Complaints Of Fever Research Articles

Hodgkin\'s Lymphoma in a Milky Way

Chylothorax refers to the accumulation of chyle in the pleural space. The most common cause of nontraumatic chylothorax is tuberculosis, malignancy, and congenital causes. We share a case of bilateral chylothorax in a 24-year-old male patient admitted with complaints of fever, dry cough, and dyspnea, initially suspected of tuberculosis. The effusion was drained, and a biochemical test revealed chylothorax. Chest radiograph showed widening of mediastinum. Contrast-enhanced computed tomography done revealed lobulated anterior and superior mediastinal mass lesion possibility of lymphoma. Excision biopsy of the lymph node was done, and the biopsy report revealed histological features consistent with the malignant lymphoproliferative process in favor of the nodular sclerosis variant of classic Hodgkin's disease. This case reveals bilateral chylothorax as the first manifestation in a young male patient of Hodgkin's lymphoma. Early suspicion and systematic diagnosis provide good outcome.

Features of the course of influenza and its co-infection in children at the present stage

Influenza is an acute respiratory infection, mainly affecting the respiratory tract (often the trachea), with a tendency to develop symptoms rapidly and in most cases not requiring hospitalization. All acute respiratory infections are non-specific, with symptoms of intoxication, catarrhal symptoms (nasal congestion, rhinorrhoea, sore throat or pharyngeal discomfort), fever and cough. Improvement and widespread implementation of molecular methods to identify respiratory pathogens has led to the establishment of a higher frequency of co-infections. A literature review of the frequency of influenza co-infections is presented. Clinical cases of monoinfluenza and co-infections of influenza and respiratory syncytial infection are described, demonstrating the antagonistic effect of the two viruses on the course of the disease. In the first case, the patient, 1 year 1 month old, was hospitalised with a fever of 39 ºC in a moderate condition. A nasopharyngeal swab showed RNA of influenza A virus by PCR and was diagnosed with influenza. In the second case, the patient, 2 years old, at the beginning of the disease complained of an increase in body temperature to 38.7 ºC, cough, and difficulty in nasal breathing. On admission, the patient was in moderate condition with a body temperature of 36.6 ºC, clear consciousness and well-being. On auscultation, breathing in the lungs was rigid, single moist rales, scattered on both sides. A nasopharyngeal swab showed RNA of influenza A virus and respiratory syncytial virus by PCR. A viral acute respiratory infection of combined etiology and acute bronchitis was diagnosed. In the third case, a 14-year-old patient presented with complaints of fever up to 39 ºC, headache, weakness, muscle pain, dry cough. The condition was of moderate severity. The diagnosis of influenza A was confirmed by a rapid test for influenza A/B/C. In the treatment and prevention of both monoinfection and co-infections of influenza and other viruses, these clinical examples demonstrate the effectiveness of oseltamivir. These clinical examples highlight some key parameters: respiratory co-infections change the typical clinical picture of the disease, making it difficult to clinically diagnose the infection, highlighting laboratory diagnosis, which in turn facilitates rapid verification of the diagnosis and timely prescription of adequate therapy.

Dengue Encephalopathy or Japanese Encephalitis? Co-Infection or Serologic Cross- Reactivity?

Dengue infection has a wide clinical spectrum ranging from asymptomatic presentation to life-threatening severe dengue with multiorgan failure, and increasingly recognized neurological presentation in the past decade. Japanese encephalitis on the other hand is another common mosquitoes-borne flavivirus infection endemic in Southeast Asia, which share some similar clinical features. We report a case of a 38-year-old male patient who presented to us with complaints of fever and acute encephalitis syndrome with positive dengue NS1 antigen, and positive cerebrospinal fluid serologies for both dengue and JE immunoglobulins. Magnetic Resonance Imaging findings were suggestive of encephalitic changes. Co-infection and serology cross-reactivity of these two flaviviruses is not uncommon in countries where both dengue and Japanese encephalitis are endemic, and thus, the treating clinician should have a high index of suspicion if clinical and serological evidence are present whilst treating the patient.

