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1.
Pakistan Journal of Medical and Health Sciences ; 16(5):137-139, 2022.
Article in English | EMBASE | ID: covidwho-1885028

ABSTRACT

Aim: To compare chest computed tomography (CT) diagnosis of ground glass opacities in the COVID-19 patients. Study design: Retrospective study. Place and duration of study: Department of Radiology, Ghulam Muhammad Mahar Medical College Sukkur from 1st July 2020 to 31 August 2021. Methodology: Fifty patients on differential CT diagnosis of ground glass opacities seen in COVID 19 patients were enrolled. Thoracic CT images by applying auto exposure-control settings and ranges of scan were done. The noise-index was kept as 12.3. Using helical 16 slice Alexion CT-Toshiba. Keeping a comparison with viral infection CT images a list of 7 signs which were positive for Covid CT scan were recorded. Peripheral lesions meant any lesions which effects peripheral area up to 3 to 4 cm lung periphery with/without having central dispersal. A hazy-opacity was termed as ground glass. Results: Mean age of the patients was 49.1±10.2 years with 27 (54%) males and 23(46%) females. Mix ground glass opacitites and consolidation were also the features of the CT imaging in coronavirus posisitve cases. Man-Whitney test results showed that combined-CT scoring had a SE value as 0.044 with a confidence interval between 0.756-0.927. Comparing the differential CT values within COVID and non COVID patients based on RT PCR results it was observed that posterior region lower lobe involvement was a feature of COVID-19 patients while crazy paving pattern and peripheral distribution was also seen in corona patients. Conclusion: Present study highlights that chest CT helps in differentitaing corona virus from other causes of pneumonias and grond glass opacities.

2.
J Telemed Telecare ; : 1357633X221100059, 2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1883381

ABSTRACT

Parsonage-Turner Syndrome or neuralgic amyotrophy is a peripheral neuropathy typically characterized by an abrupt onset of pain, followed by progressive neurological deficits (e.g. weakness, atrophy, occasionally sensory abnormalities) that involve the upper limb, mainly the shoulder, encompassing an extensive spectrum of clinical manifestations, somehow difficult to recognize. This case report describes the proper management of a 35-year-old, bank employee and sports amateur who reported subtle and progressive upper limb disorder with previous history of neck pain. SARS-CoV-2 pandemic era made patient's access to the healthcare system more complicated. Nevertheless, proper management of knowledge, relevant aspects of telerehabilitation-based consultation for musculoskeletal pain, advanced skills, tools and technologies led the physiotherapist to suspect an atypical presentation of Parsonage-Turner Syndrome. Further, neurologist consultation and electromyography suggested signs of denervation in the serratus anterior and supraspinatus muscle. Therefore, an appropriate physiotherapist's screening for referral is conducted to correct diagnosis and thorough treatment.

3.
Istanbul Tip Fakultesi Dergisi ; 84(4):595-598, 2021.
Article in English | Scopus | ID: covidwho-1879776

ABSTRACT

Coronavirus-19 disease (COVID-19) is a worldwide health emergency which has a high mortality ratio. Diagnosis requires a positive quantitative real-time polymerase chain reaction (qRT-PCR) test however there are radiological findings strongly suggest the diagnosis of COVID-19. Here we reported a 63-year-old woman presented with cough and dyspnea and medical history of lung cancer and systemic lupus erythematosus (SLE). Chest computed tomography demonstrated widespread ground glass opacities in both lung fields that have been reported to be compatible with COVID-19 pneumonia. qRT-PCR test was negative for twice and radiological regression after hydroxychloroquine, azithromycin and piperacillin-tazobactam was not significant. Considering lung involvement of SLE methylprednisolone was initiated, symptoms and radiological findings improved. The underlying diseases may mimic the COVID-19 infection or the signs and symptoms of the disease may be seen together with COVID-19. © 2021 Universidad Compultense Madrid. All right reserved.

