Indian Journal of Critical Care Case Report

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2022 | July-August | Volume 1 | Issue 1

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Rajesh Mishra


[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijccr-1-1-v  |  Open Access |  How to cite  | 



From the Editor's Desk

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijccr-1-1-vi  |  Open Access |  How to cite  | 



Shailesh Rohit, Vineet Rao, Sourabh Chakraborty

COVID-19 Associated Pulmonary Aspergillosis (CAPA) Producing Mycotic Aneurysm with Life-threatening Hemoptysis

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:1 - 3]

Keywords: CAPA, COVID-19, Mycotic aneurysm, Posaconazole, Voriconazole

   DOI: 10.5005/jp-journals-11006-0001  |  Open Access |  How to cite  | 


In a post-COVID-19 patient with suspected invasive mold infection of the lung and massive hemoptysis due to mycotic aneurysms, management to tackle hemoptysis takes precedence over empiric antifungal drugs. Posaconazole and isavuconazole may indeed emerge as good contemporary choices over voriconazole for invasive aspergillosis and over amphotericin B for invasive mucormycosis. This case adds to the clinical experience of using medical treatment with posaconazole as the sole drug without surgery in cases such as these, due to certain extenuating circumstances.



Jyothis MC, Bhargava Venkata Devarakonda

Role of High-flow Nasal Cannula in Postprocedure Management of Whole Lung Lavage for Pulmonary Alveolar Proteinosis

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:4 - 6]

Keywords: Anti-GM-CSF antibodies, High-flow nasal cannula, Pulmonary alveolar proteinosis, Whole lung lavage

   DOI: 10.5005/jp-journals-11006-0002  |  Open Access |  How to cite  | 


Pulmonary alveolar proteinosis (PAP) is a rare lung disorder.1 Primary autoimmune PAP is the most common form of PAP.2,3 The current standard of care in primary PAP is whole lung lavage (WLL) but the procedure has not yet been standardized. Studies about the use of high-flow nasal cannula (HFNC) in various conditions management have been found promising.4 However, use of HFNC particularly in the postprocedure period in patients who have undergone WLL has not been reported. Herein we present our experience with a patient with primary autoimmune PAP who underwent therapeutic WLL and managed with HFNC in the postprocedure period.



Ziyokov Joshi

Emergency Pericardiocentesis in Pacemaker Lead-induced Rt Ventricle Injury and Pericardial Effusion

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:2] [Pages No:7 - 8]

Keywords: Angioplasty, Complete heart block, Echocardiography and diagnosis, Myocardial infarction, Pacemaker insertion, Pericardiocentesis, Rt ventricle injury, Streptokinase injection

   DOI: 10.5005/jp-journals-11006-0004  |  Open Access |  How to cite  | 


Pericardial effusion due to rt ventricle1 injury by pacemaker lead is a serious condition. In this condition, time is a very important factor, immediate echo and diagnosis are very important factors, and immediate pericardiocentesis is life-saving. We have done diagnosis and pericardiocentesis in 20 minutes in cath lab, and the patient becomes stable in cath lab only and discharged on the 4th day. This is teamwork, and emergency treatment by a doctor on duty is very important.



Deven Juneja, Kaushal Madan, Bansidhar Tarai

Shewanella algae: A Rare Cause of Sepsis and Septic Shock

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:2] [Pages No:9 - 10]

Keywords: Bacteremia, Opportunistic infections, Sepsis, Septic shock, Shewanella algae

   DOI: 10.5005/jp-journals-11006-0003  |  Open Access |  How to cite  | 


Septic shock is still associated with high morbidity and mortality. Early aggressive care and appropriate empiric antibiotic therapy remain the cornerstone of therapy and are important for improving outcomes. Infections with rare organisms may complicate diagnosis and make initiation of appropriate antibiotics challenging. Hence, knowledge of rare infections and their sensitivity patterns is imperative for managing such cases. Shewanella spp. are facultative anaerobic gram-negative bacilli which are primarily found in marine environments. They have increasingly been recognized to cause human infections, which may rarely be life-threatening. Here, we present a case of septic shock secondary to Shewanella algae bacteremia.



Tony T Vempeny

Post-CPR Rib Fracture: Use the Correct Lens to Diagnose

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:2] [Pages No:11 - 12]

Keywords: Cardiopulmonary resuscitation, Chest X-ray, Computed tomography, Rib fracture, Ultrasonography

   DOI: 10.5005/jp-journals-11006-0006  |  Open Access |  How to cite  | 


This case report highlights the importance of good quality cardiopulmonary resuscitation (CPR). The common injuries that can happen post-CPR. Significance of selecting the correct imaging modality for diagnosing rib fractures and limitations of routine chest X-ray (CXR). Undisplaced rib fractures are more common in post-CPR injuries than seen in thoracic trauma. A high index of suspicion and good clinical examination is the key to patient management.