Severe abacavir hypersensitivity reaction in a patient with human immunodeficiency virus infection: a case report

BackgroundAbacavir is a nucleoside reverse transcriptase inhibitor that is used as a component of the antiretroviral treatment regimen in the management of the human immunodeficiency virus for both adults and children. It is efficacious, but its use may be limited by a hypersensitivity reaction linked with the HLA-B*57:01 genotype. HLA-B*57:01 has been reported to be rare in African populations. Because of the nature of its presentation, abacavir hypersensitivity is prone to late diagnosis and treatment, especially in settings where HLA-B*57:01 genotyping is not routinely done.Case reportWe report a case of a severe hypersensitivity reaction in a 44-year-old Kenyan female living with the human immunodeficiency virus and on abacavir-containing antiretroviral therapy. The patient presented to the hospital after recurrent treatment for a throat infection with complaints of fever, headache, throat ache, vomiting, and a generalized rash. Laboratory results evidenced raised aminotransferases, for which she was advised to stop the antiretrovirals that she had recently been started on. The regimen consisted of abacavir, lamivudine, and dolutegravir. She responded well to treatment but was readmitted a day after discharge with vomiting, severe abdominal pains, diarrhea, and hypotension. Her symptoms disappeared upon admission, but she was readmitted again a few hours after discharge in a hysterical state with burning chest pain and chills. Suspecting abacavir hypersensitivity, upon interrogation she reported that she had taken the abacavir-containing antiretrovirals shortly before she was taken ill. A sample for HLA-B*57:01 was taken and tested positive. Her antiretroviral regimen was substituted to tenofovir, lamivudine, and dolutegravir, and on subsequent follow-up she has been well.ConclusionsClinicians should always be cognizant of this adverse reaction whenever they initiate an abacavir-containing therapy. We would recommend that studies be done in our setting to verify the prevalence of HLA-B*57:01.

Water-borne oculoglandular tularemia: Two complicated cases and a review of the literature

BackgroundIn this study, we presented two cases of late diagnosed complicated oculoglandular tularemia and reviewed the clinical features of oculoglandular tularemia in cases reported in the last ten years. MethodTularemia was diagnosed when serum microagglutination test (MAT) was ≥ 1/160 titer or when there was at least a four-fold increase in MAT titers measured over a two-week interval. We searched the oculoglandular tularemia cases reported in the last 10 years in the PubMed and Google Academic engines. ResultsCase 1 (19 M) and case 2 (15 M) had complaints of fever and burning in the eye. In both cases, the diagnosis of tularemia was delayed. Lymph node suppuration developed in both cases. A total of 19 cases of tularemia were found within the search. In the cases of oculoglandular tularemia reported in the last 10 years, submandibular and preauricular lymphadenopathy were most common after ocular findings and fever. The mean time to diagnosis was 41 ± 94 days, and the complication rate was 31.5%. ConclusionTularemia should definitely be considered in cases of fever and ocular findings, especially in endemic areas. In non-endemic areas, a good anamnesis and clinical suspicion can help diagnose the disease early and reduce the complication rate.

A case report: a 38-year-old man with vivax relapse malaria

Introduction: Malaria is a parasitic disease caused by blood protozoa of the Plasmodium genus transmitted through the bite of a female Anopheles mosquito. Indonesia is still an endemic area, especially in the eastern regions. About 40% of malaria cases in the world are caused by Plasmodium vivax. Tertiana or vivax malaria can cause relapse because it has a hypnozoite stage that is dormant in the liver. This case report will discuss a case of relapse vivax malaria with thrombocytopenia. Case Illustration: A 38-year-old man came to the emergency room consciously with a fever complaint since 4 days before entering the hospital. Fever occurred throughout the body, disappeared, accompanied by chills and sweating. On the second day the fever began to decrease somewhat but the next day the fever began to increase. The patient has a history of serving in Papua and contracted malaria 3 months before entering the hospital. While in Papua, the patient worked as a supporter for the 2021 PON event and malaria treatment was not complete. A complete blood examination found thrombocytopenia and microscopic examination of thin drops of the presence of ring-shaped Plasmodium vivax. The patient is diagnosed with vivax relapse malaria. The patient was treated with antimalarial therapy with DHP 4 tablets in a day for 3 days and primaquine 2 tablets in a day for 14 days. Monitoring therapy was done on the eighth day, with microscopic examination, and the result was negative malaria plasmodium. Conclusion: This case report discusses vivax relapse malaria and proper management to irradiate the hypnozoite stage which has an important role in the recurrence phase.