4.
8th IEEE International Conference on Problems of Infocommunications, Science and Technology, PIC S and T 2021 ; : 80-84, 2021.
Article in English | Scopus | ID: covidwho-1878968

ABSTRACT

Currently, the relevance of remote express diagnostics of various diseases is beyond doubt. The active spread of various types of epidemics and pandemics necessitates the improvement of various types of express diagnostics. The authors conduct research in the field of remote visual diagnostics using modern methods of processing telemedicine video information. This paper discusses the possibility of improving the quality of visualization of diagnostic signs using the digital dermatoscopy method for express diagnostics of skin rashes in COVID-19 in comparison with the manifestations of atopic dermatitis. The prospect of this work is the study of illumination conditions during registration and selection of skin areas for the analysis of diagnostic images. © 2021 IEEE.

5.
American Journal of Public Health ; 112(6):818-820, 2022.
Article in English | ProQuest Central | ID: covidwho-1877081

ABSTRACT

Procedures are strictly followed to ensure all research conduct is ethical, and the data reveal levels of appropriate and inappropriate care provided.3 It is important to recognize how these data differ from medical records and why USP data should not be considered a substitute for real-patient data or vice versa. Because of standardization, USP data allow researchers to examine the care provided in response to the same patient presentation by different providers composing an intentionally designed sample. Because the underlying condition is known (predetermined) by the researchers, several crucial advantages exist over other data types. [...]how a provider arrives at a specific diagnosis through the process of analyzing patient history and conducting physical examinations, known as differential diagnosis, can be accurately evaluated. [...]the use of technology throughout the entire SP implementation process from design to data collection, including monitoring, appeared essential for reducing expenditures without sacrificing implementation fidelity.

6.
Iranian Red Crescent Medical Journal ; 24(4), 2022.
Article in English | CAB Abstracts | ID: covidwho-1876520

ABSTRACT

Introduction: Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain that is often misinterpreted. Only about 2% of patients who present with acute abdominal pain display this condition. Damage to the superior or inferior epigastric arteries or their branches, as well as direct rupture of the rectus abdominis muscle, causes bleeding into the rectus sheath. In hospitalized COVID-19 patients, anticoagulant prophylaxis with heparin has become a standard part of medical care. This method may raise the risk of bleeding in older people with comorbidities. Case presentation: The patient was a 60-year-old woman with a history of asthma and diabetes mellitus who was referred to the emergency department with shortness of breath and cough. Chest X-Ray demonstrated Covid-19 pneumonia. On the second day of hospitalization, after the exacerbation of tachypnea, computed tomography (CT) angiography was performed, and the results confirmed pulmonary embolism;therefore, the therapeutic dose of heparin was initiated. On the 21st day of hospitalization, the patient experienced abdominal pain and was visited by a general surgeon. A large ecchymosis was observed in the periumbilical;nonetheless, there was no significant tenderness in the abdominal exam. The patient's hemoglobin dropped to 7.9 mg/dl at this time. An abdominal and pelvic CT scan showed a 45 mm hematoma in the left rectus muscle.

7.
Medical Laboratory Journal ; 15(6):1-62, 2021.
Article in English | CAB Abstracts | ID: covidwho-1870459

ABSTRACT

This special issue contains 10 papers on the following topics: evaluating association between ABO blood groups and COVID 19;impact of COVID-19 on Libyan laboratory specialists;microscopic agglutination test for diagnosis of leptospirosis by using filter paper-dried serum samples;prevalence of haemoparasites among blood donors in Calabar, Nigeria;assessment of peripheral blood lymphocytosis in adults and determination of thresholds for differential diagnosis between clonal and reactive lymphocytosis;investigation of antibiotic resistance pattern in isolates from urine and blood samples of patients admitted to the Intensive Care Unit of Velayat Hospital in Qazvin, Iran;evaluation of rejection rates and reasons among specimens taken from different hospital units;quality tools to ensure patient safety and reduce the turnaround time of medical laboratories in tertiary care teaching hospitals;prevalence and antibiotic resistance pattern of Gram-positive isolates from burn patients in Velayat Burn Center in Rasht, North of Iran;and infective endocarditis caused by Staphylococcus aureus in a 6-year-old girl with no history of heart and dental problems.

