Leptospirosis is a bacterial infection caused by spirochaete. It's a gram-negative bacterium. It spreads Through animal urine or soil or water contaminated with Animal urine (Rat), when coming into contact with mouth, nose, eyes or breach in the skin. It is more common in farmers and people involved in water sports. In leptospirosis symptoms can range from mild muscle pains, headache and fever to severe forms including jaundice and renal failure (Clavel et al., 2010;MoHFW, 2021). This is a case report of a 23-year-old male with no previous co-morbidity presented to us in severe ARDS. Due to COVID-19 pandemic 1st possibility of COVID-19 related ARDS was considered, but after repeated negative RT-PCR tests and COVID serology, work up for other causes was done. On further investigating the patient, his Leptospira IgM came positive. Diagnosis of Leptospira induced ARDS was made and treated for the same. But despite of best-efforts patient expired during hospital stay.
Non-Specific Interstitial Pneumonia (NSIP) is linked to numerous etiologies, including connective tissue diseases, certain drugs, HIV and idiopathic causes. We present a case of an 82-year-old woman with subacute onset shortness of breath as the presenting feature of Non-specific interstitial pneumonia. Chest imaging demonstrated bilateral infiltrates and tentatively diagnosed as NSIP and started on Tyrosine kinase inhibitor -Nintedanib. But she worsened symptomatically and on further evaluation, Mycobacterium tuberculosis had been detected in her Sputum. Anti-tuberculous therapy and Tyrosine Kinase Inhibitor (TKI) resolved her pulmonary symptoms to an extent and she was discharged on Long term oxygen therapy. In this case, we encountered a Tuberculosis (TB) case with NSIP where NSIP could overlap the diagnosis of TB and we should have a strong suspicion of TB in geriatric people.
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