe complication of Cryptococcus neoformans infection in immunocompromised patients.

scholarly journals A case-report of widespread pulmonary embolism in a middle-aged male seven weeks after asymptomatic suspected COVID 19 infection

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mats Beckman ◽  
Sven Nyrén ◽  
Anna Kistner
Keyword(s):  
Pulmonary Embolism ◽  
High Frequency ◽  
Laboratory Testing ◽  
Troponin T ◽  
Case Presentation ◽  
Contrast Angiography ◽  
History Of ◽  
Exercise Induced ◽  
Significant Disease

Abstract Background Pulmonary embolism (PE) is seen in high frequency in hospital-treated patients with Covid-19. We present a case of suspected Covid-19 with long-term dyspnea and widespread PE. Case presentation A 51- year old male, with no prior medical history, no medication, and non-smoker arrived at the emergency department with exercise induced dyspnea during 4–5 weeks and for the last 48 h dyspnea at rest. Seven weeks before hospitalization, he felt difficulties taking deep breaths for some days but no other symptoms. Oxygen saturation at rest was 93%. Troponin T was 1200 mg/L (ref < 15 mg/L). CT angiography revealed widespread bilateral segmental pulmonary embolism. Additional findings were ground glass opacities that could match Covid-19. The patient tested negative for SARS -CoV-2. Full dose tinzaparin was given for 2 days in hospital, followed by apixaban for 6 months. Recovery has been uneventful so far. Conclusions Long-term breathing difficulties might be relatively common after non-hospitalized symptomatic Covid-19. The frequency of PE in this group is unknown. We report a case of suspected covid-19 with widespread PE and a long history of dyspnea but no other symptoms. In our case slight hypoxia and laboratory testing indicated significant disease, which was proven with contrast angiography. This case shows that PE is a differential diagnosis in non-hospitalized symptomatic Covid-19 with persisting breathing problems.

scholarly journals Fatal deep venous thrombosis and pulmonary embolism secondary to melioidosis in China: case report and literature review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hua Wu ◽  
Dongliang Huang ◽  
Biao Wu ◽  
Mengjie Pan ◽  
Binghuai Lu
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Fatal Case ◽  
Therapeutic Interventions ◽  
Case Presentation ◽  
Reduce Mortality Rate ◽  
Left Lower Extremity ◽  
Appropriate Treatment ◽  
History Of

Abstract Background Burkholderia pseudomallei is a gram-negative bacterium and the causative pathogen of melioidosis, which manifests a variety ranges of infection symptoms. However, deep venous thrombosis (DVT) and pulmonary embolism (PE) secondary to bacteremic melioidosis are rarely documented in the literature. Herein, we reported a fatal case of melioidosis combined with DVT and PE. Case presentation A 54-year-old male construction worker and farmer with a history of diabetes was febrile, painful in left thigh, swelling in left lower limb, with chest tightness and shortness of breath for 4 days. He was later diagnosed as DVT of left lower extremity and PE. The culture of his blood, sputum and bone marrow samples grew B. pseudomallei. The subject was administrated with antibiotics (levofloxacin, cefoperazone/tazobactam, and imipenem) according to antimicrobial susceptibility testing and low molecular heparin for venous thrombosis. However, even after appropriate treatment, the patient deteriorated rapidly, and died 2 weeks after admission. Conclusions This study enhanced awareness of the risk of B. pseudomallei bloodstream infection in those with diabetes. If a patient has predisposing factors of melioidosis, when DVT is suspected, active investigation and multiple therapeutic interventions should be implemented immediately to reduce mortality rate.

scholarly journals Septic Pulmonary Embolism Secondary to Klebsiella pneumoniae Epididymitis: Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Juan Sebastián Alonso Ojeda Gómez ◽  
Jorge Alberto Carrillo Bayona ◽  
Laura Cristina Morales Cifuentes
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Circulation ◽  
Respiratory Symptoms ◽  
Unusual Complication ◽  
Chest Imaging ◽  
Case Presentation ◽  
History Of ◽  
Septic Pulmonary Embolism ◽  
Uncommon Condition ◽  
Acute Epididymitis

