Pulmonary Mycetoma Due To Candida Albicans Masquerading Bronchogenic Carcinoma In A Patient With Type -2 Diabetes Mellitus

Fungal lesions of lung presenting as a mass are called mycetomas. Mycetoma is a conglomeration of cellular debris and mucous with finely woven fungal hyphae present in a cavity in pulmonary parenchyma or a bronchus.The most common infections causing pulmonary mycetoma are aspergillus.Candida species causing pulmonary mycetoma is rare. A70 year old patient of Diabetes and chronic obstructive pulmonary diseases (COPD), presented with acute on chronic respiratory symptoms. On contrast enhanced CT scan of thorax he was diagnosed as having a heterogeneously enhancing mass lesion in left lower lobe and minimal pleural effusion with a provisional diagnosis of neoplasm. Thorough examination of oral cavity revealed thrush. CT guided biopsy confirmed pulmonary candidiasis. Patient responded well to medical treatment. Only a few such cases have been reported in literature.

Study of Etiology of Hepatomegaly with special emphasis on Non Alcoholic Fatty Liver Disease at a teaching hospital

Hepatomegaly may be a presenting sign or symptom of the patient's illness or it may be an incidental finding in patients being examined for various other reasons At present, many patients are diagnosed with liver disease who are asymptomatic and who have been found to have hepatomegaly or abnormalities in biochemical liver tests These asymptomatic or undiagnosed liver diseases are of great concern so as to prevent various life threatening complications and better future outcome of patients. The present study was planned to explore of spectrum of causes of hepatomegaly from common to rare in a teaching hospital. In our cross-sectional study all consecutive patients >18 years old with hepatomegaly detected on clinical examination and/or in ultrasonographic assessment( liver span>15cm)attending as medical outpatient department were enrolled. Depending on the clinical diagnosis based on detailed history and clinical examination, patients were subjected to hematological and biochemical investigations as required.Both infective and non infective causes constituted two equal halves. Acute viral hepatitis and dengue fever (15% each) were the commonest infective causes of hepatomegaly. Among noninfective causes NAFLD was the most common (21%) followed by congestive heart failure (18%). Seasonal variation showed increased prevalence of infective causes during the rainy season while non-infective causes were more common in winter and autumn. Liver diseases are common in our population with diversified etiology,many are asymptomatic or may present only with liver enzyme abnormalities . There is almost equal prevalence of infective and non infective causes for hepatomegly and nonalcoholic fatty liver disease has emerged as an important cause of hepatomegaly.