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Compound Qinlan Oral Liquid (,CQOL) is derived from Yinqiao San (), which is composed of Jinyinhua (Lonicerae Japonicae Flos), Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus) and Banlangen (Isatidis Radix). It is a common clinical herbal medicine for clearing heat and detoxification, and has antiviral effects. By reviewing the active ingredients of CQOL and the research progress on its anti-influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) efficacy, with view to providing a basis for the clinical use of CQOL in treatment of respiratory diseases caused by SARS-CoV-2.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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The COVID-19 has placed pandemic modeling at the forefront of the whole world's public policymaking. Nonetheless, forecasting and modeling the COVID-19 medical waste with a detoxification center of the COVID-19 medical wastes remains a challenge. This work presents a Fuzzy Inference System to forecast the COVID-19 medical wastes. Then, people are divided into five categories are divided according to the symptoms of the disease into healthy people, suspicious, suspected of mild COVID-19, and suspicious of intense COVID-19. In this regard, a new fuzzy sustainable model for COVID-19 medical waste supply chain network for location and allocation decisions considering waste management is developed for the first time. The main purpose of this paper is to minimize supply chain costs, the environmental impact of medical waste, and to establish detoxification centers and control the social responsibility centers in the COVID-19 outbreak. To show the performance of the suggested model, sensitivity analysis is performed on important parameters. A real case study in Iran/Tehran is suggested to validate the proposed model. Classifying people into different groups, considering sustainability in COVID 19 medical waste supply chain network and examining new artificial intelligence methods based on TS and GOA algorithms are among the contributions of this paper. Results show that the decision-makers should use an FIS to forecast COVID-19 medical waste and employ a detoxification center of the COVID-19 medical wastes to reduce outbreaks of this pandemic. © 2023, Crown.
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Post-covid syndrome is characterized by a spectrum of persistent symptoms that do not disappear for many months, which may be due to an inadequate immune system response. This leads to a discussion of potentially new methods immunorehabilitation with the use of effective enterosorbents. The aim of the study was to assess the clinical effectiveness of enterosorbents and immunological parameters of patients with a long-term "post-covid syndrome" who have undergone a new coronavirus infection COVID-19. In n pilot monitored open non-randomized experimental clinical observationanl study 33 patients who had a novel coronavirus infection with COVID-19 underwent comprehensive treatment with the inclusion of azoximer bromide (Polyoxidonium) and colloidal silicon dioxide (Polisorb MP). Analysis of clinical and laboratory data showed that after immunorehabilitation, most of the indicators characterizing the state of the immune system in patients who had COVID-19 were restored to control values. And the use of enterosorbents in complex immunorehabilitation therapy is justified and confirmed by the relief of dyspeptic and asthetovegetative syndromes, which makes it possible to recommend it for use in complex treatment.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
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When COVID-19 ARDS abolishes pulmonary function, VV-ECMO can provide gas exchange. If oxygenation remains insufficient despite maximal VV-ECMO support, the addition of esmolol has been proposed. Conflict exists, however, as to the oxygenation level which should trigger beta-blocker initiation. We evaluated the effect of esmolol therapy on oxygenation and oxygen delivery in patients with negligible native lung function and various degrees of hypoxemia despite maximal VV-ECMO support. We found that, in COVID-19 patients with negligible pulmonary gas exchange, the generalized use of esmolol administration to raise arterial oxygenation by slowing heart rate and thereby match native cardiac output to maximal attainable VV ECMO flows actually reduces systemic oxygen delivery in many cases.
Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Respiratory Distress Syndrome , Humans , Respiratory Distress Syndrome/therapy , COVID-19/complications , COVID-19/therapy , Hypoxia/drug therapy , Hypoxia/etiology , OxygenABSTRACT
Compound Qinlan Oral Liquid (,CQOL) is derived from Yinqiao San (), which is composed of Jinyinhua (Lonicerae Japonicae Flos), Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus) and Banlangen (Isatidis Radix). It is a common clinical herbal medicine for clearing heat and detoxification, and has antiviral effects. By reviewing the active ingredients of CQOL and the research progress on its anti-influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) efficacy, with view to providing a basis for the clinical use of CQOL in treatment of respiratory diseases caused by SARS-CoV-2.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Aim To assess the safety and efficacy of extracorporeal therapy in patients with COVID-19. The study included 27 patients aged 67+/-9.7 [min 38, max 87] years with a laboratory-confirmed SARS-CoV-2 and bilateral polysegmental pneumonia, various concomitant chronic diseases who were admitted to Intensive Care Unit and received extracorporeal therapies. All patients had the mean NEWS score of 6.9+/-2.7 [min 4, max 9] and the mean SOFA score of 8.1+/-3.1 [min 3, max 16] at admission Methods to the ICU. 19 patients (70.4%) had severe lung lesions over 75% according to the chest CT scans. 48 extracorporeal therapies were performed using the Multifiltrate (Fresenius Medical Care, Germany) and Aquarius (Nikkiso Aquarius RCA, Great Britain) medical devices. Indications for extracorporeal therapy initiation included cytokine storm associated with acute respiratory distress syndrome and septic shock. Generally, each patient received at least one extracorporeal therapy. 11 patients underwent 2 to 6 sessions. Isolated plasma separation and hemoperfusion helped to reduce vasopressor / cardiotonic support, slightly improved ventilation parameters, with a significant, but not long-term decrease in the levels of inflammation markers. Combining different modalities of extracorporeal therapy that provide rapid elimination of agents, controlled temperature response and hydration, maintaining Results homeostasis and detoxification, appeared to be most optimal. Extracorporeal therapy did not improve the volume of lung parenchyma or lung parenchyma damage. However, 19 (70.4%) patients who received extracorporeal therapy transitioned from mechanical ventilation to spontaneous breathing, whereas 8 (29.6%) patients had severe lung lesions (over 75%) according to the repeated chest CT scans. The mean length of stay in the ICU among survivors was 9+/-3.5 [min 4, max 22]. The 28-day mortality and in-hospital mortality rate was 25.9% (7). Prolonged extracorporeal therapy in patients with SARS-Cov-2 has demonstrated Conclusion efficacy in relieving organ dysfunctions and shock states, but did not significantly affect the remaining lung parenchyma damage.Copyright © 2022 University of Latvia. All Rights Reserved.
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SARS-CoV-2 is a kind of coronavirus that produces Covid-19 illness, which is still a public health concern in Indonesia. Meanwhile, an effective drug has not yet been found and although vaccination has been carried out, in several regions and neighboring countries there is still an increase in Covid-19 cases. This study aimed to obtain bioactive compounds from sea urchins (Echinometra mathaei) that have greater antiviral potential and lower toxicity than remdesivir. This research was started by predicting druglikeness with SwissADME, followed ADMET predicition with pkCSM online, and docking of molecule using the Molegro Virtual Docker (MVD) 5.5 software against the main protease (Mpro) target (PDB ID: 6W63). The results showed that six compounds from sea urchins (Echinometra mathaei) had antiviral activity, where the bioactive compound from sea urchins (Echinometra mathaei) with the highest affinity was shown by Spinochrome C a smaller rerank score compared with Remdesivir and native ligand (X77). So that Spinochrome C compounds are candidates as SARS-CoV-2 inhibitors potential developed drug.Copyright Published by Oriental Scientific Publishing Company © 2023.
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Background: Acute Alcohol Withdrawal Syndrome (AWS) is a severe disorder that affects many patients admitted to the Intensive Care Unit (ICU). Current treatments include the use of benzodiazepines and the Critical Institute Withdrawal Assessment tool (CIWA-Ar). Improper use of this assessment tool can lead to inappropriate dosing of medications leading to adverse patient outcomes. In recent years, a newer and more effective assessment tool has emerged. The Modified Minnesota Detoxification Scale (mMINDS) has shown a significant decrease in the usage of benzodiazepines and the incidence of respiratory distress, delirium, and decreased length of stay (LOS) in the ICU for AWS patients. Methods: The Promoting Action Research Implementation in Health Service (PARiHS) conception model and the Donabedian model for evaluation of health care were used to support the development and implementation of the intervention. After receiving education on the mMINDS assessment tool, nurses assessed AWS patients over one month and tracked their LOS in the ICU. This measurement was compared to the ICU length of stay for AWS patients treated with the CIWA-Ar assessment tool.Intervention: Nurses assessed patients suffering from acute alcohol withdrawal using the mMINDS assessment tool. Pre- and post-intervention data was collected on the length of stay in the ICU for each patient. Simple statistical analysis compared the LOS in the ICU between the pre- and post-intervention groups. Results: Patients who were assessed with the mMINDS alcohol withdrawal assessment tool had a decreased LOS in the ICU by 12 hours or 0.5 days. However, the pre- and post-implementation data was analyzed using a paired sample t-test. The results from the mMINDS assessment tool were not statistically significant for a LOS in the ICU for patients with AWS. Conclusion: Patients assessed with mMINDS had a decreased LOS in the ICU. However, there were multiple limitations for this project, such as an implementation on one unit in one facility, a small sample size, limited implementation period, the COVID-19 pandemic, and the opening of a new inpatient treatment facility. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Symposium title: Addressing chronic pain and the opioid epidemic using auricular neuromodulation Symposium description: Our proposed symposium integrates a diverse group of scientist and clinician experts (Drs. Cunningham, Wilkes, Khodaparast, Badran) who have committed to exploring the anti-nociceptive and opioid sparing effects of auricular neuromodulation to progress toward non-opioid interventions for chronic pain and opioid use disorders. The demand for chronic pain therapies has increased at an unprecedented rate over the last several decades, contributing in part to a surge in prescription and illicit opioid demand. Countless patients were escalated to prolonged, high-dose opioid regimens over years of treatment. By 2014, 5.4% of U.S. adults were estimated to use prescription opioids on a long-term basis. As the harms of opioid proliferation became increasingly clear, a dramatic paradigm shift occurred in which these drugs are now perceived as more dangerous than beneficial for chronic pain. New clinical guidelines highlight the risks of high-dose regimens as well as the limited benefits, particularly insufficient analgesia and hyperalgesia, associated with long-term use. According to this new perspective, the preferred therapeutic modality for many patients is to safely taper, or even completely stop, using opioids. Transcutaneous auricular neurostimulation (tAN) is a novel therapeutic paradigm that includes stimulation of both the auricular branch of the vagus nerve and auriculotemporal nerve (branch of trigeminal). tAN therapy results in clinically significant reductions in opioid withdrawal symptoms associated with opioid detoxification and tapering. Either adjunctive vagal or trigeminal stimulation modulates pain transmission suggesting overlapping common effector pathways, possibly targeting the endogenous opioid system, which could lead to a synergistic therapeutic benefit for pain. This symposium will explore the scientific basis for this hypothesis across targeted and interconnected topics, including fundamental neuropharmacological mechanisms underlying pain and opioids, clinical challenges of tapering opioids, managing opioid withdrawal symptoms with tAN, and the prospects for tAN to deliver a safe alternative treatment option for pain disorders. The United States is experiencing an epidemic for prescription and non-prescription opioids, which have continued to rise since the 1990s. During 2015, approximately 2.1 million people were severely dependent on prescription opioids, and 513,000 on heroin. In 2020, the Centers for Disease Control reported 93,331 substance use overdose deaths. The continuing increase in opioid-related deaths from 2015 (18%) to 2020 (60%) is partly attributed to the mental health crisis during the Covid-19 pandemic. Aside from pain mitigation, individuals with opioid use disorder (OUD) may be motivated to continue drug-seeking by both the positive reinforcement of the euphoric effects of opioids and the negative reinforcement of opioid withdrawal symptoms due to cessation. Alternative approaches for OUD are a major priority for government agencies given the substantial impact on health, social, and economic welfare. Transcutaneous auricular neurostimulation (tAN) is a non-invasive form of vagus and trigeminal neuromodulation that was recently proven to be an efficacious non-pharmacologic based treatment for reducing opioid withdrawal symptoms. In 2021, tAN therapy received FDA clearance as an adjunctive treatment for opioid withdrawal symptoms in adults. tAN therapy was also proven safe and effective in reducing symptoms of neonatal opioid withdrawal syndrome (NOWS) in neonates. tAN as an adjuvant was safe, well-tolerated, while facilitating the successful rapid weaning of oral morphine and decreasing length of stay in the neonatal ICU. Based on these preliminary findings, tAN therapy is currently in two NIH-funded pivotal clinical trials to: 1) evaluate the long-term effects of tAN on opioid use relapse prevention and cravings in adults with OUD, and 2) determine f tAN therapy can reduce withdrawal symptoms and reduce morphine length of treatment for neonates with NOWS. Lastly, we will explore how tAN could be utilized as neuromodulatory approach for opioid sparing, and ultimately pain mitigation. Research Category and Technology and Methods Clinical Research: 12. Vagus Nerve Stimulation (VNS) Keywords: Vagus Nerve Stimulation, Opioid Use Disorder, Pain, NeurostimulationCopyright © 2023