Background. Septic pulmonary embolism (SPE) is defined as the occurrence of septic thrombi in the pulmonary circulation. We report a case of SPE secondary to K. pneumoniae epididymitis. Case Presentation. A 74-year-old male with a history of diabetes mellitus experienced SPE secondary to epididymitis, with isolation of K. pneumoniae in blood and presence of lung nodules, with a chest computed tomography showing the halo and reversed halo signs. Discussion. SPE is characterized by the presence of septic thrombi in the pulmonary circulation coming from an extrapulmonary infective focus. SPE secondary to K. pneumoniae epididymitis is an uncommon condition that is characterized by the presence of multiple bilateral nodules of peripheral distribution. Conclusion. SPE is an unusual complication of acute epididymitis. Suspicion of SPE should be considered in patients with a diagnosis of epididymitis, respiratory symptoms, and multiple nodules in chest imaging assessments.

scholarly journals Isolated Pulmonary Hydatid Cyst: A Rare Presentation in a Young Maasai Boy from Northern Tanzania

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Jay Lodhia ◽  
Ayesiga Herman ◽  
Rune Philemon ◽  
Adnan Sadiq ◽  
Deborah Mchaile ◽  
...  
Keyword(s):  
Rare Presentation ◽  
Case Presentation ◽  
The Public ◽  
Post Procedure ◽  
Northern Tanzania ◽  
Typical History ◽  
History Of ◽  
One Year ◽  
The Right ◽  
Pulmonary Hydatid Cyst

Introduction. Hydatidosis is a parasitic manifestation caused by Echinococcus granulosus. It is characterized by cystic lesions in the liver and lungs. Diagnosis is based on typical history and radiological measures. Case presentation. A four-year-old boy presented with a one-year history of dry cough and difficulty in breathing which was of gradual progression. Computed tomography of the chest revealed a large 11.7 cm×8.6 cm×11.0 cm cyst in the right hemithorax. The patient underwent thoracotomy and recovered well post procedure. Conclusion. This case report highlights that large hydatid cysts can be surgically removed with good outcome and the importance of realizing that the disease is a burden to the public health and is much neglected.

scholarly journals Persistent hiccups as the presenting symptom of a pulmonary embolism

2012 ◽  
Vol 2 (1) ◽  
pp. 2
Author(s):  
Steven Durning ◽  
David J. Shaw ◽  
Anthony J. Oliva ◽  
Michael J. Morris
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
Pulmonary Embolus ◽  
Lower Lobe ◽  
Initial Evaluation ◽  
Unique Case ◽  
Case Presentation ◽  
History Of ◽  
Symptomatic Bradycardia

An 81-year-old male with a history of symptomatic bradycardia controlled by a pacemaker presented to our institution with three days of persistent hiccups. He denied any pulmonary symptoms and his initial evaluation showed no evidence of tachypnea, tachycardia, or hypoxia. Pacemaker malfunction or migration of the pacer leads was ruled out as an etiology and no intracranial pathology was present. Admission chest radiograph was normal but a computed tomography of the chest demonstrated a left lower lobe pulmonary embolus. After treatment with anticoagulation was initiated, the hiccups resolved within the next week. This is a unique case presentation of hiccups as the only presenting symptom of an otherwise asymptomatic pulmonary embolism.

scholarly journals Case of acute pulmonary embolism in post pneumonectomy-a rare clinical presentation and management

2017 ◽  
Vol 5 (8) ◽  
pp. 3745
Author(s):  
Manjunath B. V. ◽  
Bhabani Sahoo ◽  
Gaurav Thakre ◽  
Nitin Gudage
Keyword(s):  
Pulmonary Embolism ◽  
Troponin I ◽  
Clinical Decision ◽  
Leg Pain ◽  
Normal Lung ◽  
Case Scenario ◽  
Pulmonary Infarction ◽  
Pulmonary Angiogram ◽  
Submassive Pulmonary Embolism ◽  
History Of

