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He had made several prior visits to the ED for the cough and was hospitalized 4 months earlier for similar symptoms, at which time he underwent a bronchoscopy with BAL and was discharged with antibiotics for presumed pneumonia. He did not report any itching, rashes, sinus infections, joint swelling, joint pain, or GI symptoms. His long-term medications included omeprazole and amlodipine. The patient had a past medical history of grade III follicular lymphoma for which he completed six cycles of bendamustine 4 years before presentation and had been in remission since. He was a never smoker, had a recent travel history to the Dominican Republic 8 months before admission, and had no recent sick contacts.

A woman in her late 40s with a history of recurrent deep vein thromboses and hypersensitivity pneumonitis (HP) presented to the ED with progressive exertional dyspnea and productive cough. She recently had started oral corticosteroids after HP was confirmed via transbronchial lung cryobiopsy from both the right upper and lower lobes, which showed poorly formed granulomas with mild interstitial and perivascular lymphocytic infiltrates. A causative antigen for her HP was never clearly identified.

A woman in her late 40s with a history of recurrent deep vein thromboses and hypersensitivity pneumonitis (HP) presented to the ED with progressive exertional dyspnea and productive cough. She recently had started oral corticosteroids after HP was confirmed via transbronchial lung cryobiopsy from both the right upper and lower lobes, which showed poorly formed granulomas with mild interstitial and perivascular lymphocytic infiltrates. A causative antigen for her HP was never clearly identified.

A 27-year-old man from Eritrea presented to the ED complaining about a progressively worse blunt chest pain in the anterior right hemithorax. Chest pain started 4 years ago and was intermittent. During the last 6months, symptoms got worse, and the patient experienced shortness of breath in mild exercise. For this purpose, he visited another institution, where a chest radiograph was performed (Fig 1). He was advised to visit a pulmonologist for further evaluation, with the diagnosis of a loculated pleural effusion in the right upper hemithorax.

A 27-year-old man from Eritrea presented to the ED complaining about a progressively worse blunt chest pain in the anterior right hemithorax. Chest pain started 4 years ago and was intermittent. Selleck DT2216 During the last 6 months, symptoms got worse, and the patient experienced shortness of breath in mild exercise. For this purpose, he visited another institution, where a chest radiograph was performed (Fig 1). He was advised to visit a pulmonologist for further evaluation, with the diagnosis of a loculated pleural effusion in the right upper hemithorax.

A 21-year-old woman, a housewife with no known comorbidities, presented to the outpatient department with complaints of dry cough, left-sided pleuritic chest pain, modified Medical Research Council grade II breathlessness and backache. She had started developing these symptoms 1month earlier. There was no history of fever, hemoptysis, or significant weight loss. She had no features suggestive of connective tissue disorder. There was no history of recurrent respiratory infections in the past. She was married for 1 year and had no children. Her sleep, bowel, and bladder habits were normal. No significant family history or medication history was noted.

A 21-year-old woman, a housewife with no known comorbidities, presented to the outpatient department with complaints of dry cough, left-sided pleuritic chest pain, modified Medical Research Council grade II breathlessness and backache. She had started developing these symptoms 1 month earlier. There was no history of fever, hemoptysis, or significant weight loss. She had no features suggestive of connective tissue disorder. There was no history of recurrent respiratory infections in the past. She was married for 1 year and had no children. Her sleep, bowel, and bladder habits were normal. No significant family history or medication history was noted.