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The aim of the study. To analyze formation features of the epidemic situation for tuberculosis (TB) in the context of the COVID-19 pandemic in order to predict the further actions of medical organizations. Materials and methods. The data for the region for the last 5 years (2017-2021) were analyzed, including 1,762 newly diagnosed cases of patients with TB and comorbidities (according to the data of the Regional Public Health Organization «Regional Clinical Anti-Tuberculosis Dispensary»). All cases were verified using standard diagnostic methods, including molecular genetic methods, to determine the resistance of pathogens to antibacterial drugs. Results. It was revealed that the epidemiological situation in the region was multidirectional: thus, during the COVID-19 epidemic, the most pronounced incidence decrease was observed among cases of chronic course hepatitis (by 16.4 times), while among patients with tuberculosis the incidence decreased by 2.75 times, and among patients with acute hepatitis - only by 1.5 times (P<0.05). Among the cases of comorbid infection, the most severe course was observed in patients with combined (TB + HIV) infection: there was both a more severe general condition, and the development of adverse (undesirable) reactions to anti-TB drugs, which required an extension of maintenance therapy. Conclusions. The results of the study showed that against the background of the COVID-19 pandemic in the region, there was no tendency towards a worsening of the epidemic situation, primarily for the more socially significant infection - tuberculosis. At the same time, there was an increase in the number of cases of comorbid pathology, including HIV + TB. In the treatment of patients with comorbid forms of infection, it is necessary to take into account the possibility of developing hepatotoxic reactions and, as a result, the appointment of accompanying drugs with hepatoprotective and detoxification effects in therapy.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) has highlighted the scope of heroin dependence and need for evidence-based treatment amongst marginalised people in South Africa. Acute opioid withdrawal management without maintenance therapy carries risks of increased morbidity and mortality. Due to the high costs of methadone, Tshwane's Community Oriented Substance Use Programme (COSUP) used tramadol for opioid withdrawal management during the initial COVID-19 response. AIM: To describe demographics, route of heroin administration and medication-related experiences amongst people accessing tramadol for treatment of opioid withdrawal. SETTING: Three community-based COSUP sites in Mamelodi (Tshwane, South Africa). METHODS: A retrospective cross-sectional study was conducted. Data were collected using an interviewer-administered paper-based tool between April and August 2020. Descriptive statistics were used to analyse data. RESULTS: Of the 220 service users initiated onto tramadol, almost half (n = 104, 47%) were not contactable. Fifty-eight (26%) people participated, amongst whom most were male (n = 55, 95%). Participants' median age was 32 years. Most participants injected heroin (n = 36, 62.1%). Most participants experienced at least one side effect (n = 47, 81%) with 37 (64%) experiencing two or more side effects from tramadol. Insomnia occurred most frequently (n = 26, 45%). One person without a history of seizures experienced a seizure. Opioid withdrawal symptoms were experienced by 54 participants (93%) whilst taking tramadol. Over half (n = 38, 66%) reported using less heroin whilst on tramadol. CONCLUSION: Tramadol reduced heroin use but was associated with withdrawal symptoms and unfavourable side effects. Findings point to the limitations of tramadol as opioid withdrawal management to retain people in care and the importance of access to first-line opioid agonists.Contribution: This research contributes to the limited data around short-acting tramadol for opioid withdrawal management in the African context, with specific focus on the need for increased access to opioid agonists for those who need them, in primary care settings.
Subject(s)
COVID-19 , Substance Withdrawal Syndrome , Tramadol , Adult , Analgesics, Opioid/adverse effects , Communicable Disease Control , Cross-Sectional Studies , Female , Heroin/adverse effects , Humans , Male , Methadone/therapeutic use , Narcotics/adverse effects , Retrospective Studies , Substance Withdrawal Syndrome/diagnosis , Substance Withdrawal Syndrome/drug therapy , Substance Withdrawal Syndrome/rehabilitation , Tramadol/therapeutic useABSTRACT
As preventive, curative and restorative measures in modern conditions of the spread of infectious diseases (Covid 19), the use of sorption materials and detoxification methods with their use in hemosorption are of particular importance. It is known that hemosorption is an effective method of detoxification of the body, and no less important is the use of safe sorbents in relation to the shaped elements of blood, both time-tested sorbents and new, less studied, but more promising from the point of view of their safe production technology. The purpose of this work is to study with the help of scanning flow cytometry the effect of a sorbent with carbon nanofiber A1203@PDMS/CNF in comparison with a carbon-free sorbent A1203@PDMS on morphofunctional parameters erythrocytes. The study of the physico-chemical properties of sorbents was carried out according to standard methods. The biological properties of sorbents were evaluated by its effect on erythrocytes of erythrocyte concentrate during hemoperfusion of blood through columns with sorbents using the method of scanning flow cytometry according to the standard method. The data obtained using the method of scanning flow cytometry made it possible to conclude that the studied sorbents do not have a traumatic effect on the morphofunctional parameters of erythrocytes. The introduction of carbon nanofiber into the composition of the sorbent in an amount of 0.02% improves the functional parameters of blood erythrocytes both in comparison with the initial donor blood and compared to the sorbent without carbon. © 2022 IEEE.
