Objective This study was aimed to describe the cardiopulmonary profiles of adult patients with bronchopulmonary dysplasia (BPD), comparing them to normative adult values.
Study Design This study presents a retrospective chart review of all BPD patients followed in the adult BPD clinic, identified from institutional and archive databases, born preterm at ≤33 weeks estimated gestational age (EGA) between January 1980 and December 2000.
Results Forty-four patients with BPD (26.4 ± 2.7 weeks of EGA) were included. Average age at follow-up was 19 years. Majority (61.4%) of the patients had a diagnosis of asthma. Mean spirometry values were: first second of forced expiration (FEV1) 74.1%, forced vital capacity (FVC) 80.7%, and FEV1/FVC 82.5%. Echocardiography (ECHO) images were reviewed, left ventricular (LV) structure and performance did not differ between obstructive and nonobstructive pulmonary function test (PFT) groups, but values of LV longitudinal strain were 4.8% lower than expected normal for adults. Patients with obstructive PFT had additional decreased right ventricular (RV) function by ECHO.
Conclusion BPD patients in this study were found to have a burden of cardiorespiratory alterations that persisted into adulthood, with RV performance abnormalities found among patients with obstructive PFT.
Key Points
Introduction: Cryptoccocus neoformans is an encapsulated fungal pathogen which is contracted through inhalation of the infectious organisms which cause primarily pulmonary disease. The infection remains latent until the host becomes immunocompromised. The disease may disseminate to different sites; however most patients essentially present with brain and lung disease (meningitis and pneumonia, respectively). Cryptococcal lymphadenitis is therefore an uncommon occurrence of this infection.
Objective: We describe the clinico-pathological features of an 18-year-old male with vertically transmitted HIV/AIDS infection who presented to our hospital with features of disseminated cryptococcal infection and notable lymph node involvement.
Case Presentation: An 18-year-old secondary school adolescent boy presented to our hospital with a 3-week history of fever, headache, body weakness and marked loss of body weight. He had been recently diagnosed with HIV infection and initiated on antiretroviral therapy (ART). On examination, he was weak, dehydrated and had multiple enlarged lymph nodes and facial skin papules. Notably, laboratory investigations revealed positive India ink test on cerebrospinal fluid (CSF) microscopy examination and culture, positive PAS stain for yeasts on lymph node histopathology and markedly prominent chest lymph nodes on the chest X-ray. A diagnosis of disseminated Cryptococcosis with lymph node involvement was made. He improved on Amphotericin B and oral fluconazole and a repeat CSF culture two weeks later was negative for Cryptococcus neoformans.
Conclusion: Cryptococcal lymphadenitis is a rare manifestation of Cryptococcal disease.
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