ABSTRACT
A 53-year-old man with diabetes came to the emergency department with fever and dry cough for 5 days, swelling of the left leg for 2 days, shortness of breath and chest pain for 1 hour. He had raised temperature, tachycardia, tachypnoea, reduced oxygen saturation and swollen tender left leg on examination. The frontal chest radiograph showed bilateral ground-glass opacities; he tested positive for COVID-19 with elevated D-dimer. The colour Doppler examination of the left leg revealed acute deep vein thrombosis (DVT) of the common femoral and the popliteal veins. The chest CT showed bilateral diffuse ground-glass opacities predominantly involving peripheral zones and the lower lobes. The CTPA revealed left pulmonary thromboembolism (PTE), treated with low-molecular-weight heparin. COVID-19 predominantly affects the respiratory system. DVT and PTE are common in COVID-19 but lethal. They should be diagnosed early by clinical and radiological examinations and treated promptly with anticoagulants.
Subject(s)
COVID-19/complications , Pulmonary Embolism/etiology , Venous Thrombosis/etiology , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Alanine/analogs & derivatives , Alanine/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use , Antiparasitic Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/blood , COVID-19/diagnosis , COVID-19/therapy , Computed Tomography Angiography , Diabetes Mellitus, Type 2/complications , Doxycycline/therapeutic use , Femoral Vein , Fibrin Fibrinogen Degradation Products , Glucocorticoids/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Ivermectin/therapeutic use , Male , Methylprednisolone/therapeutic use , Middle Aged , Oxygen Inhalation Therapy , Popliteal Vein , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/therapy , SARS-CoV-2 , Tomography, X-Ray Computed , Ultrasonography, Doppler, Color , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/therapy , COVID-19 Drug TreatmentABSTRACT
Eosinophilic ascites is a manifestation of serosal eosinophilic gastrointestinal disease. We present a 44-year-old male with low serum ascites albumin gradient with high eosinophil count and contrast-enhanced computed tomography of the abdomen showing circumferential wall thickening of the esophagus, mid to distal ileal loops, and ascending colon. The patient was managed with tablet prednisolone 20 mg twice daily for two weeks, then gradual tapering over one month. The patient responded to treatment. Awareness of the condition, timely diagnosis, and early treatment carries excellent responses.
ABSTRACT
Paraquat (1,1'-dimethyl-4,4'-dipyridylium) is a liquid herbicide associated with accidental and suicidal ingestion, leading to fatal toxicity. It can lead to multiple organ dysfunction, including metabolic acidosis, acute kidney and liver injury, pulmonary fibrosis, and acute respiratory distress syndrome (ARDS). Very rarely, this can present with spontaneous pneumothorax or pneumomediastinum or both, which are poor prognostic markers with a mortality rate of almost 100%. Here, we present a young male presenting with paraquat poisoning followed by the development of both pneumothorax and pneumomediastinum and death from respiratory failure. Paraquat poisoning should always be considered in the differential diagnosis in patients presenting with spontaneous pneumothorax or pneumomediastinum in places with high paraquat poisoning prevalence.