PSAT347 New Onset of Graves’ Disease after COVID-19 Vaccination

Abstract Introduction Adjuvants are substances that are commonly found in vaccines. They can enhance the efficacy and potency of a vaccine via an immunological response. However, in some susceptible individuals, these adjuvants can lead to a serious autoimmune response known as autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This can lead to the onset of autoimmune disorders following vaccination. There are many case reports of the onset of autoimmune disorders following COVID-19 vaccination. However, new onset of Graves’ disease within one day after COVID-19 vaccination, is of rare occurrence. Clinical Case We present the case of a 33-year-old Caucasian male who presented to his primary care physician with chief complaints of fever ranging between 99.2F to 101.3F, palpitations and hand tremors which started one day after he received his first dose of COVID-19 vaccine. Initial laboratory evaluation included a negative throat swab for Group A Streptococcus, a negative nasal swab for Influenza A & Influenza B and a negative nasopharyngeal swab for SARS-COV-2 RNA. On physical examination, he was afebrile, pulse rate 101/min, blood pressure 125/74 mm Hg and oxygen saturation 98%. Due to persistence of tachycardia, an EKG was done which showed a normal sinus rhythm with no other abnormalities. Further laboratory testing was remarkable for a suppressed TSH 0.005 (0.300-4.00 uUI/ml), elevated FT4 2.36 (0.80-1.80 ng/dl) and an elevated TSH receptor Antibody (TRAb) 8.67 (0.00-1.75 IU/L), which confirmed the diagnosis of Graves’ disease. Subsequently, patient established care at our endocrinology clinic. Labs were repeated which showed persistence of hyperthyroidism with TSH <0.005, high normal FT4 1.56 and an elevated FT3 5.36 (2.00-4.40 pg/ml). Thyroid ultrasound was remarkable for mild thyromegaly with increased vascularity and no discrete nodules. Patient was initiated on Methimazole 10 mg daily and propranolol 10 mg twice daily. During the first follow-up visit, the dose of Methimazole was reduced to 5 mg daily based on improved labs. However, it had to be increased back to 10 mg daily due to subsequent worsening of labs. Since then, patient has been maintained on a stable dose of Methimazole 10 mg once daily and the beta-blocker has been discontinued. It has been almost 1 year since the diagnosis and the Graves’ disease specific Thyroid Stimulating Immunoglobulin (TSI) antibody is still elevated at 1.31 (0.00-0.55 IU/L). Conclusion Graves’ disease should be considered high in the differential diagnosis in a patient presenting with fever and tachycardia following COVID-19 vaccination. Our unique case supports the current literature available on the various autoimmune conditions caused by the autoimmune/inflammatory syndrome induced by adjuvants, also known as ASIA. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m., Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Endocarditis with No Valve Involvement? A Case of Superior Vena Cava Endocarditis, Rare but Serious Vascular Infection

Patients with end-stage renal disease (ESRD) will likely need vascular access for hemodialysis, the vascular access increases the risk of having bloodstream infections such as Catheter-Related Bloodstream Infections (CRBSI). Rarely some patients may have non-valvular endocarditis. Fibrin sheath usually plays a role in this infection, and these can be identified on a transesophageal echocardiogram (TEE). ESRD patients can present without fever in cases of endocarditis due to uremia impaired cellular host defenses, therefore, a low threshold for TEE should be considered in these patients. We report a case of SVC endovascular endocarditis in the setting of MSSA bacteremia in an ESRD patient. A 49 -year-old female with a past medical history significant for ESRD secondary to diabetic nephropathy on dialysis with a tunneled subclavian hemodialysis dialysis catheter. Presented to the hospital for a chief complaint of fever for 2 days duration. The patient was vitally stable on admission; the area around the catheter was indurated and tender. The patient had a blood culture on the first day of her fever, it came back positive upon admission as the blood culture showed staphylococcus aureus bacteremia, and the patient was started on IV Vancomycin. Ultrasound was done and showed an abscess surrounding the dialysis port. TTE was done and showed no obvious evidence of endocarditis. TEE was done which demonstrated a large, mobile RA mass consistent with vegetation, which is attached at the lower junction of SVC and right interatrial septum. Angiovac of vegetation was done. The catheter was out. Blood culture sensitivity grew MSSA, susceptible to ancef, therefore vancomycin was switched to ancef 2g for a total of 6 weeks. Clinical suspicion should always be high for endocarditis in patients with fever and having dialysis catheter. TTE can be negative many times in these patients; therefore, having a high index of suspicion should always be there in these patients. Non-valvular endocarditis such as superior vena cava endocarditis is very uncommon and is only documented in a few cases in the literature. This infection responds very well to the antibiotic and Angiovac is helpful in these situations too.

