Intralobar pulmonary sequestration in 2 extremes of ages: A Case report.

Pulmonary sequestration is a relatively rare phenomenon characterized by nonfunctional lung tissue supplied by one or more systemic arteries without direct connection to the tracheobronchial tree. Intra-lobar pulmonary sequestration comprises 75% of the total pulmonary sequestrations. Most patients with pulmonary sequestrations are often diagnosed with a childhood chest infection, so pulmonary sequestration is considered a childhood disease. However, few cases are found in adults and the elderly, with or without symptoms, and imaging findings on computed tomography (CT) or magnetic resonance imaging (MRI) are variable due to infection and inflammation. Failure to diagnose and treat this condition may lead to recurrent pneumonia and fatal hemoptysis. In this case report, we present cases of pulmonary sequestration at extremes of ages, one at 12 and the other at 65.

Drug reaction with eosinophilia and systemic symptoms syndrome secondary to isoniazid and ethambutol: a case report and literature review.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening condition precipitated by reaction of therapeutic drugs. The prevalence of potential antitubercular therapy (ATT)-induced DRESS is 1.2%. Case presentation: A 71-year-old female patient after 5 weeks of starting ATT complaints of fever, vomiting, dizziness, and generalized itchy maculopapular rash over the body. It was associated with marked eosinophilia (absolute eosinophil count 3094 cell/mm3, 36% in peripheral blood smear). Discussion: Fever, rash, lymphadenopathy, and internal organ involvement with marked eosinophilia constitute the major clinical manifestations of DRESS. RegiSCAR scoring system is usually used to diagnose DRESS. Identification of the culprit drug is based on the temporal correlation of symptoms with drug exposure and rechallenge test, patch test and lymphocytic transformation tests may be valuable adjunctive tools. Treatment includes withdrawal of offending agent and use of topical or systemic corticosteroids, antihistamines, cyclosporin or JAK inhibitor with clinical judgement. Conclusion: Clinicians from the tuberculosis burden region must be aware of DRESS associated with ATT and they must counsel the patient properly before prescription and manage them without delay if DRESS ensues.

Optic neuropathy induced by ethambutol: A rare case from Nepal.

Introduction: Ethambutol is a drug used against tuberculosis and causes side effects like problems with vision, which may lead to optic neuropathy. It has a low prevalence of 1% and typically develops after 4-12 months of its medications. Case presentation: Here, we report a case of a 42-year-old male with ethambutol-induced optic neuropathy after six weeks of initiations of ethambutol. Discussion: Nutritional and tobacco/alcohol, ischemia, compressive, demyelinating, and genetic optic neuropathies were all ruled out as differential diagnosis for toxic optic neuropathy. Because our patient did not have vasculopathy and his vision loss was progressive on follow up and bilateral, rather than acute and unilateral, as is more usual with an ischemic disease, ischemic optic neuropathy was ruled out. Finally, because hereditary optic neuropathy usually manifests at a younger age and is expressed in many generations which was not the case in our patient, it was effectively ruled out as the cause of optic neuropathy. Conclusion: This case highlights that ethambutol toxicity is rare in cases of new onset pulmonary tuberculosis where ethambutol has been administered for only 2 months.