8.
Journal of Investigative Medicine ; 70(4):1022-1023, 2022.
Article in English | EMBASE | ID: covidwho-1868746

ABSTRACT

Case Report A male infant is born at 37w to a 34-year-old G3P2 mother by vaginal delivery after an uncomplicated pregnancy. Prenatal screens are negative. The patient had a birth weight of 2,620 g, with Apgar scores of 9 and 9. On day 2 after birth, had increased work of breathing which prompted transfer to a level II NICU for further management. On arrival to the unit, the infant is tachypneic with mild chest wall retractions and thick nasal secretions. A CBC and blood culture were collected and empiric antibiotic therapy was started. Respiratory viral panel and COVID test are negative. A chest radiograph shows a middle lobe opacity concerning for pneumonia (figure 1). His clinical status failed to improve and on day 4 after birth, supplemental oxygen was provided. The primary team consulted ENT and Pulmonology services. Flexible laryngoscopy showed a normal anatomy. Pulmonology recommended transferring to our NICU for a chest CT with bronchoscopy. Our differential diagnosis for this neonate with respiratory distress that fails to improve over time or with antibiotics was broad, but further testing revealed this infant's condition. A CBC, CRP and a blood gas were collected on admission and were normal. ID service was consulted. A Chest CT showed bilateral atelectasis. Bronchoscopy showed a normal anatomy. Bronchoalveolar lavage was sent. Umbilicus swab was positive for MRSA, nasal wash/sputum culture/bronchoalveolar fluid also grew moderate S. aureus. Nasal ciliary biopsy sent for electron microscopy. Positive umbilicus and nasal swab, and subsequently BAL for MRSA led to a diagnosis of MRSA neonatal rhinitis. Therapy with IV vancomycin was initiated and later changed to oral clindamycin to complete a total of 14 days of therapy. The neonate was weaned off oxygen support on day 11. His clinical symptoms improved. He was discharged on oral clindamycin with follow up appointments with pulmonology and ID clinics. His ciliary biopsy showed absence of outer and inner dynein arms, compatible with the diagnosis of primary ciliary dyskinesia (PCD) (figure 2). Genetic testing for PCD showed mutations in the DNAAF1 and CCDC40 genes. This neonate was diagnosed with primary ciliary dyskinesia (PCD) but his presentation at birth was nonspecific and the differential diagnosis was broad. There is no gold standard diagnostic test for PCD and high clinical suspicion is important. Since it is most likely an AR inheritance, screening of family members is essential. Initial management of neonates may include measures that manage the respiratory distress, airway clearance to prevent respiratory infections and treat bacterial infections. Chest physiotherapy may help if recurrent atelectasis. Flexible bronchoscopy and bronchoalveolar lavage may help both to diagnose and treat the underlying infection. Antibiotic therapy based on organism growth for exacerbations may prevent development of bronchiectasis. (Figure Presented).