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Physical and mental health challenges seem to be part of our daily living. To understand the latest consensus, I attended a symposium, June 30, 2021, advocating global health by using acupuncture and integrative medicine at the Lansdowne Resort for a Global Wellness Event, in Leesburg, Virginia. Group sound bathing and meditation were offered to the participants in a therapeutic session. This was to prepare our minds and bodies for the experience of this symposium. Do we wish to lead a revolution in the science of health—especially now—to maintain and thrive in the era of COVID-19? This was the main theme of this event. To understand COVID-19 better, experts were present who explained its biology and perhaps what might be expected in the future as this virus winds down or rebounds as variants.
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White blood cells (WBCs) are immune cells that play essential roles in critical diseases including cancers, infections, and inflammatory disorders. Their dynamic and diverse functions have inspired the development of WBC membrane-coated nanoparticles (denoted "WBC-NPs"), which are formed by fusing the plasma membranes of WBCs, such as macrophages, neutrophils, T cells, and natural killer cells, onto synthetic nanoparticle cores. Inheriting the entire source cell antigens, WBC-NPs act as source cell decoys and simulate their broad biointerfacing properties with intriguing therapeutic potentials. Herein, the recent development and medical applications of WBC-NPs focusing on four areas, including WBC-NPs as carriers for drug delivery, as countermeasures for biological neutralization, as nanovaccines for immune modulation, and as tools for the isolation of circulating tumor cells and fundamental research is reviewed. Overall, the recent development and studies of WBC-NPs have established the platform as versatile nanotherapeutics and tools with broad medical application potentials.
Subject(s)
Nanoparticles , Neoplasms , Cell Membrane/metabolism , Drug Delivery Systems , Humans , Leukocytes , Neoplasms/drug therapy , Neoplasms/metabolismABSTRACT
COVID-19 pandemic has placed human health under unprecedented issues since its outbreak in 2019. During COVID-19, people were restricted to one place, which caused many psychological and other health-related concerns among them. Hence, this study aims to understand wellness tourists' key wellness travel motivations in Rishikesh, India, during the COVID-19 lock-down period and post-pandemic. To conduct this quantitative research work, data were collected through a structured questionnaire from 232 domestic wellness tourists. Exploratory factor analysis was used for the factorial structure of the observed variables, and multiple regression analysis was used to test the study hypotheses. The study establishes an understanding that Rishikesh offers an anticipated atmosphere to wellness tourists from rejuvenation to d-stress to detoxification and body fitness even in a COVID-19 type crisis. Though India is getting momentum in wellness tourism, its infrastructure and professionalism need improvement to maintain the faith of wellness tourists in the destination image.
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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has shaken the health systems worldwide. Severe depression and anxiety symptoms are expected to be the most prevalent psychopathological presentations connected with global health crisis like the COVID 19 pandemic. Untreated depression and severe anxiety are noticed to be the most prevalent accompanying medical conditions in social, public health crisis which very frequently result in a suicide attempt . This paper aims to present a case report where the "trigger" for a suicide attempt was the current situation during the Covid-19 Pandemic. The suicide attempt was a poisoning with Anti-HIV drugs. Case report. A 28 year old male, student, homosexually oriented, HIV positive, single, with previously diagnosed general anxiety disorder was admitted to the emergency centre because of the self-poisoning for suicidal purposes. After detoxification and initial management at the emergency centre, the patient was admitted to psychiatric clinic where support and cognitive behavioral therapy was administered in combination with antidepressants which eventually led to a satisfactory improvement in his mental state. The suicide attempt followed a difficult period in the patient's personal and emotional life, and socioeconomic problems that are a direct consequence of the Covid 19 pandemic. Several times the patient tried to seek help at the local health centre, but was unable to make an appointment because his family doctor worked in Covid 19 Centre. Conclusion. One of the leading reasons for the increased number of attempted and committed suicides is the unrecognition and lack of treatment of mental disorders symptoms especially in such a public health crisis like Covid 19 pandemic is globally.
