Platypnoea–orthodeoxia syndrome (POS) is a rare entity characterised by respiratory distress and/or hypoxia developing in the sitting/upright posture, which is relieved in the supine posture. It is caused by cardiac, pulmonary and non-cardiopulmonary diseases. COVID-19 can have varying respiratory manifestations including acute respiratory distress syndrome (ARDS) and sequelae-like pulmonary fibrosis. POS has been rarely reported in patients with COVID-19. Here we report a case of POS in a patient recovering from severe COVID-19 ARDS. As he was gradually mobilised after his improvement, he had worsening dyspnoea in the sitting position with significant relief on assuming a supine posture. He was diagnosed with POS after ruling out other causes of POS. He was treated with oxygen support in upright posture and chest physiotherapy was continued, to which he showed improvement. POS is a rare manifestation of COVID-19 which needs awareness as it can be diagnosed easily and can respond to continued supportive care.
Background Fungal disease is frequent in India, but its incidence and prevalence are unclear. This review aims at defining the frequency or burden of various fungal infections in India. Methods A systematic review of the literature on the PubMed, Embase, and Web of Science (WOS) databases was conducted using appropriate search strings. Deterministic modeling determined annual incidence and prevalence estimates for multiple life- and sight-threatening infections with significant morbidity. Results Literature searches yielded >2900 papers; 434 papers with incidence/prevalence/proportion data were analyzed. An estimated 57 251 328 of the 1 393 400 000 people in India (4.1%) suffer from a serious fungal disease. The prevalence (in millions) of recurrent vulvovaginal candidiasis is 24.3, allergic bronchopulmonary aspergillosis is 2.0, tinea capitis in school-age children is 25, severe asthma with fungal sensitization is 1.36, chronic pulmonary aspergillosis is 1.74, and chronic fungal rhinosinusitis is 1.52. The annual incidence rates of Pneumocystis pneumonia (58 400), invasive aspergillosis (250 900), mucormycosis (195 000), esophageal candidiasis in HIV (266 600), candidemia (188 000), fungal keratitis (1 017 100), and cryptococcal meningitis (11 500) were also determined. Histoplasmosis, talaromycosis, mycetoma, and chromoblastomycosis were less frequent. Conclusions India's fungal burden is high and underappreciated in clinical practice.
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Fungal disease is frequent in India but its incidence and prevalence are unclear. Literature searches yielded over 2900 papers; 434 papers with incidence/prevalence/proportion data were analyzed. Deterministic modeling allowed annual incident and prevalence estimates for multiple life and sight-threatening infections with significant morbidity. An estimated 55 916 148 of 1 393 400 000 people in India (4.01/100 000) suffer from a serious fungal disease. The prevalence (in millions) of recurrent vulvovaginal candidiasis is 24.3, allergic bronchopulmonary aspergillosis (ABPA) is 2.0, tinea capitis in school-age children is 25, severe asthma with fungal sensitization of 1.36, chronic pulmonary aspergillosis of 1.75 and chronic fungal rhinosinusitis of 1.52. The annual incidence of Pneumocystis pneumonia (58 400), invasive aspergillosis (250 900), mucormycosis (195 000), esophageal candidiasis in HIV (266 600), candidemia (18 800), fungal keratitis (1 017 100) and cryptococcal meningitis (11 300) were also determined. Histoplasmosis, talaromycosis, mycetoma, and chromoblastomycosis are less frequent. India's fungal burden is high and under-appreciated in clinical practice. See Figures below.
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