BACKGROUND The lung is one of the most frequently involved organs in complications of immunocompromised host. Among these, pulmonary infection is the most common complication. The chest radiograph is initial diagnostic tool for detection of suspected pulmonary infection in immunocompromised. However, chest radiograph ndings are nonspecic in determining pathogens. The early use of Computed Tomography (CT) is helpful in detecting pulmonary lesions which may not be evident on routine chest radiographs. But there is overlap of CT nding in different infections. This study is therefore, designed to document the clinical, radiological & microbial prole of pulmonary infection in immunocompromised patients. AIM To study the clinical, radiological and microbial prole of pulmonary infection in immunocompromised patients, and to study diagnostic yield of sputum examination, induced Sputum examination & bronchoscopic BAL examination. METHODS The present prospective descriptive observational study was conducted in the Department of Chest Medicine at King Edward Memorial Hospital, Pune. It included immunocompromised patients with lower respiratory tract infection symptoms. A total number of 70 indoor & OPD patient with urban & rural background were included in the study. Among them 45 patients were HIV reactive group and 25 patients were having Non-HIV immunocompromised condition. All of them had pulmonary infection. The study was conducted over a period of 15 months. RESULTS Incidence of pulmonary infection was higher in age 31-40 years (28.58%). There were 51 males and 19 females. Opportunistic infections were more common in males as compared to females. Majority of immunocompromised patients were HIV reactive (64.3%) followed by of Malignancy (15.7%). Focal non homogenous opacity (37.5%) was most common radiological nding followed by consolidation with air brochogram (25%). Pulmonary Tuberculosis (40.5%) was most common opportunistic infection in immunocompromised patients followed by bacterial (30.38 %) and fungal infections (17.72%). Sputum (40.98), induced sputum examination (19.29), and Bronchoscopy with BAL (91.42%) had good diagnostic yield in diagnosis of pulmonary infection in immunocompromised patients. CONCLUSION Induced sputum had less diagnostic yield in immunocompromised patients and also it is time consuming.Early bronchoscopy with BAL remains crucial to establish the diagnosis in immunocompromised patients with pulmonary infection when the cause is infectious in nature.
BACKGROUND The rst case of Covid-19 was identied in Wuhan city, China in December 2019. The symptoms of Covid-19 are variable that include fever, cough, fatigue, breathing problem, loss of smell and taste. The virus is spreading through human touch and small droplets and aerosols. The numbers of deaths due to the virus is increasing day by day and it causing various issues for the government and people to maintain the business and employment. AIMTo study clinical prole, radiological presentation, and prognostic predictors of COVID-19 positive patients in a Tertiary Care Hospital METHODS It was a retrospective observational study conducted on 103 patients diagnosed with COVID-19. Clinical characteristics and outcomes of consecutive adult patients admitted to Sahyaadrie Multi-specialty hospitals, dedicated covid health care (DCHC), Osmanabad, st (Maharashtra) from 1 October 2020 to 31 Dec 2020 were studied. The diagnosis of SARS-CoV-2 infection was conrmed by Rapid antigen test and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) on the throat and/or nasopharyngeal swabs. RESULTS There were 49 patients (47.6%) belonging to the rural area and 54 patients (52.4%) belonging to the urban area. The majority of the patients (n = 77) had an abnormal respiratory rate of more than 20 breaths per minute. Chest X-Ray showed that 26 patients (25.24%) had a normal chest x-ray and 77 patients (74.75%) had an abnormal chest x-ray. The average HRTCT score was 10.92 with 12 patients (11.7%) having upper HRCT level, 63 patients (61.2%) having middle HRCT level and 89 patients (86.4%) with lower HRCT level. CONCLUSION Male patients over the age of 55 years are most prone to Covid-19. The virus is hurting the respiratory system of human and affecting the living condition as patients with cancer, diabetes and other critical illnesses are having a strong impact on the body and internal system.
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