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Post-covid syndrome is characterized by a spectrum of persistent symptoms that do not disappear for many months, which may be due to an inadequate immune system response. This leads to a discussion of potentially new methods immunorehabilitation with the use of effective enterosorbents. The aim of the study was to assess the сlinical effectiveness of enterosorbents and immunological parameters of patients with a long-term “post-covid syndrome” who have undergone a new coronavirus infection COVID-19. In n pilot monitored open non-randomized experimental clinical observationanl study 33 patients who had a novel coronavirus infection with COVID-19 underwent comprehensive treatment with the inclusion of azoximer bromide (Polyoxidonium) and colloidal silicon dioxide (Polisorb MP). Analysis of clinical and laboratory data showed that after immunorehabilitation, most of the indicators characterizing the state of the immune system in patients who had COVID-19 were restored to control values. And the use of enterosorbents in complex immunorehabilitation therapy is justified and confirmed by the relief of dyspeptic and asthetovegetative syndromes, which makes it possible to recommend it for use in complex treatment. © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
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Pesticide treatment dramatically reduces crop loss and enhances agricultural productivity, promoting global food security and economic growth. However, owing to high accrual and persistent tendency, pesticides could create significant ecological consequences when used often. Lately, the perspective has transitioned to implementing biological material, environmentally sustainable, and economical strategies via bioremediation approaches to eradicate pesticides contaminations. Microalgae were regarded as a prominent option for the detoxification of such hazardous contaminants. Sustainable application and remediation strategies of pesticides pollutants in the agriculture system by microalgae from the past studies, and recent advancements were integrated into this review. Bibliometric strategies to enhance the research advancements in pesticide bioremediation by microalgae between 2010 and 2020 were implemented through critical comparative analysis of documents from Scopus and PubMed databases. As a result, this study identified a growing annual research trend from 1994 to 2020 (nScopus > nPubMed). Global production of pesticide remediation by microalgae demonstrated significant contributions from India (23.8%) and China (16.7%). The author’s keyword clustering was visualized using bibliometric software (VOSviewer), which revealed the strongest network formed by “microalgae”, “bioremediation”, “biodegradation”, “cyanobacteria”, “wastewater”, and “pesticide” as significant to the research topic. Hence, this bibliometric review will facilitate the future roadmap for many scholars and authors who were drawing attention to the burgeoning research on bioremediation of pesticides to counteract environmental impacts while maintaining food sustainability.
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TYPE: Case Report TOPIC: Chest Infections INTRODUCTION: Irpex lacteus is a basidiomycete found on decaying wood. Known uses include the saccharification of wheat for ethanol production;decolorization of textile effluent wastewater;and detoxification of effluents from the debittering process of olives. Rarely found to cause a human mycosis, and ours is the first adult pulmonary case that is reported. CASE PRESENTATION: 61 yr old male with Stage 4ae B cell lymphoma and bcl6 amplification s/p RCHOP, presented with recurrent right effusions. The patient yielded 500mL of transudative effusion. No prior COVID infections and he was fully vaccinated. He worked by cutting down wood in the forests. No complaints of hemoptysis, night sweats, or weight loss. PET scan revealed anterior mediastinal calcifications, a large right effusion, and a LLL nodule. The LLL nodule was biopsied, and pathology revealed necrotizing granulomas. Bronchoscopy with EBUS did not reveal granulomas within the mediastinal lymph nodes. BAL from the LLL revealed a fungal culture positive for I. lacteus. The patient did not undergo further treatment for the positive fungal culture. Follow up PET scan did not reveal progression of his lymphoma. DISCUSSION: The two documented cases of I. lacteus were within a 9 yr old with ALL and pulmonary abscess;and a 73 yr old with sarcoidosis and fungal meningitis. Due to his clinical stability, he did not require amphotericin B, as was needed in the two prior cases. CONCLUSIONS: I.lacteus is a rare cause of a human mycosis. Further investigation would be warranted in terms of treatment, as there are so few cases. DISCLOSURE: Nothing to declare. KEYWORD: fungal