Thrombotic thrombocytopenic purpura a new threat of a savior: A case report

Thrombotic thrombocytopenic purpura (TTP) is a potentially fatal consumptive coagulopathy that requires prompt diagnosis and treatment. It is characterized by microangiopathic hemolytic anemia and thrombocytopenia, with microthrombosis. COVID-19 vaccination is proven to reduce disease morbidity and mortality. Vaccines have been hypothesized to link to certain autoimmune diseases. We present the case of a 43-year-old man with no personal or family history of hematologic diseases who admitted with a chief complaint of fever and icterus 15 days after vaccination with the second dose of COVID_19 AstraZeneca (ChAdOx1-S). Clinical and Laboratory data (increased LDH, decreased haptoglobin, and indirect hyperbilirubinemia) was suspicious of TTP. We confirm the diagnosis of TTP With low ADAMTS13. To our knowledge, this is the first Iranian case of vaccine-induced TTP that has been reported. In conclusion, for accurate diagnosis of patients with clinical symptoms of thrombocytopenia after COVID-19 vaccination, clinicians should be alert to the possibility of acquired TTP.

Clinical malaria incidence and health seeking pattern in geographically heterogeneous landscape of western Kenya

BackgroundMalaria remains a public health problem in Kenya despite sustained interventions deployed by the government. One of the major impediments to effective malaria control is a lack of accurate diagnosis and effective treatment. This study was conducted to assess clinical malaria incidence and treatment seeking profiles of febrile cases in western Kenya.MethodsActive case detection of malaria was carried out in three eco-epidemiologically distinct zones topologically characterized as lakeshore, hillside, and highland plateau in Kisumu County, western Kenya, from March 2020 to March 2021. Community Health Volunteers (CHVs) conducted biweekly visits to residents in their households to interview and examine for febrile illness. A febrile case was defined as an individual having fever (axillary temperature ≥ 37.5 °C) during examination or complaints of fever and other nonspecific malaria related symptoms 1–2 days before examination. Prior to the biweekly malaria testing by the CHVs, the participants' treatment seeking methods were based on their behaviors in response to febrile illness. In suspected malaria cases, finger-prick blood samples were taken and tested for malaria parasites with ultra-sensitive Alere® malaria rapid diagnostic tests (RDT) and subjected to real-time polymerase chain reaction (RT-PCR) for quality control examination.ResultsOf the total 5838 residents interviewed, 2205 residents had high temperature or reported febrile illness in the previous two days before the visit. Clinical malaria incidence (cases/1000people/month) was highest in the lakeshore zone (24.3), followed by the hillside (18.7) and the highland plateau zone (10.3). Clinical malaria incidence showed significant difference across gender (χ2 = 7.57; df = 2, p = 0.0227) and age group (χ2 = 58.34; df = 4, p < 0.0001). Treatment seeking patterns of malaria febrile cases showed significant difference with doing nothing (48.7%) and purchasing antimalarials from drug shops (38.1%) being the most common health-seeking pattern among the 2205 febrile residents (χ2 = 21.875; df = 4, p < 0.0001). Caregivers of 802 school-aged children aged 5–14 years with fever primarily sought treatment from drug shops (28.9%) and public hospitals (14.0%), with significant lower proportions of children receiving treatment from traditional medication (2.9%) and private hospital (4.4%) (p < 0.0001). There was no significant difference in care givers' treatment seeking patterns for feverish children under the age of five (p = 0.086). Residents with clinical malaria cases in the lakeshore and hillside zones sought treatment primarily from public hospitals (61.9%, 60/97) traditional medication (51.1%, 23/45) respectively (p < 0.0001). However, there was no significant difference in the treatment seeking patterns of highland plateau residents with clinical malaria (p = 0.431).The main factors associated with the decision to seek treatment were the travel distance to the health facility, the severity of the disease, confidence in the treatment, and affordability.ConclusionClinical malaria incidence remains highest in the Lakeshore (24.3cases/1000 people/month) despite high LLINs coverage (90%). The travel distance to the health facility, severity of disease and affordability were mainly associated with 80% of residents either self-medicating or doing nothing to alleviate their illness. The findings of this study suggest that the Ministry of Health should strengthen community case management of malaria by providing supportive supervision of community health volunteers to advocate for community awareness, early diagnosis, and treatment of malaria.