9.
Rheumatology (United Kingdom) ; 61(SUPPL 1):i98, 2022.
Article in English | EMBASE | ID: covidwho-1868409

ABSTRACT

Background/Aims Chilblain-like lesions (perniosis) have been reported frequently during COVID-19 pandemic in children and adolescents with no history of exposure to cold temperatures or underlying autoimmune conditions. Patients with these skin changes reported mild COVID-19 symptoms or previous contact with confirmed COVID-19 cases before they became symptomatic. In the majority of cases, a causal relationship between SARS-CoV-2 infection and chilblain-like lesion has not been proven. Methods Retrospective review of patients with chilblain-like lesions, possibly secondary to SARS-CoV-2 infection, presenting to a tertiary Adolescent Rheumatology service between January and August 2021. Results We identified five, male, adolescent patients (mean age, 16 years old) who presented with new onset of chilblain-like lesions affecting fingers, toes and heels in December 2020, which coincided with the peak of second wave of COVID-19 infection. One month prior to skin changes occurrence, 3 out of 5 patients experienced mild respiratory COVID-19-like symptoms and the rest of the patients were asymptomatic but were in contact with COVID-19 positive cases following outbreaks in schools. 1 of 3 symptomatic patients had a positive COVID-19 PCR test prior to skin manifestations. 2 out of 4 patients with heel lesions had deep, full thickness skin loss heel ulcers and 2 of 5 patients had superficially ulcerated lesions on a finger and toes, respectively, resulting in inability to attend school. None of the patients had any other symptoms or signs to suggest an underlying autoimmune connective tissue disorder. Demographics, clinical features and serological data are summarised in Table 1. One patient underwent a biopsy of heel ulcer which was histologically consistent with perniosis. In two patients (40%) chilblain like lesions resolved spontaneously within 2 months. Three patients (60%), with progressive ulcerated lesions, required various combinations of treatments with aspirin, calcium channel blockers (nifedipine), topical or oral steroids and hydroxychloroquine with complete resolution of symptoms within 6 months. Conclusion Chilblain-like lesions, including heel involvement associated with mildly symptomatic COVID-19 infection, have been reported before. Our mini-case series raises awareness of ulcerating chilblain like lesions possibly secondary to COVID-19 in adolescent patients, which require early recognition and instigation of treatment leading to better patient's outcomes.

10.
Mskmuskuloskelettale Physiotherapie ; 26(02):96-104, 2022.
Article in German | Web of Science | ID: covidwho-1868036

ABSTRACT

After being affected by Covid-19 a month before, a patient presented with ongoing symptoms of extreme headache, pain in the region of the neck and a very disturbing, pulse-synchronous (pulsatile) tinnitus (NRS 6-7/10). In the course of physiotherapeutic assessment, it transpires that the patient should not receive any physiotherapeutic treatment without previous medical clearance. After clearance is given to go ahead with physiotherapy, a treatment plan is developed, focusing primarily on the patient's stress coping strategies. This is supported by educational measures as well as manual therapy techniques directed at the cervical spine and the mandibular region. Owing to a fruitful collaboration between medical clearance, physiotherapy and psychotherapy as well as good patient communication, the patient can be treated successfully and his symptoms are reduced significantly.

11.
Neurologia Argentina ; 14(1):13-25, 2022.
Article in English | EMBASE | ID: covidwho-1867624

ABSTRACT

Introduction: The Argentine Hemorrhagic Fever (AHF) or stubble disease is one of the most frequent endemic zoonoses. Restricted to the farming areas of the Central West region of Argentina, it is produced by the Junín virus and it is transmitted by a rodent, the corn-mouse (Calomys musculinus). Objectives: To recognize the neurological signs and symptoms of AHF that appear in the first 24-48 hours of the onset of the disease. To describe the sequence of neurological manifestations in its common and severe clinical forms. Also, of the sequelae and late neurological complications Content: Early diagnosis and timely intervention define the clinical evolution and prognosis. Attention must be paid to previously healthy adult patients undergoing “acute nonspecific febrile syndrome” of an unknown cause for less than a week of evolution. Differential diagnosis should be made with other endemic infectious diseases, and the emerging infectious disease COVID 19, appraising epidemiological surveillance. Conclusions: Clinical examination, laboratory tests, serological diagnosis and images allow the early diagnosis. In Argentine Hemorrhagic Fever, immune plasma therapy within the 5 days of the onset of the disease prevents progression towards severe clinical forms with high mortality rates. The fatality rate for FHA without treatment is 30%. Early convalescent plasma treatment reduced the general mortality rate to 1%.

