COVID-19 cases are still rising globally in the middle of the tuberculosis epidemic. Several countries have reported TB-COVID-19 coinfection that could pose a double burden in the health care facilities in developing countries. We reported two pulmonary tuberculosis patients coinfected with COVID-19 with an overlapping clinical manifestation of tuberculosis and COVID-19 with a good prognosis at the end of COVID-19 treatment. This paper aims to discuss TB patients' susceptibility against SARS-COV-2 infection, the clinical profile of TB-COVID-19 coinfection, and the disease's prognosis. The clinician should be aware of both common disease symptoms that appear in a patient and should be confirmed and treat promptly.
Introduction: Pneumocystis jirovecii pneumonia (PJP) is a lung mycosis commonly found in immunocompromised patients (e.g., HIV patients); however, its role in solid cancer remains unclear. This study aims to identify Pneumocystis jirovecii colonization among naïve non-small-cell lung cancer (NSCLC) through bronchoalveolar lavage (BAL) and explore its correlation with clinical parameters. Methodology: This cross-sectional study recruited newly diagnosed naïve NSCLC patients who had not been given systemic treatments. We tested BAL from patients for P. jirovecii colonization with nested PCR targeting the mtLSU rRNA gene. Demographic and clinical characteristics were obtained from medical records, and the correlation between P. jirovecii colonization and clinicopathological data were analyzed. Kaplan-Meier analyses were done to evaluate survival. Results: Among 56 newly diagnosed, naïve NSCLC patients enrolled, the prevalence of P. jirovecii colonization was 17.9% (10 subjects). There was no statistically significant difference in demographic and clinical characteristics between the P. jirovecii colonization group versus no colonization (p value > 0.05). The overall survival duration for both groups demonstrated no significant difference. Conclusions: This study demonstrated a relatively high prevalence of P. jirovecii colonization among BAL samples of naïve Indonesian NSCLC patients. Further study is needed to delineate its implications for the potential transmission source, lung cancer pathogenesis, and prognosis.
Background: Advanced lung cancer has the lowest overall survival than other stage and tyrosine kinase inhibitor (TKI) are promising to prolong life and prevent disease progression. ROS1 rearrangement was very rare and constitute around 1.4 % of all NSCLC. Previous preclinical and clinical trial have reported the efficacy and safety of crizotinib against advanced NSCLC with ROS1 rearrangement, but little is known about its efficacy with nonstandard dosage.Case: A female, 58 years old, with no history of cancer nor smoking, came with persistent chest pain and cough for three months. The patient was then diagnosed with advanced lung cancer by FDG-PET CT Scan. The biopsy confirmed adenocarcinoma with genotyped ROS1-rearrangement. After receive standar dose of 200 mg bid, the patient intolerated and treatment plan was adjusted with 200 mg of alternated daily dosage (one-day on-off drug administration). Fortunately, the intolerance symptoms were alleviated and showed positive response during 3-years therapy.Discussion: Pulmonary tuberculosis has been linked to pneumothorax in HIV-associated TB patients. This study is done to better our understanding of the link between the two. The patient had active pulmonary tuberculosis as well as HIV and a rare case of bilateral pneumothorax in the ER.Conclusion: This case showed that advanced NSCLC with ROS1 rearrangement has positive response to crizotinib despite using alternating daily dose, with good response during 3 years and on.
Background: Crizotinib is a drug designed to treat advanced NSCLC with ROS-1 rearrangement. Nevertheless, no reviews have assessed available studies to determine the efficacy and safety of first-line crizotinib against advanced NSCLC with ROS-1 rearrangement.Methods: PubMed, Cochrane Library, EBSCOHost, and ScienceDirect, were searched, filtered by inclusion and exclusion criteria, and read the full text. The researchers summarized and extracted efficacy as the primary outcome, including patients’ best response (complete response, partial response, stable disease, progressive disease, disease control rate, and objective response rate) and prognosis (overall survival rate and progression-free survival rate). Safety was also extracted as the secondary outcome.Results: Out of 91 articles electronically searched, four observational studies were included, extracted, and summarized descriptively. After full-text reading, entire studies were included. Across studies, the median PFS of the first line crizotinib varied from 14.9 months, 23.0 months, and 18.4 months with the median OS being 60 days to “Not Reach.” The patients’ best responses were similar among the studies. However, two out of four studies did not report the adverse event outcome. This study concluded that first-line crizotinib was safe.Conclusions: This systematic review suggests the potency of the first line of crizotinib therapy in advanced NSCLC patients. Regarding the current limitation of included studies, further higher quality with subsequent research in this scope is needed.
<p align="justify"><strong><em>Introduksi:</em></strong><em> Coronavirus Disease 2019 (COVID-19) merupakan penyakit infeksius yang masih menjadi permasalahan serius di dunia. Meskipun presentasi klinis utama COVID-19 adalah gejala respirasi, manifestasi gastrointestinal seperti nyeri perut dan diare dapat ditemukan sebagai satu-satunya presentasi dari penyakit ini. Swab anal dapat dilakukan untuk penegakkan diagnosis COVID-19 dengan presentasi gastrointestinal. Namun perananya dalam diagnosis COVID-19 masih belum diketahui secara pasti.</em></p><p align="justify"><strong><em>Laporan kasus:</em></strong><em> Laporan kasus ini membahas seorang pasien dewasa yang datang dengan keluhan gastrointestinal tanpa adanya gejala respirasi. Pasien ini kemudian terkonfirmasi COVID-19 melalui pemeriksaan polymerase chain reaction (PCR) pada sampel swab nasofaring dan swab anal.</em></p><p align="justify"><strong><em>Diskusi: </em></strong><em>COVID-19 dapat ditandai dengan berbagai gejala dari organ tubuh manapun, salah satunya adalah gejala gastrointestinal. Swab anal menjadi sampel yang cukup representatif dalam membantu penegakkan diagnosis COVID-19 dengan gejala gastrointestinal. </em></p><div><p align="justify"><strong><em>Kesimpulan</em></strong><em>: Di tengah pandemi ini, presentasi gastrointestinal tanpa gejala respirasi perlu dipertimbangkan sebagai presentasi klinis atipikal dari COVID-19. Hal ini menuntut kehati-hatian tenaga kesehatan untuk menghindari misdiagnosis COVID-19 dengan menggunakan pengambilan sampel dari organ lain seperti swab anal.</em></p></div>
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