Browsing by Author "Ashis Kumar Choudhury"

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Case report: Histoplasmosis accompanying disseminated tuberculosis in an immunocompetent adolescent boy
(American Society of Tropical Medicine and Hygiene, 2020) Ashis Kumar Choudhury; Ankit Kumar Mishra; Deepak Kumar Gautam; Ragini Tilak; Vijai Tilak; Indrajeet Singh Gambhir; Sankha Shubhra Chakrabarti
The incidence of tuberculosis in India is quite high. In such a situation, empirical antitubercular therapy (ATT) is often resorted to, when some of the investigation findings are clearly diagnostic of tuberculosis. This may mean missing out on coinfections. Whereas this is particularly true for immunosuppressed patients, rarely even immunocompetent patients may present with such diagnostic dilemmas.Wepresent the case of an adolescent boy who had been previously asymptomatic and who presented with fever with lymphadenopathy, splenomegaly, and pancytopenia. Initially, ATT was administered based on the detection of acid-fast bacteria in lymph node, caseating granulomas with Langhans giant cells, and a positive cartridge-based nucleic acid amplification test specific for Mycobacterium tuberculosis. However, when the patient failed to respond fully to the treatment, additional investigation in the form of bone marrow fungal culture led to the diagnosis of histoplasmosis. © 2020 by The American Society of Tropical Medicine and Hygiene.
Hypokalaemic quadriparesis following torsemide and spironolactone use
(All India Institute of Medical Sciences, 2018) Upinder Kaur; Sankha Shubhra Chakrabarti; Ashis Kumar Choudhury; Indrajeet Singh Gambhir
Mild hypokalaemia is a common electrolyte abnormality following therapeutic doses of diuretics such as torsemide. If undiagnosed and untreated, hypokalaemia progresses and smooth muscle, skeletal muscle and the heart are affected. Potassium-sparing diuretics such as spironolactone are commonly added to loop diuretics to prevent symptomatic hypokalaemia. We present a patient with moderate hypokalaemia associated with the use of torsemide and spironolactone, resulting in quadriparesis, hospitalization and electrophysiological abnormalities. © The National Medical Journal of India 2018.