Rifampicin-Induced Pneumonitis Mimicking Severe COVID-19 Pneumonia Infection.

BACKGROUND Rifampicin-induced pneumonitis is an infrequent occurrence, with only a few cases reported in the literature. Furthermore, this condition constitutes a diagnostic challenge, particularly in the era of COVID-19 infection. Here, we report a case of rifampicin-induced pneumonitis with clinical, imaging, and histological features of acute respiratory distress syndrome (ARDS), which required severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to exclude a diagnosis of coronavirus disease 2019 (COVID-19) pneumonia. CASE REPORT A 43-year-old man on anti-TB treatment for TB meningitis developed new-onset fever, fatigue, hypoxemic respiratory failure, and bilateral pulmonary opacities. His clinical, chest X-ray, and CT thorax findings of ARDS were similar to both rifampicin-induced pneumonitis and severe COVID-19 pneumonia. However, reverse transcription polymerase chain reaction (RT-PCR) testing from a nasopharyngeal swab and bronchoalveolar lavage (BAL) via the GeneXpert system was negative for SARS-CoV-2. A detailed workup, including lung biopsy, revealed drug-induced pneumonitis as the cause of his presentation. His pneumonitis improved after discontinuation of rifampicin and recurred following the rifampicin challenge. CONCLUSIONS This case highlights the importance of early, rapid, and accurate testing for SARS-CoV-2 during the COVID-19 pandemic for patients presenting with acute respiratory symptoms, so that accurate diagnosis and early patient management are not delayed for patients with treatable causes of acute and severe lung diseases. Timely identification of rifampicin-induced pneumonitis via a high clinical suspicion, detailed workup, and histopathological analysis is required to avoid permanent damage to the lungs.

Optimization of bioresource material from oil palm trunk core drying using microwave radiation; a response surface methodology application.

In this study optimization of drying oil palm trunk core lumber (OPTCL) biomass using microwave radiation was reported. Optimizing of the drying conditions using microwave, avoid burning, shrinkage and increasing the permeability of OPT was aimed to develop a new value added material. A set of experiments was designed by central composite design using response surface methodology (RSM) to statistically evaluate the findings. Three independent process variables including time (2-10 min), sample weight (300-1000 g) and input power (660-3300 W) were studied under the given conditions designed by Design Expert software. The results showed the effectiveness of microwave drying in reducing the time and better removal of moisture as compared to that of oven drying with no significant changes. Employing optimum conditions at 6.89 min of time with a microwave power set at 4 for a sample of 1000 g, predicting 14.62% of moisture content.