A case of localized lung scedosporiosis is reported here that mimicked aspergilloma in an immunocompetent host. Through this case the importance of considering Scedosporium spp. in differential diagnosis of locally invasive lung infections and fungal ball is highlighted. As it is difficult to differentiate Scedosporium from Aspergillus on clinical grounds, microscopy, radiology and histopathology, this case is further emphasizing the significance of the definitive etiological characterization of Scedosporium through culture or molecular diagnostic tools. Accurate identification of Scedosporium, surgical resection and high-dose voriconazole has been associated with favorable outcome in most reported cases of scedosporiosis.

Serum levels of the inflammatory C-X-C motif chemokine 10 (CXCL10) are raised in tuberculosis (TB). CXCL10 gene expression is downregulated in monocytes by metabolically active vitamin D3 (1,25dihydroxy vitamin D). Stratification of patients by serum 25hydroxyvitamin D (25[OH]D) levels at baseline showed that treatment-induced decrease in CXCL10 occurred in those with 'insufficient' and 'deficient' but not in those with 'optimal' levels. In the deficient group, 25(OH)D showed an inverse correlation with CXCL10 levels. CXCL10 may thus be a useful biomarker for the follow-up of response to treatment. However, CXCL10 levels should be interpreted taking into account the baseline serum vitamin D levels of the TB patients.

Objective: The purpose of study was to assess the role of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) and hydrocortisone in patients with COVID-19 and their outcome during hospitalization. Materials and Methods: A clinical comparative prospective hospital-based study was conducted in the Department of Pulmonology & Intensive Care Unit (ICU) of Dow University of Medical & Health Sciences, Karachi in patients positive for COVID-19 infection during their hospitalization. A comparative analysis was performed between two groups, i) those who received an injection of hydrocortisone and ii) those who received oral ACEi/ARB. All the baselines and clinical variables were recorded in a structured questionnaire and the data were evaluated in the Statistical Package for the Social Sciences (SPSS) version 22.0. A p-value of <0.05 is considered statistically significant. Results: The final analysis was performed on 130 patients among them 68 patients received an injection of hydrocortisone and 62 patients received the tablet ACEi/ARB, which ever indicated. Patients who need injection hydrocortisone were older than patients who received ACEi/ARB, 58.37±15.20 and 51.01±90.22. Patients who received injection hydrocortisone were more likely to receive mechanical ventilation support as compared to other groups, 11.7% vs. 4.8%, respectively, p-value 0.02. The overall mortality rate was 10% (n = 13) in both groups in which a higher number of deaths was observed in patients who were taking ACEi/ARB as compared to patients who were receiving injection hydrocortisone, 12.9% vs. 7.3%, respectively, but it had an insignificant association, p-value 0.17. Conclusion: We have observed in our study that patients who received an injection of hydrocortisone had lower rates of mortality irrespective of their gender and age while patients who received ACEi/ARB during hospitalization had lower complications rate but higher mortality rates.