ABSTRACT
Bronchial carcinoid tumours are rare, slow-growing, malignant, Low-grade neuroendocrine tumours that arise from Enterochromaffin (Kulchitsky) cells and are usually detected typically as indolent and solitary tumours. Approximately 2% of all lung tumours are bronchial carcinoid tumours. Case presentation: The authors report a case of 55-years-old man who presented with a history of cough for 1 month and was initially diagnosed with a case of COVID-19. Then he was treated as a case of pneumonia as seen on high-resolution computed tomography. Later, contrast-enhanced computed tomography and bronchoscopy-guided biopsy were done which revealed a right lower lobe neuroendocrine tumour (carcinoid), which was successfully resected. Clinical discussion: The majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, and wheezing. During the COVID-19 pandemic, lung cancer patients were at higher risk of being affected by COVID-19. This study emphasizes that early identification and differential diagnosis are extremely difficult in the absence of comprehensive study and workup as the clinical and imaging findings of COVID-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids, most lymphadenopathies are caused by a reactive inflammatory reaction. Conclusion: Bronchial carcinoids are uncommon, malignant neuroendocrine tumours for which the only curative management is complete surgical resection. With full resection, the result of typical carcinoids with lymph node metastases is favourable.
ABSTRACT
Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. Patients may present with a sudden onset of muscle weakness. Though hyperthyroidism occurs more commonly in females, TPP typically occurs in young males in their third decade. Case Presentation: This is a case of a 32-year-old male who presented to the emergency room with a sudden onset of weakness in bilateral upper and lower limbs, which progressed to complete paralysis in an hour. A provisional diagnosis of hypokalemic periodic paralysis was made and admitted. Later, on further diagnostic workup, the final diagnosis of TPP was made. Discussion: Clinical features of hyperthyroidism in patients with TPP may be subtle. With immediate potassium supplementation, serious cardiopulmonary complications can be prevented and may hasten the recovery of muscle weakness. Nonselective ß-adrenergic blockers can lessen and prevent the recurrence of paralytic attacks. Conclusion: This case is reported with the objective of generating awareness regarding the clues to the diagnosis, appropriate management, and definitive treatment to a render euthyroid state in order to prevent future recurrence of similar episodes and prevent any complications, and eventually to raise the index of suspicion among treating physicians in cases that present with paralysis in clinical practice.
ABSTRACT
Introduction and importance: Multisystem Inflammatory Syndrome in Children (MIS-C) is an uncommon condition that can present with a wide range of clinical features and complications. As it can be confused with various diseases, diagnosis is crucial as proper management can improve the patient's condition. Case presentation: 14-year male presented with fever, abdominal pain, and cough on September 2021. On examination, he was febrile with a distended abdomen and enlarged liver. Following investigations, abdominal tuberculosis was suspected but his condition improved with broad-spectrum antibiotics, intravenous immunoglobulins, and high-dose steroids. Clinical discussion: Any children with COVID 19 infection who have fever with multiple systems involved after ruling out other causes of infections should be suspected to have MIS-C. Diagnosis can be challenging as its clinical presentation mimics conditions like Kawasaki disease, ricketssial disease and acute appendicitis, etc. In high prevalence countries, with predominant gastrointestinal features, it can be confused with abdominal tuberculosis as well, hence, proper diagnosis is crucial. Conclusion: The course of MIS-C can be fatal where most children require intensive care units and early institution of immunomodulatory therapy for their recovery. Also, all pediatricians need to have a high degree of suspicion to diagnose MIS-C as it can be confused with different illnesses.
ABSTRACT
Introduction: Lymphatic filariasis (LF) is a vector-borne illness caused due to Wuchereria bancrofti. Genital abnormalities may result from chronic inflammation of the lymphatic vessels and obstruction of the afferent vessels in Bancroftian filariasis. Doxycycline, albendazole, diethylcarbamazine, and ivermectin are among the treatments available. Case: A 16-year male presented to our OPD with a complaint of left inguinal swelling for the past 6 Months. Examination of the swelling revealed a left-sided inguinal swelling of 5 × 4 cm with intact overlying skin. A provisional diagnosis of inguinal lymph varix was made, and real-time ultrasound scanning along with FNAC was performed. Swelling resolved after conservative management. Discussion: Ultrasonography can easily observe adult worms due to their size and fast movements. Using pulsed-wave doppler mode, the characteristic movement profile of adult worms in pulsed-wave doppler mode can be distinguished from other movements (e.g., blood in venous vessels). Conclusion: Ultrasound is the imaging modality of choice to detect filarial worms/microfilaria in the lymphatic system, which produces the classic twirling of microfilaria in the lymphatic system, known as the "filarial dance sign".
