Tuberculous lymphadenitis is the most common presentation of extra pulmonary tuberculosis EPTB. Clinical and radiological presentation of disease may vary and differential diagnosis includes both benign and malignant conditions such as lymphomas and sarcoidosis. We present two case reports of tuberculous lymphadenitis with varied presentation. In case report Ⅰ, patient had undergone splenectomy due to traumatic splenic rupture had classical symptoms of tuberculosis, chest X-ray, CT thorax showed mediastinal and cervical lymphadenopathy. FNAC showed a picture of granulomatous lesion. In case report ⅠⅠ patient came with complaints of abdominal pain in hypochondriac region. CT and USG abdomen showed multiple enlarged retroperitoneal lymph nodes which led to a provisional diagnosis of lymphoma after which lymph node biopsy showed a granulomatous picture. This case report stresses the importance of early and quick diagnosis of tuberculosis in immunocompromised patients and highlights the risk of misdiagnosis of tuberculous lymphadenitis with other benign and malignant causes of lymphadenopathy and the importance of humoral mediated immunity in tuberculosis.
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Introduction and Aim: Interstitial lung disease (ILD) is a heterogeneous disorder that share common clinical, radiographic, and physiological features. Most patients with ILD usually experience an exertioninduced dyspnea as first symptom. A noticeable change in oxygen saturation was noticed in ILD patients while exercise. The study objective was to ascertain the functional parameter that correlates best with ILD by comparing age, sex, and smoking history with different ILD pattern. Materials and Methods:A proforma (including Six Minute Walk Test and Pulmonary Function Test with lung diffusion capacity) for one-year period (September 2014 -November 2015) was taken for the 40 included participants. The study includes patients with Interstitial Lung diseases diagnosed by clinical, radiological and spirometric parameters. The study tests the sensitivity and the specificity of six-minute walk test versus lung carbon monoxide diffusing ability.Results: A total of 40 participants were included (19 were males and 21 were females). 12 were smokers and 28 were non-smokers. 20 patients belonged to Usual Interstitial Pneumonia (UIP) pattern, 14 were Non-Specific Interstitial Pneumonia (NSIP) and 6 were others. The mean±SD spirometric parameters were FEV1/FVC=101.71±16.752, FVC=55.29±17.322, FEV1=57.66 ± 20.246. Conclusion:There was no statistical significance between age, gender, smoking and ILD patterns. Spirometer and diffusion capacity indices co-relate best with NSIP pattern of ILD in our study. In a resource limited setting, clinical and radiological assessment of ILD with six-minute walking distance and spirometry should or need not be supplemented by DLCO for severity assessment.
Miliary tuberculosis (TB) is a lethal form of TB, if left untreated. Miliary TB accounts for <2% of all cases of TB in immunocompetent individuals. Intracranial tuberculoma is a rare manifestation of Mycobacterium tuberculosis (MTB), seen in only 1% of TB patients. It can occur as single or multiple lesions, most commonly located in the frontal and parietal lobes. Clinical features mimic that of any space-occupying lesion in the brain. In pregnant women, diagnosis of TB may be delayed by the non-specific nature of early symptoms and because they are often attributed to pregnancy.Here we report one such case where the diagnosis of TB was delayed due to the non-specific nature of her symptoms in ante-natal period.
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