12.
African Journal of Neurological Sciences ; 40(2):86-88, 2021.
Article in English | EMBASE | ID: covidwho-1866093

ABSTRACT

Introduction The coronavirus disease 2019 (COVID-19) was first known by its respiratory symptoms. Neurological complications are increasingly seen and described. Our case emphasizes the difficulties of differential diagnosis between encephalitis and post-traumatic stress disorder (PTSD) in SARS-COV2 patients. Case report A healthy 62 years old man tested positive for COVID-19 during a travel procedure. He was admitted to hospital because of a sudden drop of oxygen saturation from 99% to 89% with pulmonary CT scan showing a parenchymal bilateral ground-glass lesions and consolidative opacities of about 50% of lung while the patient remained asymptomatic. After he has been discharged from hospital he developed isolated executive disorders. Post COVID-19 encephalitis or PTSD were questioning. Discussion and conclusion Our patient had an acute hypoxemia which is well known to be associated with executive disorders such as in acute respiratory distress. But these signs appeared after the COVID-19 came negative hence the executive disorders were likely to be related to direct brain infection or to a non-infectious condition like the PTSD. Functional neuroimaging is then the gold standard to rule out a brain damage.

13.
Minerva Respiratory Medicine ; 61(2):39-45, 2022.
Article in English | EMBASE | ID: covidwho-1863569

ABSTRACT

BACKGROUND: The final diagnosis of COVID-19 pneumonia relies on a clinical and radiological picture, along with SARS-CoV2 RNAdetection in the oral and nasal-pharyngeal swab. The latter, has a high rate of false negative results, even in presence of symptoms and radiological abnormalities suggestive for COVID-19. In case of an atypical or indeterminate radiological pattern, the need of excluding COVID-19 and ruling out other differential diagnoses would be necessary. In such settings, the role of invasive procedures for obtaining samples from the lower respiratory tract such flexible bronchoscopy has been debated, due to the risk of contagion. The aim of this study was to evaluate the role of flexible bronchoscopy with bronchial washing during the pandemic of COVID-19. We aimed to define the value of bronchial washing in patients with an atypical or indeterminate chest CT-scan pattern for viral pneumonia. METHODS: We retrospectively reviewed patients with an atypical or indeterminate CTscan pattern for COVID-19 pneumonia and a negative test for SARS-CoV2 RNAon oral/ nasal-pharyngeal swabs, who underwent bronchoscopy for bronchial washings to exclude or confirm the diagnosis of SARS-CoV2 pneumonia. RESULTS: Among the 44 patients included with an atypical or indeterminate chest CT-scan pattern for COVID-19 pneumonia, no SARS-CoV2 RNAwas detected in the bronchial washing. CONCLUSIONS: The role of bronchoscopy in the diagnosis of COVID-19 pneumonia is negligible in indeterminate or atypical patterns on chest CT scan. However, we should not shy away from these invasive procedures in these profiles of cases to exclude bronchoscopically diagnosed differential diagnoses like other infections and non-infectious causes.

14.
B-ENT ; 16(1):86-90, 2020.
Article in English | EMBASE | ID: covidwho-1863151

ABSTRACT

Objective: The Basso Lodigiano is located in southern Lombardy. The capital of this district is the city of Codogno where on February 21, 2020, the first case of COVID-19 (Corona Virus Disease 2019) was diagnosed in Italy. The etiological agent is known to be a new coronavirus called SARS Cov-2 (Severe Acute Respiratory Syndrome – Coronavirus – 2). Even asymptomatic or paucisymptomatic patients can transmit the virus and contribute to the expansion of the infection. From 21 February 2020, we have noticed a significant increase of anosmia cases in the population of Codogno and we believe there may be a relationship with the SARS-Cov 2 infection. Methods: In the period between 21 February and 15 March 2020, we described 27 patients, living in Codogno, with anosmia. We calculated the incidence of the anosmia symptom in our patients in the period following the first diagnosis of COVID- 19 in Italy (February 21, 2020/ March 15, 2020) and then compared it to the incidences relating to the same period of the years 2019 and 2018 and to the incidences in other periods from 1 January 2018. We then analysed the results through test χ2 in order to verify a statistical significance in the results. Results: We observed a statistically significant increase in the incidence of the anosmia symptom in the period between 21 February and 15 March of 2020 compared to the incidence of the same symptom in other periods Conclusion: The interpretation of the results leads us to argue that anosmia may be a symptom related to SARS-Cov2 infection. This symptom could be significant in paucisymptomatic patients who represent a potential viral transmission reservoir. In this regard, in this age of pandemic, when doctors observe patients with anosmia, they should consider SARS-Cov 2 infection in the differential diagnosis.

