Tuberculosis septic shock (TBSS) is a rare diagnosis due to inherent diagnostic difficulty or attribution to alternate causes. We report six cases of TBSS, along with comorbidities, clinical characteristics, hospital course, and in-hospital outcomes. All patients were middle-aged, with a median age of 54.5 years (interquartile range (IQR): 47-62). Four patients were males, whereas two were females. Majority (n = 4, 66.7%) of patients had comorbidities. Diabetes mellitus (n = 3, 50%), systemic hypertension (n = 2, 33.3%), and chronic obstructive pulmonary disease (n = 1, 16.7%) were the reported comorbidities in included patients. Median Acute Physiology and Chronic Health Evaluation (APACHE) II score at admission was 12 (IQR: 12-16). All patients had a microbiologic diagnosis of tuberculosis (TB). Four patients (66.7%) had respiratory secretions positive for Mycobacterium tuberculosis (MTB) by acid-fast bacilli (AFB) smear or cartridge-based nucleic acid amplification test (CBNAAT), two had sputum positivity, one had induced sputum positivity, whereas another had bronchoalveolar lavage specimen positive for MTB. One patient had lymph node aspirate positivity, and another had chest wall abscess positive for MTB. All had drug-sensitive TB. Five patients could be prescribed all four primary antitubercular drugs; one patient had deranged liver enzymes, requiring initiation of modified antitubercular therapy (ATT). Five patients were discharged successfully, whereas one patient died during the hospital stay. In-hospital mortality was 16.7%.

Background: Adherence to National Airborne Infection Control Guidelines (NAIC) by health-care facilities is an effective way of reducing the spread of air-borne infections such as H1N1, drug-resistant tuberculosis, and COVID-19 disease. Aims and Objectives: This study aims to assess the gaps in knowledge, attitude, implementation, and satisfaction regarding resources availability of NAIC among postgraduate resident doctors. Materials and Methods: Across-sectional study was conducted from December 2019 to February 2021 at a medical college in central India. Total 301 interns, postgraduates, and senior residents in surgery and medicine allied clinical departments were included by convenient sampling method. A pre-designed, self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP) and their satisfaction with available resources regarding NAIC. The data collected were tabulated and were analyzed using descriptive test and comparison of means by Analysis of variance test. Results: Almost 95%, 77%, and 74% of study participants were having adequate KAP on NAIC, respectively. Sixty-one percent participants were satisfied with the resources availability in their work area. Statistically significant association was observed between participants age, designation with their KAP score (P<0.05) and between gender and essential resources provided in the hospital. There was an existence of difference between study participants mean KAP score and essential resources score with statistically significance (P<0.05). Conclusion: The overall KAP was adequate, but there was a gap that exists between knowledge, practice, and satisfaction for availability of essential resources. The study findings were useful for healthcare workers in designing interventions to improve the adherence toward the NAIC guidelines and also to benchmark evaluation of interventions.

Sarcoidosis is an idiopathic granulomatous disease and can virtually affect any organ system. Multiple factors, including tubercular antigens organic and environmental exposures, have been implicated in its pathogenesis. In addition to drugs, sarcoid-like reactions have been reported following varicella and influenza vaccination. Few reports of erythema nodosum and Lofgren syndrome have been reported after the COVID19 vaccination, though no histologic diagnosis was pursued in these cases. We herein report a case of sarcoidosis presenting with bilateral acute onset vision loss with a temporal association with COVID19 vaccination (ChadOx-1 n-COV, COVISHIELDTM). Symptoms started within two weeks of receiving the vaccine. Alternate causes for optic neuritis were excluded. Transbronchial lung biopsy showed the presence of non-caseating epithelioid cell granulomas. The patient received high-dose corticosteroids immediately after diagnosis, albeit with incomplete clinical improvement in vision on a three-month follow-up. In conclusion, we report a novel case of sarcoidosis-related optic neuritis following COVID19 vaccination.

Synovial sarcoma is a rare malignant mesenchymal tumor that can develop at any anatomic site. Pulmonary sarcomas constitute 0.1–0.5% of all primary lung malignancies. Primary pulmonary synovial sarcoma is highly uncommon. Most of the patients present with large intrathoracic masses with complaints of cough, chest pain, shortness of breath, or hemoptysis. Multimodality treatment in the form of wide excision, chemotherapy, and radiotherapy is the mainstay of therapy. Synovial sarcoma is considered a high-grade tumor with a poor prognosis. We hereby present three cases of histologically proven synovial sarcoma with predominantly pulmonary involvement, along with their management and in hospital outcome.

Echinococcosis, commonly known as hydatid disease, is a zoonotic infection caused by dog tapeworm Echinococcus granulosus. Hydatid disease of the head and neck region is scarcely reported even in endemic areas. We herein report a case with with neck swelling and respiratory symptoms subsequently diagnosed to have disseminated echinococcosis of the neck and left lung.