Helicobacter pylori infection manifesting as Hypereosinophilic syndrome and immune thrombocytopenia complicated by portal vein thrombosis and ischemic colitis.

Hypereosinophilic syndromes (HES) are a group of uncommon disorders characterized by persistent eosinophils overproduction which can lead to tissue damage and organs dysfunction secondary to eosinophils tissue infiltration and inflammatory mediators' release. Causes of secondary HES include parasitic infection, some solid tumors, underlying connective tissue disease, allergic conditions and T cell lymphoma. Helicobacter pylori (H. pylori) has been reported only once as a cause of secondary HES in the literature. We report the second case of H. pylori infection in 29-year-old male patient who presents with HES and secondary Immune thrombocytopenic purpura (ITP). This case is different from the first reported case by the presence of HES complication on presentation manifesting as portal vein thrombosis, which was further complicated by ischemic colitis. H, pylori eradication therapy alone was successful in a resolution of hypereosinophilia and platelets recovery without the need of corticosteroids or any other treatment.

The Role of Post-Bronchoscopy Sputum Examination in Screening for Active Tuberculosis.

Early diagnosis is a fundamental component of global tuberculosis control. The objective of this study was to evaluate the diagnostic yield of post-bronchoscopy sputum (PBS) testing as part of a tuberculosis diagnostic work-up. All new residents in the State of Qatar undergo a tuberculosis (TB) screening program. Those with abnormal chest radiology, negative sputum acid-fast bacilli (AFB) smears, and nucleic acid amplification testing (NAAT) for M. tuberculosis, undergo an additional bronchoscopic evaluation for TB. We prospectively enrolled individuals who were going to undergo bronchoscopy to provide two PBS samples for AFB smears and mycobacterial cultures between 18 September 2018 and 12 March 2021. A total of 495 individuals, with a median age of 31 years, were included. The majority of the patients were males (329, 66.5%). The most frequent country of origin was India (131, 26.5%) followed by the Philippines (123, 24.8%). The addition of PBS to bronchoalveolar lavage (BAL) testing allowed microbiological confirmation of tuberculosis in an additional 13 patients (3.9%), resulting in improved sensitivity (from 77.9% to 81.9%), negative predictive value (from 69.2% to 73.2%), and negative likelihood ratio (from 0.22 to 0.18). Where resources are available, the incorporation of routine PBS examination as part of tuberculosis diagnostic work-up can enhance the diagnostic yield.

Frequency of Acute Kidney Injury in Patient Receiving Piperacillin - Tazobactam: A Hospital-based Study from Qatar.

BACKGROUND: several studies have been reported piperacillin-tazobactam (TAZ / PIPC)-associated AKI with various frequencies. The aim of this study was to determine the frequency of TAZ/PIPC- associated AKI among our patients and to identify the risk factors for this clinical entity. METHODS: this retrospective cross-sectional study was conducted at Hamad General Hospital; it involved adult patients who were admitted from January 2017 to December 2017. RESULTS: we involved 917 patients, of whom 635 (69.25%) were males and 282 (30.75%) were females. The mean age of the patients was 52 (SD 19) years, and 98 (10.7%) patients were diagnosed with AKI. The patients with AKI were significantly older than without AKI [59.71 (SD 19.79) versus 51.06 (SD 18.67); P <0.001]. After TAZ/PIPC initiation, the mean creatinine level in the AKI group was higher than the mean creatinine level in the non-AKI group, [158.91 (SD 81.93) versus 66.78 (SD 21.42); P<001]. The mean time of onset of AKI after PIPC/TAZ initiation was 4.46 (SD 3.20) (1-12 days). AKI was significantly associated with low mean serum albumin (P<0.001), high mean fasting blood glucose (P<0.001), coronary artery diseases (P<0.001), heart failure (P<0.001), liver diseases (P=0.047), diabetes mellitus (P=0.021) and hypertension (P<0.001). The in-hospital mortality was significantly higher in the AKI group [38.78% versus 5.13% in the non-AKI group; P<0.001], and only advanced age and heart failure were found as independent risk factors for TAZ/PIPC-associated AKI. CONCLUSION: TAZ/PIPC was significantly associated with AKI. Advanced age and heart failure were identified as independent risk factors for TAZ/PIPC-associated AKI.

Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma.

Pleural effusion can rarely present as an initial manifestation of Ewing sarcoma. We illustrate a case of a young male adult who was admitted with pleural effusion that led to the diagnosis of Ewing sarcoma.

Parathyroid Adenoma as a Rare Cause of Persistent Hypercalcemia in a Female with Polycythemia Vera.

Polycythemia vera is one of the myeloproliferative neoplasms that is distinguished by the uncontrolled production of blood cells and an increased red cell mass due to acquired JAK2 mutation. It has many complications and it might increase the risk of other tumors. However, it does not cause hypercalcemia and is rarely associated with parathyroid adenoma. Here, we report on a 64-year-old female with polycythemia vera found to have hypercalcemia due to parathyroid adenoma.

Confirmed Coronavirus Disease-19 (COVID-19) in a Male with Chronic Myeloid Leukemia Complicated by Febrile Neutropenia and Acute Respiratory Distress Syndrome.

Coronavirus disease-19 is a respiratory viral disease that commonly presents with mild symptoms. However, it can cause serious complications such as acute respiratory disease, especially in patients with comorbidities. As it is a new disease, the full picture of the disease and its complications are not yet fully understood. Moreover, the patients at risk of complications are not well identified; and the data about the risk in patients with hematological malignancies is limited. Here, we report a 65-year-old male with accelerated phase chronic myeloid leukemia, on dasatinib, tested positive for coronavirus disease-19, then complicated with febrile neutropenia acute respiratory distress syndrome.

Primary Bone Lymphoma in Axial Skeleton in a Middle-Aged Female Presented as Recurrent Anemia.

Primary bone lymphoma (PBL) is a peculiar extranodal presentation of non-Hodgkin's lymphoma. Primary bone diffuse large B-cell lymphoma (DLBCL) is the most common pathological type, comprising about 80% of PBL. The diagnosis of PBL depends on the combined clinical examination and imaging studies and is confirmed with immunohistochemical examination. Due to the rarity of this disease, more relative studies and case reports are needed to provide insight into this obscure lymphoproliferative malignancy. Here, we report one rare case of primary bone DLBCL involving the axial skeleton in a 37-year-old female.