15.
Front Microbiol ; 13: 847836, 2022.
Article in English | MEDLINE | ID: covidwho-1862625

ABSTRACT

Background: Both coronavirus disease 2019 (COVID-19) and influenza pneumonia are highly contagious and present with similar symptoms. We aimed to identify differences in CT imaging and clinical features between COVID-19 and influenza pneumonia in the early stage and to identify the most valuable features in the differential diagnosis. Methods: Seventy-three patients with COVID-19 confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) and 48 patients with influenza pneumonia confirmed by direct/indirect immunofluorescence antibody staining or RT-PCR were retrospectively reviewed. Clinical data including course of disease, age, sex, body temperature, clinical symptoms, total white blood cell (WBC) count, lymphocyte count, lymphocyte ratio, neutrophil count, neutrophil ratio, and C-reactive protein, as well as 22 qualitative and 25 numerical imaging features from non-contrast-enhanced chest CT images were obtained and compared between the COVID-19 and influenza pneumonia groups. Correlation tests between feature metrics and diagnosis outcomes were assessed. The diagnostic performance of each feature in differentiating COVID-19 from influenza pneumonia was also evaluated. Results: Seventy-three COVID-19 patients including 41 male and 32 female with mean age of 41.9 ± 14.1 and 48 influenza pneumonia patients including 30 male and 18 female with mean age of 40.4 ± 27.3 were reviewed. Temperature, WBC count, crazy paving pattern, pure GGO in peripheral area, pure GGO, lesion sizes (1-3 cm), emphysema, and pleural traction were significantly independent associated with COVID-19. The AUC of clinical-based model on the combination of temperature and WBC count is 0.880 (95% CI: 0.819-0.940). The AUC of radiological-based model on the combination of crazy paving pattern, pure GGO in peripheral area, pure GGO, lesion sizes (1-3 cm), emphysema, and pleural traction is 0.957 (95% CI: 0.924-0.989). The AUC of combined model based on the combination of clinical and radiological is 0.991 (95% CI: 0.980-0.999). Conclusion: COVID-19 can be distinguished from influenza pneumonia based on CT imaging and clinical features, with the highest AUC of 0.991, of which crazy-paving pattern and WBC count play most important role in the differential diagnosis.