Dhanushree Jayaramaiah, Padmakumar V Arayamparambil, Ganesh K Manjunatha

Metformin and Acute Kidney Injury: Recipe for Disaster

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:13 - 15]

Keywords: Acute kidney injury, Hemodialysis, Metformin, Metformin-associated lactic acidosis, Type II diabetes mellitus

   DOI: 10.5005/jp-journals-11006-0005  |  Open Access |  How to cite  | 


Type II diabetes is a common disease worldwide and, metformin is one of the first line of drugs used in its treatment. Metformin elimination is mainly through the kidney; hence when the patient develops dehydration and acute kidney injury, it will lead to life-threatening lactic acidosis. Hemodialysis improves the patient's condition rapidly. We would like to present two patients who were on metformin and developed life-threatening lactic acidosis with hemodynamic instability following an episode of acute gastroenteritis and acute kidney injury. Hemodialysis hastened the recovery emphasizing the need for early identification and treatment.



Narayanan Sarat, Dedeepiya Devaprasad

A Rare Diagnosis of a Common Problem: Acute Severe Low Back Pain with Paraplegia

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:4] [Pages No:16 - 19]

   DOI: 10.5005/jp-journals-11006-0007  |  Open Access |  How to cite  | 



Vivekananthan Poongavanam, Sivakumar Mudalipalayam Nandakumar

Calcific Constrictive Pericarditis: Putting Things in a Nutshell

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:20 - 22]

Keywords: Calcific pericarditis, Constrictive pericarditis, Eggshell calcification, Pericardiectomy

   DOI: 10.5005/jp-journals-11006-0008  |  Open Access |  How to cite  | 


Calcified pericarditis is a rare occurrence, most commonly seen with constrictive pericarditis. Our patient was a rare case where the presentation was a seizure, with the rare complication of refractory prolonged corrected QT interval (QTc) ventricular tachycardia, which was appropriately managed. The diagnosis of calcific pericarditis arrived early, the patient stabilized in the intensive care unit (ICU) appropriately and underwent the definitive surgery on time to survive this fatal condition.



Tatikonda Chandra Mouli, Rupali Patnaik, Priyanka Samal, Sarita Pradhan, Shakti Bedanta Mishra

Leukemoid Reaction Associated with Scrub Typhus Infection: A Rare Case Report with a Review of Literature

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:23 - 25]

Keywords: Fever with rash, Leukemoid reaction, Scrub typhus

   DOI: 10.5005/jp-journals-11006-0009  |  Open Access |  How to cite  | 


Scrub typhus is a tropical disease caused by the rickettsia group of obligate intracellular bacterium, Orientia tsutsugamushi, which usually presents as fever with rash. Scrub typhus has a wide spectrum of involvement which include acute kidney injury, thrombocytopenia, leukopenia, and hepatopathy. Leukemoid reaction is a reactionary proliferation of white blood cells secondary to stress or infection. Leukopenia is scrub typhus norm, but our patient developed a lymphocyte-predominant leukemoid reaction. The patient had hypofibrinogenemia and platelet dysfunction, which was detected early by rotational thromboelastometry (ROTEM) analysis. We are bringing forward a case of scrub typhus with a leukemoid reaction.



Amit Kumar, Shweta Tanwar, Rajesh Chetiwal

Severe Pulmonary Hemorrhage Syndrome in Leptospirosis: An Uncommon but Emerging Presentation

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:2] [Pages No:26 - 27]

Keywords: Acute respiratory distress syndrome, Leptospirosis, Weil's disease

   DOI: 10.5005/jp-journals-11006-0010  |  Open Access |  How to cite  | 


Pulmonary hemorrhage leading to acute respiratory distress syndrome (ARDS) is one of the grave manifestations of severe leptospirosis. In recent years there has been an increase in the incidence of severe pulmonary hemorrhage syndrome (SPHS) in leptospirosis cases due to the emergence of more virulent strain. This report presents a case of leptospirosis complicated by SPHS. In the Indian scenario, where the range of differential diagnoses of acute febrile illness is very wide, it is prudent to keep a high level of clinical suspicion to prevent the progression to a more severe and fatal illness.



Aayush Kulshrestha, Yudhyavir Singh

DRESS Syndrome in Trauma Intensive Care Unit

[Year:2022] [Month:July-August] [Volume:1] [Number:1] [Pages:3] [Pages No:28 - 30]

Keywords: Drug reactions, Drug reaction with eosinophilia and systemic symptoms, Phenytoin, Registry of severe cutaneous adverse reactions

   DOI: 10.5005/jp-journals-11006-0011  |  Open Access |  How to cite  | 


Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction characterized by a range of clinical manifestations, including an extensive skin rash, fever, lymphadenopathy, eosinophilia, and visceral organ involvement. The prolonged latency period and heterogeneous clinical profile with overlapping symptoms make the diagnosis of DRESS challenging as it mimics many common presentations, though mortality constitutes about 10%. Here we report a postoperative case of decompression craniectomy with acetabulum fracture discharged on phenytoin therapy presented with fever, rash, and breathing difficulty, which was later diagnosed as DRESS.


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