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Infectious Disease Case Reports Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: An 85 year old male with CAD, severe aortic stenosis, sick sinus syndrome status post pacemaker and CHF, underwent a coronary artery bypass graft and an aortic valve replacement surgery with pericardial valve. He received a preoperative dose of IV vancomycin and cefazolin and 3 postoperative doses of cefazolin as part of the prophylactic protocol. On Hospital Day (HD) #4 he became septic and had several episodes of diarrhea with right lower quadrant abdominal pain. ⋯ We believe that the institution of IVIG was surgery averting for this patient with significant comorbidities even though it has only been described in case reports.Reference #1: J Salcedo, S Keates. Intraveous immunoglobilin therapy for severe Clostridium Difficile colitis. Gut 1997; 41: 366-370DISCLOSURE: The following authors have nothing to disclose: Nicolas Crescimone, Giri Srikanthanoff label use.
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ILD Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: The Antisynthetase syndrome is a rare entity, its comprises of a triad of inflammatory myopathy, diffuse interstitial lung disease, and small joint involvement. Serum auto antibodies to aminoacyl transfer RNA synthetases (anti-ARS) especially anti Jo-1 antibody present in most of the cases. Interstitial lung disease is an important diagnostic criteria and a major determinant of mortality of this syndrome. We are reporting a case of ASSCASE PRESENTATION: 48 year old female patient presented in OPD with complained of persistent dry cough and grade III dyspnea on exertion, generalised muscular pain and weakness. On examination she had mild anaemia, Pulse rate 96/mt BP 140/90 no lymphadenopathy, no clubbing. Respiratory system examination revealed crepitation in infrascapular area on both the side.Her hand were rough with creaky skin, crease of palm were dark suggestive of classical mechanics hand (figure 1). The movements of both the thumb were restricted .She was giving the history of joint pain and of Reynaud phenomenon.Investigations revealed,Hb 9.5 % gm, serum ANA was positive, Anti Ds DNA was negative, and C3 C4 and Rheumatoid factor was also negative. Transbronchial lung biopsy revealed nonspecific fibrosis and no evidence of granulomatus disorders. HRCT scan thorax was suggestive of bilateral lower lobe interstitial fibrosis in form of septal thickening, traction bronchieactasis and early honeycombing (figure 3&4). Spirometry revealed restrictive pattern . In the serum anti JO-1 was strongly positive. X-ray of the hand revealed subluxations of metacarpophalengeal joints in both the hand and progressive ankylosis of the same joint (figure2). Clinic radiological findings and serological findings were suggestive of interstitial lung disease due to AAS. ⋯ The Antisynthetase syndrome is a rare clinical entity, having multisystem involvement .It is comprises of a triad of inflammatory myopathy, diffuse interstitial lung disease, and small joint involvement. If this clinical entity diagnosed on time and treated adequately , then irreversible changes can be prevented.Reference #1: Love LA, Leff RH, Fraser DD , Targoff IN, Dalakas M, Plotz PH. Miller FW.A new approach to the classification of idiopathic inflammatory myopathy:myositis-specific autoantibody define useful homogeneous patient groups.Medicine(Baltimore) 70:360-74;1991Reference #2: Marguerie C, Bunn CC, Beynon HL, Bernstein RM, Hughes JM, So AK et al. Polymyositis, pulmonary fibrosis and autoantibodies to aminoacyl-Trna synthetase enzymes. Q J Med 1990; 77(282):1019-38.Reference #3: Chinoy H, Salway F, Fertig N, Shephard N, Tait BD, Thomson W et al. In adult onset myositis, the presence of interstitial lung disease and myositis specific/associated antibodies are governed by HLA class II haplotype, rather than by myositis subtype. Arthritis Res Ther 2006; 8(1):R13DISCLOSURE: The following authors have nothing to disclose: Ashok Singh, Raghvendra JaiswalNo Product/Research Disclosure Information.
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Bronchoscopy & Interventional ProceduresSESSION TYPE: Slide PresentationsPRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:30 AMPURPOSE: To evaluate the role of transesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) in patients with mediastinal or paramediastinal lesions. ⋯ The following authors have nothing to disclose: Carmen Centeno Clemente, Felipe Andreo, Zoran Stojanovic, Jose Sanz, Gloria Bonet, Pere Serra, Mariona Llatjòs, Joan RuizNo Product/Research Disclosure Information.
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Infectious Disease Case Reports Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Case report ⋯ This case highlights the fact that HIV patients with low CD4 count are at risk of dual opportunistic infection with histoplasmosis and cryptococcus pneumonia.Reference #1: Clin Infect Dis. (2000) 30 (4): 710-718. doi: 10.1086/313757DISCLOSURE: The following authors have nothing to disclose: Parth Rali, Hardik Soni, Win Naing, Viral GandhiNo Product/Research Disclosure Information.