A 27-year-old man was hospitalized in the burn unit after sustaining an acute inhalational injury and facial burns after an accidental occupational exposure to an industrial disinfectant consisting of a mixture of hydrogen peroxide (15%-30%), acetic acid (5%-15%), and peracetic acid (5%-15%). He demonstrated cough, shortness of breath, and hoarseness of voice at presentation that had developed 6h after exposure. In addition to the inhalational injury of the vocal cords and lower airways on bronchoscopy (Fig 1), the patient also was diagnosed with acute inhalational pneumonitis based on the findings of hypoxemic respiratory failure and bilateral perihilar airspace opacities on chest radiography (Fig 2). He required intubation and mechanical ventilation initially for 2days for upper airway edema and was discharged 19days after exposure with resolution of hypoxemia and reduction of airspace opacities on chest radiography. However, symptoms of productive cough and shortness of breath on exertion persisted, and and was discharged 19 days after exposure with resolution of hypoxemia and reduction of airspace opacities on chest radiography. However, symptoms of productive cough and shortness of breath on exertion persisted, and he was rehospitalized 27 days after exposure. He was a nonsmoker with no prior history of atopy, asthma, or lung disease. His medical history was remarkable for hypertension and severe obesity with a BMI of 34.7 kg/m2.We report here a case of portopulmonary hypertension following transjugular intrahepatic portosystemic shunt.A trisomy 21 neonate presented with congenital chylous pleural effusion and ascites that was refractory to conventional pharmacotherapy. Midodrine, an oral alpha-1-adrenoreceptor agonist, achieved remission of chylous effusion without any adverse effects. To the best of our knowledge, this is the first neonatal case of successful management of congenital chylous pleural effusion and ascites with midodrine.Inhaled antibiotics have long been used for chronic lung infections, especially in patients with cystic fibrosis and increasingly for non-cystic fibrosis bronchiectasis. Amikacin liposome inhalation suspension (ALIS) has emerged as a promising treatment for Mycobacterium avium complex infection refractory to oral antibiotics. However, despite its efficacy, nearly one-half of patients in phase II and III trials experienced dysphonia as a treatment-associated adverse effect. Here, we describe a patient who experienced severe, acute-onset laryngitis while receiving ALIS for refractory M avium complex infection, prompting discontinuation of ALIS therapy. This is the first report directly describing vocal fold injury due to such therapy. Given the high frequency of dysphonia reported with ALIS, this case highlights the potential severity of laryngeal toxicity, the importance of coordination of care for patients receiving inhaled antibiotics for chronic pulmonary disease, and the need for better insight into mechanisms of toxicity.Some severe asthmatic patients experience frequent bacterial respiratory tract infections, which contribute significantly to their disease burden, and often are attributed to their use of systemic corticosteroids and comorbid bronchiectasis. We report a case of a 58-year-old woman who had prednisone-dependent asthma and exacerbations with intense mixed eosinophilic and neutrophilic bronchitis. Autosomal dominant hyper-IgE syndrome, which is a primary immunodeficiency characterized by elevated IgE, eosinophilia, and recurrent infections, caused by a novel pathogenic mutation in STAT3 was identified as the cause of her airway disease. We believe that this is the first report of the demonstration of an IL-5 driven eosinophilia that is associated with a STAT3 mutation that was treated successfully with an anti-IL5 biological.Farmers' knowledge and farm management practices can potentially help to mitigate the prevalence and severity of chicken coccidiosis, a devastating protozoan disease. Here, we assessed the farmers' perception and on-farm practices of coccidiosis management in small-scale broiler farms at Gazipur district, Bangladesh. A semi-structured questionnaire was used to obtain data from the randomly selected 119 small-scale broiler producers followed by detection of coccidiosis cases through gross and microscopic examination of 58 broilers. Overall bird-level prevalence of coccidiosis was 34.48% in this study. Survey data revealed that most of the farmers maintained all-in-all-out strategy (68.91%), good quality chicks (73.11%) and floor system rearing (96.63%) in their farms, and a mixture of old and new litter was used as bedding in all the study farms. Interval between flocks in 57.99% of farms was 8 to 14 days. Prevalence of coccidiosis was recorded in all surveyed farms, even though routine anticoccidial treatment. At the age of 15 to 18 days of broiler, 68.07% of farmers used chemoprophylaxis. Usage of amprolium was the highest (74.78%) followed by toltrazuril (55.46%), sulphaquinoxaline (23.52%), sulphaclozine (28.57%), sulphadimidine (24.36%) and sulphadimethoxine (24.36%). Traditional herbal medicines like extracts of bollygum (Litsea glutinosa), sal (Shorea robusta) and arjuna (Terminalia arjuna) bark and leaves were also in-use by 4.20% farmers during coccidiosis outbreak. In conclusions, this study explored the field scenario of coccidiosis, relevant farmers' knowledge and practices, and recommends the judicious use of drugs for safe broiler production.Ixodes ricinus followed by Dermacentor reticulatus are the most common tick species with medical and veterinary importance in Poland. Ixodes ricinus is widely distributed across Poland, whereas the range of D. reticulatus is limited to the eastern and central parts of the country, with several new foci in the mid-west and west. Concurrently, an increase in the occurrence range of D. reticulatus has been observed. Recent studies indicate its high density in eastern Poland. The aim of the study was to determine the species composition of ticks infesting dogs from the northeastern part of Lublin Province. In a three-year study (2017-2019), 501 tick specimens were collected from 122 dogs in the north-eastern part of Lublin Province (eastern Poland). 174 ticks were removed from 24 pet dogs kept by individual owners and the other 327 were collected from 98 dogs from the animal shelter. Two tick species D. reticulatus 55.5% (278/501) and I. ricinus 44.5% (223/501) were identified in the group of 501 ticks removed from the dogs. Dogs in the north-eastern part of Lublin Province are exposed to contact with two tick species I. ricinus and D. reticulatus, with a higher frequency of the latter species. Identification of the species of ticks infesting dogs in an analyzed area and knowledge of pathogens transmitted by ticks facilitates correct differential diagnosis of tick-borne diseases.House dust mite allergy is a serious problem that affects about six million people in Poland and if left untreated could be the reason for the development of bronchial asthma. The main purpose of this study was to analyse how aware the patients in the respiratory ward were about the prevention of allergic diseases caused by house dust mites and the prophylactic measures that can be taken. The study took place between September 2018 and November 2018 and involved 109 patients, hospitalised in the Respiratory Ward of the Railway Hospital in Wilkowic-Bystra, who had been diagnosed with asthma and house dust mite allergy. People between 51 and 60 years of age comprised the largest group of respondents. A diagnostic survey method was utilised for the study, whereby the survey data was collected by way of a questionnaire completed by the participants. Most people (45.0%) experience an increase in allergy symptoms when cleaning the house and when sleeping at night (35.0%). Over half of the respondents (59.0%) believe, that the main places in which dust mites are found in the home are rugs, blankets and bedding.