E-CIGARETTE OR VAPING PRODUCT USE ASSOCIATED LUNG INJURY: A DIAGNOSTIC DILEMMA

E-CIGARETTE OR VAPING PRODUCT USE ASSOCIATED LUNG INJURY: A DIAGNOSTIC DILEMMA

COVID-19-INDUCED PULMONARY SARCOIDOSIS: A CASE REPORT

COVID-19-INDUCED PULMONARY SARCOIDOSIS: A CASE REPORT

FATAL ASPERGILLUS TRACHEOBRONCHITIS IN AN IMMUNOCOMPROMISED HOST ASSOCIATED WITH PARAINFLUENZA VIRUS INFECTION

FATAL ASPERGILLUS TRACHEOBRONCHITIS IN AN IMMUNOCOMPROMISED HOST ASSOCIATED WITH PARAINFLUENZA VIRUS INFECTION

BRONCHOSCOPIC LOCALIZATION OF PERIPHERAL LUNG LESION TO GUIDE SURGICAL RESECTION IN A TODDLER

BRONCHOSCOPIC LOCALIZATION OF PERIPHERAL LUNG LESION TO GUIDE SURGICAL RESECTION IN A TODDLER

S3257 A Fatal Case of Herpes Simplex Hepatitis in Pregnancy

Introduction: Herpes Simplex Virus (HSV) hepatitis is a rare but potentially fatal presentation of HSV that can affect immunocompromised individuals such as pregnant women, particularly in the 3rd trimester. It can lead to liver failure with mortality up to 75%. Early recognition with the initiation of antivirals and supportive therapy has been shown to reduce mortality, however, insult to the liver can lead to liver failure complicated with encephalopathy and ascites. We present a case of HSV hepatitis in pregnancy which despite supportive therapy and acyclovir, resulted in demise. Case Description/Methods: A 24 year old pregnant female at 23 weeks gestation presented to a facility with complaints of fevers and fatigue. She was discharged and treated symptomatically. 2 weeks later she developed encephalopathy, profound liver failure, and thrombocytopenia, with induction of labor and loss of the infant. She was intubated and developed shock requiring pressors. She was placed on Molecular Adsorbent Recirculating System (MARS) dialysis for support. Cultures were collected, including HSV panel, which was positive for HSV-1. Acyclovir was immediately started, and patient continued to be on supportive therapy. She improved on MARS and acyclovir, with improvement of her liver enzymes and viral load, and later extubated. Patient appeared to return to baseline, however days later, patient developed jaundice, ascites significant for spontaneous bacterial peritonitis, and encephalopathy refractory to lactulose and rifaximin. Despite acyclovir, broad-spectrum antibiotics, and prior MARS therapy, her liver enzymes increased and patient had to be reintubated, where she had multiorgan failure and expired to disseminated HSV. Discussion: This case demonstrates a rare occurrence of HSV hepatitis in a pregnant woman. Recognition of HSV occurred once patient developed acute liver failure and encephalopathy, however, based on her history patient likely presented with HSV symptoms, such as fevers, and fatigue that remained untreated. Despite supportive therapy such as MARs and Acyclovir, patient expired of liver failure from HSV. This case shows the importance of considering HSV in the pregnant population, for if it were recognized and treated earlier, patient may not have reached fulminant liver failure resulting in death. In conclusion, HSV hepatitis and initiation of early antiviral therapy should be considered in all pregnant patients with concern for evolving hepatic failure.

S2533 An Unusual Finding Lurking in the Colon

Introduction: Deep Invasive gastrointestinal endometriosis (DIGIE) is rare. Out of all endometriosis cases, 7-12% of cases can have gastrointestinal involvement, ranging from single lesions, to multiple lesions, to full colonic stenosis. Symptoms can include dyspareunia, dysmenorrhea, infertility, dysphasia, diarrhea, constipation, bloating, and rectal bleeding. Here we present a patient who was incidentally found to have endometrioma. Case Description/Methods: A 24-year-old female with a past medical history significant for polycystic ovarian syndrome, HIV and endometriosis, presented to the hospital with chief complaints of fever, dysuria, hematochezia, and lower abdominal pain which had been ongoing for 3-4 days. On admission, the patient was noted to be hemodynamically stable. Abnormal laboratory results included hematocrit 32.6% (reference range 36-46%), hemoglobin 10.2 g/dL (reference range 12-16 g/dL), mean corpuscular volume 72.4 fL (reference range 80-100 fL), ferritin 15.8 ng/mL (reference range 6.3-137 ng/mL), total iron binding capacity 306 mcg/dL (reference range 265-497 mcg/dL), and iron 19 mcg/dL (reference range 37-170 mcg/dL). The following day, she underwent a colonoscopy which showed isolated diverticulosis involving the sigmoid colon. There was an active oozing diverticulum that was successfully treated with endoscopic clip placement. At the rectosigmoid junction, there was a 3 cm submucosal lesion bulging into the lumen. This appeared to have a smooth surface and was without ulceration. Biopsies were taken and the pathology showed submucosal granulation tissue with chronic inflammatory reaction and iron deposition. CD10 specific immunostains were positive, suggesting the diagnosis of an endometrioma (Figure). Discussion: This case highlights an incidental finding of DIGIE. It is important to think about colonic involvement in patients with endometriosis who have GI complaints. Rarely, these lesions can cause obstruction and may require surgery. There are currently no formal guidelines or recommendations, with most of these patients being managed on a personalized basis. Management for these patients includes symptomatic therapies, progresterones, colonic shaving, disc excision, and laparoscopic resection. As for our patient, she pursued conservative symptomatic management with close outpatient Gynecology follow up.Figure 1.: A 3 cm submucosal lesion bulging into the lumen at the rectosigmoid junction.

