April 29, 2022

Pulmonary embolism is and has been an established medical dia gnosis. The complications, however, seem to awe physicians and healthcare workers across the globe. The purpose of this report is to bring to awareness a case involving a 37-year-old female with pulmonary embolism which was complicated by develop ment of right-sided empyema. This patient initially presented with shortness of breath, heart rate/pulse of 109 beats per minute and right sided pleuritic chest pain and was diagnosed with pulmona ry embolism and started on apixaban. Upon discharge after three days, she continued to have persistent progressively worse right sided chest pain. She was readmitted five weeks later, and further investigation resulted in the diagnosis of right sided pleural effu sion. CT guided drainage of the effusion was consistent with em pyema with cultures growing streptococcus intermedius. The aim of this report is to present a readmission of a 37-year-old woman patient who developed streptococcus intermedius empyema after initial diagnosis and management for acute pulmonary embolism. 2. Introduction Acute pulmonary embolism results in pulmonary infarct at a rate of approximately 16% to 31% [5]. The predisposing risk factors for pulmonary infarct are active smoking and increase body height. Patients are often of younger age groups without cardiopulmonary comorbidities [10, 11]. 4% to 7% of patients with pulmonary in farction develop cavitary lesions due to necrosis or superinfection of the necrotic tissue [8, 12]. Pulmonary infarction is a wedge shaped area that usually extends to the pleural surface and causes pleural effusion due to increase pulmonary capillaries permeabi lity from ischemia or release of vasoactive cytokines [6, 9]. 23% to 52% of patients with Pulmonary embolism have pleural effusion on computed tomography [2]. The pleural effusion is usually exu dative and hemorrhagic [2, 9]. Delayed onset of pleural effusion or late enlargement in the course are associated with either recurrent pulmonary embolism or superinfection [1]. Empyema is a collection of pus [fluid filled with immune cells, dead cells, and bacteria] in the pleural cavity [14]. The risk factors for empyema include pneumonia, chronic lung disease, diabetes mellitus, prolonged corticosteroid use, illicit drug use, alcohol abuse, aspiration, thoracic or esophageal surgery or trauma [3]. Empyema had rarely been associated with pulmonary embolism [3, 7]. The implicated pathogens in empyema include gram po sitive bacteria especially viridans strep species in community ac q

COVID-19 infection initiates a multi systemic inflammatory syn drome with various organ manifestations. Although respiratory symptoms are the most common presentation for COVID-19, neu rological manifestations have still been reported, but with devas tating outcomes. A 57-year-old male smoker was admitted with severe COVID-19.

COVID-19 gives the chance to address long-term care categories that are sometimes disregarded and undervalued, such as nursing and residential homes, as well as homecare. Each method of de livering long-term care must meet the highest possible standards of ongoing care and quality of life. More study and evaluation are needed to aid decision-making and policy-making, particularly on the cost-effectiveness and cost-quality elements for each country, region, or system. So far, data suggests that person- and relation ship-centered solutions, paired with coordinated health and social care, as well as telehealth, are effective in ensuring fast, person alised answers to people. There are common principles to consider regardless of the situation (private home or nursing home).

Health-related quality of life (HRQL) contains many aspects of patients’ health such as physical, psychological, social functioning and a general well-being. Progress in renal transplantation and im munosuppressive therapies have increased significantly in recent decades, resulting in allograft survival rates at one year is now over 90%. Numerous clinical trials have established the impor tance of quality of life in a variety of diseases, and it is extremely popular to evaluate quality of life in clinical trials as a measure of patients’ subjective state of health. The purpose of the study was to identify factors associated with quality of life after renal trans plantation