16.
Endocrine Practice ; 27(6):S172, 2021.
Article in English | EMBASE | ID: covidwho-1859548

ABSTRACT

Introduction: The severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is a novel enveloped RNA beta-coronavirus responsible for the Coronavirus disease-19 (COVID-19) ranging from asymptomatic cases to severe respiratory involvement. The SARS-CoV-2 pandemic has spread rapidly worldwide. Few cases and case series have been published reporting COVID-19 related subacute thyroiditis. We report a case of COVID-19 related thyroiditis. Case Description: 73-year-old female presented to the hospital with complaint of shortness of breath, fever and weakness. She was diagnosed with COVID-19 pneumonia and treated with dexamethasone and convalescent plasma. Patient was discharged home after 10 days. Two days after discharge, she presented with complaint of generalized weakness. She was noted to have thyrotoxicosis. Patient was not taking lithium or amiodarone and she did not receive iodinated contrast. She had no sign or symptoms of thyrotoxicosis. She denied neck pain or difficulty swallowing. On laboratory evaluation, SARS Coronavirus 2 RNA was positive. RSV, Influenza A and Influenza B by PCR were negative. TSH was low at 0.182 uIU/mL (0.450-5.330 uIU/mL), free T4 elevated at 3.00 ng/dL (0.58-1.64 ng/dL), free T3 elevated at 5.24 pg/mL (2.20-4.10 pg/mL). Her TSH 3 weeks ago was normal at 0.723 uIU/mL. Thyroid stimulating immunoglobulin negative < 0.10 (< =0.54 IU/L). Thyroid ultrasound showed normal sized gland, few sub centimeter nodules bilaterally. NM thyroid uptake and scan showed low uptake and no focal hot or cold nodule. Her workup was consistent with thyroiditis. Correlating with the diagnosis of COVID-19, this could be most likely COVID-19 related thyroiditis. Repeat labs in a week showed normal TSH 1.138 uIU/mL, normal free T4 1.28 ng/dL and low free T3 1.93 pg/mL. The patient likely had thyroiditis during early course of COVID-19 infection and was caught during the late phase and hence, improvement of thyroid function within a week of biochemical diagnosis. Discussion: Subacute thyroiditis is a self-limited inflammatory disorder, characterized by neck pain, general symptoms and thyroid dysfunction. It has been linked to viral infection like mumps virus, coxsackievirus, adenovirus, Epstein-Barr virus, rubella and cytomegalovirus. In our patient, SARS-CoV-2 was the likely cause of thyroiditis. A single center retrospective study done in 287 patients hospitalized with COVID-19 in Milan, Italy reported 20% of patients with thyrotoxicosis, 5% with hypothyroidism and 74% with normal thyroid function test. We report this case to alert clinicians that thyroiditis and resultant thyrotoxicosis should always be considered as a differential diagnosis in patients with COVID-19.

17.
Lung India ; 39(SUPPL 1):S144, 2022.
Article in English | EMBASE | ID: covidwho-1857784

ABSTRACT

Introduction: Vanishing lung syndrome , a primary bullous disease of the lung is defined as a large bulla occupying at least one third of a hemithorax. Usually it associated with riskfactors of smoking, marijuana abuse, alpha 1 antitrypsin deficiency. Here we present a rare case of vanishing lung syndrome developed in a post covid patient without any comorbidities making it a rare presentation. History: A 35year,male with no significant cigaratte smoking presented with acute onset dyspnoea along with dry cough and right sided chest pain for 1 week duration .no history of any recent trauma Past history of COVID 19 one month back, he was hospitilized was put on NIV and HFNC and was discharged on domicillary oxygen and other medications. Clinical Findings: On examination there was hyperresont note in right side along with diminished air entry in all areas in right side along with left side mammary, infraaxillary, infrascapular areas. Diagnosis and Management: Diagnosis was made with the help of contrast enchanced computed tomography aided by other serological and microbilogical workup. Patient was managed conservatively antibiotics ,analgesics and other supportive measures. Learning Points: We are well aware of lung fibrosis post covid , our intention was to throw light into the new entity of bullous lung disease Bullous lung disease (with or without pneumothorax) should be part of differential diagnosis in a patient returning with chest pain and dyspnoea after SARS-Cov-2 infection.CT imaging essential to differentiate radiographically presumed complex pneumothoraces from large bullae to prevent erroneous chest drain insertion into a bulla.

18.
Lung India ; 39(SUPPL 1):S150, 2022.
Article in English | EMBASE | ID: covidwho-1857783

ABSTRACT

Introduction: After the aftermath of covid 19 we are left to learn and understand the multiple respiratory manifestations of post covid 19 sequele The presence of bullous lung disease in post covid patients is one such a rare entity ,has been infrequently reported, studied Eventhough the exact mechanism of formation of bullae in post covid 19 are unknown, an emerging association has been observed.A bulla is an air containing space within the lung parenchyma that arises from destruction dilatation and confluence of airspaces distal to terminal bronchioles and is larger than 1 cm in diameter .Its wall are composed of attenuated and compressed parenchyma. Here in this case series we describe this unique presentation of bullous lung diseases in post covid 19 patients. Case Series: Here wepresent a case series of 7 patients without any known comorbidities who were diagnosed with post covid bullous lung disease Diagnosis was made with the help of contrast enchanced computed tomography aided by other serological and microbilogical workup. Patient was managed conservatively antibiotics, analgesics and other supportive measures. Learning Points: We are well aware of lung fibrosis post covid, our intention was to throw light into the new entity of bullous lung disease in post covid period. Bullous lung disease (with or without pneumothorax) should be part of differential diagnosis in a patient returning with chest pain and dyspnoea after SARSCov- 2 infection. CT imaging essential to differentiate radiographically presumed complex pneumothoraces from large bullae to prevent erroneous chest drain insertion into a bulla.