LIFE CYCLE OF A COVID-19-INDUCED LUNG CYST

LIFE CYCLE OF A COVID-19-INDUCED LUNG CYST

SARS-COV-2 WITH PROBABLE ANTI-NMDA RECEPTOR ENCEPHALITIS WITH MIS-C: A CASE REPORT

COVID-19 disease is caused by a novel coronavirus SARS-CoV-2 and typically causes respiratory symptoms. However, with increasing cases SARS-CoV-2 infection has been shown to be associated with dysregulated and persistent inflammatory reactions and production of some antibodies hence multi organ involvement is seen. We present a 12-year-old boy who had no pulmonary symptoms and presented with the complaints of fever and behavioral changes with examination and investigation findings suggestive of Covid 19 infection with probable Anti-NMDAR encephalitis with MIS-C.

Adverse Cutaneous Drug Reaction Following Granulocyte Colony-Stimulating Factor Administration in Nasopharynx Cancer Patient with Febrile Neutropenia: A Case Report

Introduction: Several side effects may occur during cancer treatment such as myelosuppression following systemic chemotherapy, which is mainly manifested as neutropenia and is associated with increased infection risk. Febrile neutropenia is associated with a worse prognosis. Granulocyte colony-stimulating factor (G-CSF) may be given prophylactically before chemotherapy in selected cases or as adjuvant therapy in febrile neutropenia. G-CSF administration may be associated with several side effects, including skin manifestation. More rarely, G-CSF administration may induce acute febrile neutrophilic dermatosis is which known as a Sweet syndrome. Case Presentation: A 63-year-old man with nasopharyngeal cancer stage III on chemotherapy and radiotherapy came to our emergency department with a chief complaint of fever, coughing, and shortness of breath. He was diagnosed with community-acquired pneumonia and febrile neutropenia. His white blood cell (WBC) count was 200/mm3 . On the third day of hospitalization and G-CSF administration, he developed a rash and had skin desquamation mainly on his head including the scalp, face, lips, upper trunk, arms, and the surface of both hands. His follow-up laboratory result was WBC 8300/mm3 with a neutrophil count of 87%. Presumable Sweet syndrome diagnosis with differential diagnosis of other drug eruption reactions was made. Systemic and topical were administered, and G-CSF was stopped. Significant improvement was observed. Conclusions: G-CSF administration in febrile neutropenic cancer is generally safe; however, several adverse events may occur. Cutaneous adverse events following G-CSF administration should be recognized and treated accordingly. Sweet syndrome is rare but should be recognized as a possible G-CSF-induced drug skin complication.

A HIV /AIDS case diagnosed with concomitant Pneumocystis jiroveci pneumonia and pulmonary tuberculosis confused with COVID-19 pneumonia

Bakteriyel ve fungal infeksiyonlar COVID-19 ile birlikte görülebilir. Ayrıca, bazı infeksiyon hastalıkları COVID-19 infeksiyonuna bağlı pnömoni ile karışabilir. Bu yazıda, COVID-19 pnömonisi ön tanısıyla kliniğimize sevkedilen, HIV infeksiyonuna bağlı Pneumocystis jiroveci pnömonisi ve akciğer tüberkülozu tanısı konulan 60 yaşında bir erkek hasta sunuldu. Hastanın başvuru esnasındaki ateş, öksürük ve balgam çıkarma yakınmaları Pneumocystis jiroveci ve akciğer tüberkülozu tedavisi sonrasında tamamen düzeldi.