With a history of right pneumonectomy, pulmonary embolism affecting bilateral pulmonary artery is rare and needs to be meticulously managed to prevent pulmonary infarction of the normal lung with a clinical decision regarding thrombolysis. A 64 years male diabetic and hypertensive with a history of right pneumonectomy 10 years back, presented to ER with dyspnea and 2 episodes of syncope with right leg pain and swelling for 3 days. BP was 140/90mmHg and pulse rate of 100/min. SPO2 in room air was 95%. ECG suggested S1Q3T3 with sinus tachycardia. Echocardiogram revealed features of pulmonary embolism. Venous doppler of right leg showed DVT and CT Pulmonary angiogram was suggestive of pulmonary embolism. High-sensitive troponin I and NT-pro BNP were negative. Diagnosis of submassive pulmonary embolism was made. Protecting the normal lung from infarction was of paramount importance. There was no indication for thrombolysis. Treatment with LMWH was initiated and overlapped with the novel oral anticoagulant (NOAC) dabigatran. Symptomatically patient improved along with a reduction in pulmonary arterial hypertension and improved RV function. Post pneumonectomy of one lung, protecting the normal lung from infarction is utmost important in a setting of pulmonary embolism. It is a rare case scenario. Clinical decision regarding thrombolysis should be taken carefully. In this case thrombolysis was not indicated as per guidelines. LMWH, oral anticoagulation and broad-spectrum antibiotic to prevent secondary lung infection are the mainstay in the treatment of submassive pulmonary embolism where thrombolysis is not indicated.

scholarly journals Case Report: Unprovoked venous thromboembolism in a young adult

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 182
Author(s):  
Jeyhan Dhabhar ◽  
Varshil Mehta ◽  
Nimit Desai ◽  
Sameer Dawoodi ◽  
Sojib Bin Zaman
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Trauma Surgery ◽  
Sudden Onset ◽  
Vein Thrombosis ◽  
Doppler Study ◽  
Pulmonary Angiogram ◽  
Co Morbidity ◽  
History Of ◽  
Prolonged Immobilization

A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The Electrocardiogram showed tachycardia with S1Q3T3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.

scholarly journals Determinants of anemia among HIV positive children on Highly Active Antiretroviral Therapy (HAART) attending hospitals of North Wollo Zone, Amhara Region, Ethiopia, 2019: A case-control study

2019 ◽  
Author(s):  
Biruk Abate Beletew ◽  
Ayelign Mengesha ◽  
Mohammed Ahmed
Keyword(s):  
Rural Area ◽  
Case Control Study ◽  
Opportunistic Infections ◽  
Case Control ◽  
Hiv Positive ◽  
Amhara Region ◽  
Highly Active ◽  
History Of ◽  
North Wollo ◽  
Control Study

Abstract Background: Anemia is one of the most commonly observed hematological abnormalities and an independent poor prognostic marker of HIV disease. The rate of progression and mortality in this subgroup of patients is high compared to non-anemic patients. WHO estimates that over 2 billion people are anemic worldwide and young children bear the world's highest prevalence rate of anemia. In Ethiopia, there is limited information about the determinant factors associated with anemia among HIV positive children. Thus, the main purpose of this study was to assess the determinants of anemia among children on highly active anti-retroviral therapy attending hospitals of North Wollo Zone, Amhara Region, Ethiopia. Methods: A case-control study was conducted on 350 HIV infected children on HAART attending Hospitals of North Wollo Zone, from February 1 to March 30, 2019. The study participants were selected with consecutive sampling technique. An adapted, interviewer-administered, and pre-tested questionnaire and chart review were employed to collect the data. Besides, blood and stool sample was investigated to determine hematologic indices and to investigate intestinal parasites respectively. Data were analyzed by using the SPSS version 24 statistical software and bivariate and multivariate logistic regression was used to identify predictors. Results: A total of 350 HIV positive children (117 cases and 234 controls) were included in this study with an overall response rate of 100%.On multivariate analysis, variables which have spastically significance association with anemia were; had Amebiasis (AOR = 7.29, 1.22 - 43.56), had history of opportunistic infections (AOR = 9.63, 1.94 - 47.85), had malaria infection (malaria pf) (AOR = 4.37, 1.16 - 16.42),eating non-diversified (AOR = 10.39, 2.25 - 48.0), WGT –Age Z score value between -2_-3 (AOR = 9.80, 2.46 - 39.14),level of adherence (AOR = 2.31, 1.92, 7.77) and being from rural area(AOR = 8.8, 2.07 - 37.79). Conclusion: In this study having parasitic infections, history of opportunistic infections, being malnourished, poor adherence to ART, caregivers living in the rural area and eating non-diversified foods were significantly associated with anemia among HIV positive children on HAART.This indicates the need of an integrated package of interventions to design anemia prevention program.

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