Assuntos
Perfuração Esofágica/complicações , Perfuração Esofágica/diagnóstico por imagem , Doenças do Mediastino/complicações , Doenças do Mediastino/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Dor no Peito/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Dear Editor, A 55-year-female, house wife, non-smoker, morbidly obese (BMI>35) with no other co-morbidities or pre-existing lung disease presented to the emergency room with complaints of highgrade fever, cough with minimal sputum, progressive breathlessness, streaky haemoptysis, and anorexia for the past 5 days. She was admitted in intensive care unit (ICU) for severe COVID-19 pneumonia three months back and had successfully recovered after 24 days of hospitalization....
Assuntos
COVID-19/complicações , Aspergilose Pulmonar Invasiva/complicações , Antifúngicos/uso terapêutico , COVID-19/terapia , Coinfecção , Cuidados Críticos , Feminino , Humanos , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/tratamento farmacológico , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , SARS-CoV-2 , Resultado do Tratamento , Voriconazol/uso terapêuticoAssuntos
Aspergilose Pulmonar Invasiva/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/diagnóstico por imagem , Idoso de 80 Anos ou mais , Aspergillus fumigatus/isolamento & purificação , Feminino , Humanos , Aspergilose Pulmonar Invasiva/complicações , Doenças Pulmonares Intersticiais/complicaçõesRESUMO
OBJECTIVES: To study the clinical profile of cases, evaluation of comorbidities and problems encountered in initiation of second-line drugs for multidrug-resistant tuberculosis (MDR-TB) patients. METHODOLOGY: A prospective observational study was conducted on MDR patients admitted in drug resistance tuberculosis (DRTB) center of RDGMC Surasa Ujjain, a rural medical college, over a span of one year. RESULTS: Out of 130 admitted cases, majority (30%) were between 31 and 40 years of age. Males were predominant (70%). Females were significantly younger compared to males (p=0.00308). Most patients (83.8%) were underweight (body mass index (BMI)<18.5kg/m2). According to MDR-TB suspect criteria, majority were defaulter cases (39.23%). The anemia was the most common comorbidity (73.84%) among the study group followed by diabetes mellitus (9.23%), chronic obstructive pulmonary disease (COPD) (9.23%), 10 (7.69) asthma, 10 (7.69%) thyroid disease 9 (6.92%) followed by respiratory insufficiency 4 (3%), HIV 2 (1.5%), deep venous thrombosis (DVT) 2 (1.5%), renal failure 2 (1.5%), and hepatic failure 1 (0.76%). Majority had minimal lesion - 57 (43.8%), moderate - 38 (29.2%), and moderate advanced - 23 (17.7%) while far advanced was noted on X-rays in 12 (9.2%). A total of 91 (70%) cases had non-cavitary lesions and 39 (30%) had cavitary lesions, of which 27 were unilateral and 12 were bilateral. CONCLUSION: The males were predominant in our study however females were affected at a younger age compared to the males. Most of the patients had taken Anti tuberculosis treatment (ATT) from Revised National Tuberculosis Control Program (RNTCP) in which defaulter and relapse were the major contributors of MDR-TB cases in our study. Radiological extent of lesions of these patients was less than expectation. Management of comorbidities is essential for compliance to treatment. It necessitates prolonged hospitalization and requires frequent follow-up in the DRTB center.