Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum, a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive therapy or in solid organ transplant recipients. Tuberculosis and histoplasmosis may cooccur rarely in HIV and the clinical resemblance of both diseases may hinder identification of patients’ harbouring dual infection, especially in regions non-endemic for histoplasmosis. We report a case of disseminated histoplasmosis with disseminated tuberculosis in an incidentally detected patient with HIV-positive who presented with reports of fever and skin rash for 10 days. The Mantoux positivity and CT of chest and abdomen revealing multiple necrotic lymph nodes coupled with bone marrow and skin biopsy divulging histoplasmosis and tuberculosis helped us clinch the concurrent infection.

Social media platforms are increasingly deploying complex interventions to help users detect false news. Labeling false news using techniques that combine crowd-sourcing with artificial intelligence (AI) offers a promising way to inform users about potentially low-quality information without censoring content, but also can be hard for users to understand. In this study, we examine how users respond in their sharing intentions to information they are provided about a hypothetical human-AI hybrid system. We ask i) if these warnings increase discernment in social media sharing intentions and ii) if explaining how the labeling system works can boost the effectiveness of the warnings. To do so, we conduct a study (N=1473 Americans) in which participants indicated their likelihood of sharing content. Participants were randomly assigned to a control, a treatment where false content was labeled, or a treatment where the warning labels came with an explanation of how they were generated. We find clear evidence that both treatments increase sharing discernment, and directional evidence that explanations increase the warnings' effectiveness. Interestingly, we do not find that the explanations increase self-reported trust in the warning labels, although we do find some evidence that participants found the warnings with the explanations to be more informative. Together, these results have important implications for designing and deploying transparent misinformation warning labels, and AI-mediated systems more broadly.

Scrub typhus is a mite-borne rickettsial infection that presents with fever and a diverse array of complications. Lately, many epidemics have been reported from the Indian subcontinent. Data from these outbreaks suggest that liver injury in scrub typhus is common and reversible. We are reporting the case of a 27-year-old pregnant female who presented with fever, encephalopathy, jaundice and seizure. She had acute liver failure and dead fetus on admission. Despite appropriate antibiotics and supportive treatment, she continued to deteriorate and developed multiorgan dysfunction, leading to her demise.

Purpose With increasing use of PSMA PET/CT in the staging and restaging of prostate cancer (PCa), the identification of non-prostate cancer tumours (NPCaT) has become an increasing clinical dilemma. Atypical presentations of PSMA expression in prostate cancer and expression in NPCaT are not well established. Understanding the normal and abnormal distribution of PSMA expression is essential in preparing clinically relevant reports and in guiding multidisciplinary discussion and decisions. Methods Retrospective review of 1445 consecutive 18F-DCFPyL PSMA PET/CT studies by experienced radiologists and nuclear medicine physicians. Lesions indeterminate for PCa were identified. Correlation was made with patient records, biopsy results, and dedicated imaging. Lesions were then categorized into four groups: 1. Confirmed prostate cancer, metastases, 2. NPCaT 3. Benign, and 4. Indeterminate lesions. Results 68/1445 patients had lesions atypical for prostate cancer metastases. These comprised 8/68 (11.8%) atypical prostate cancer metastases, 17/68 (25.0%) NPCaT, 29/68 (42.6%) indeterminate, and 14/68 (20.6%) benign. In the context of the entire cohort, these are adjusted to 8/1445 (0.6%), 17/1445 (1.2%), 29/1445 (2.0%), and 14/1445 (1.0%) respectively. With the exception of Renal Cell Carcinoma (RCC), NPCaT demonstrated no or low PSMA expression. A similar trend was also observed for indeterminate and benign lesions. Conversely, most atypical PCa metastases demonstrated intermediate or high PSMA expression. Conclusion 18F-DCFPyL PSMA PET/CT detection of NPCaT is low. Lesions demonstrating intermediate to high PSMA expression were exclusively prostate cancer metastases, aside from RCC, and lesions detected in organs with high background expression.

Bone marrow suppression has a wide variety of causes. One of the overlooked causes is linezolid, a drug that is now being extensively used in the management of not only soft tissue infections but also hospitalacquired infections. Methicillin-resistant Staphylococcus aureus (MRSA) is widely being treated with linezolid. It becomes imperative that we comprehensively understand the hematological adverse effect profile of this drug. A reversible myelosuppression is seen with its extended use, though a number of risk factors like renal impairment are usually present. A prompt diagnosis can help us to timely discontinue the drug. We report one such case of an elderly patient with septic arthritis of the knee who developed pancytopenia after 32 days of linezolid therapy. Withdrawal of the drug led to a complete recovery of the blood counts in 21 days.