19.
Lung India ; 39(SUPPL 1):S238, 2022.
Article in English | EMBASE | ID: covidwho-1857782

ABSTRACT

Background: Schwannomaare benign tumors arising from Schwann cells of nerve root sheaths. Schwannomasare mostly solid / heterogeneous solid tumours, rarely cystic. Presentation of cystic schwannomainthorax is extremely rare. Case Study: A 62-year-old female came to our hospital withthe complaint of right sided chest pain for 2 months, which is dull, non-radiating. She had history of fever 4 months back, diagnosed to have covid and took treatment at home. Chest x-ray showed a homogenous opacity in the right upper lobe extending up to 1stintercostal space. Ct reported well-defined thick-walled cyst, hypodensewith central low attenuation, forming acute angles with lung parenchyma in apical segments of right upper lobe towards mediastinum. Mild perilesional atelectasis is seen.On contrast, cyst is non enhancing. Patient is evaluated for the possibilities of Foregut duplication cyst, Hydatidcyst, Neoplasm. Endoscopic ultrasonography revealed a 5cms×5cms cyst, which is not communicating, infiltrating to esophagus. Patient was referred to ctvswhere excision of cyst is done by right thoracotomy .A 6cms×6cms×2cms unilocularcyst with wall thickness ranging from 0.1- 0.4cms. Its outer surface is congested, inner surface showed dark-brown hemorrhagic contents. Histopathological examination revealed cystic schwannoma. Discussion: Schwannomasare mostly benign in nature .Treatment includes excision of Bronchogenic cyst, Brachial cyst, neurogenic tumours, apical lung tumour, hydatid cyst, foregut duplication cyst are to be considered as differential diagnosis. It is important to consider cystic schwannomasin the differential diagnosis of thoracic cystsince the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.

20.
Lung India ; 39(SUPPL 1):S136-S137, 2022.
Article in English | EMBASE | ID: covidwho-1857457

ABSTRACT

Background: Mucormycosis is an invasive-fungal infection, often associated with extremely severe complications in immuno-compromised patients. The prevalence of mucormycosis in India is about 80 times higher than other developed countries. But the clinical presentation of pulmonary mucormycosis has wide diversity. Case Study: We are reporting a case of a 45-year-old man admitted to our side as a case of post-COVID sequelae in the setting of a new left sided loculated pyo-pneumothorax. He is a known case of type 2 diabetes and hypothyroidism for 1.5 years and 3 years respectively. Prior to our rescue, he underwent pigtail insertion in the loculated collection, but there was no output. So, the drain was removed and the patient was planned for pneumonectomy. On visiting to our side, appropriate investigation and interventions were done. On bronchoscopy a large fungating fragile blackish growth was seen coming out from left main bronchus. Histopathological report of the endobronchial biopsy revealed mucormycosis. The patient was planned for Liposomal Amphotericin-B (LAMB) but unfortunately developed anaphylaxis. He was managed accordingly and was taken on oral Posaconazole therapy. On follow up visit remarkable clinical and radiological improvement was noted. Discussion: The above-mentioned case showed the management of a not so mimicking case of usual pulmonary mucormycosis without opting for surgical intervention. Thus, limiting the patient from the postsurgical complications. Conclusion: This case illustrates the heterogeneousness of mucormycosis, regardless of patient profile. Bronchoscopic findings and mycology report helped us to rule out other differential diagnosis.

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