A RARE MANIFESTATION OF TROPICAL ENDEMIC INFECTION

TYPE: Late Breaking Abstract TOPIC: Diffuse Lung Disease PURPOSE: To insist on rare complication of common disease in india ,assess the differential diagnosis acute onset breathlessness ,hemoptysis and to emphasis importance Bronchscopic evaluation Pulmonary Complication METHODS: alveolar hemorhage is a clinical entity encountered with tropical pulmonary like dengue fever.The incidence DAH accounts for 1.4%.Other causes includes viruses(cytomegalovirus,hantavirus,H1N1),bacteria(Tuberculosis,Leptospirosis),Fungi(Invasive aspergillosis) atypical organisms(Mycoplasma,Legionella).The myriad manifestations include febrile illness,dengue fever,dengue hemorrhagic fever ad shock syndrome India, being an endemic area infection. The unusual lung changes infection pleural effusion,diffuse hemorrhage,ARDS consolidation.The etiologic depends upon history,chest imaging ,BAL,Microbiologic serologic tests histopathologic examination. We evaluated patient hemogram,radiology,immunology bronchoscopic RESULTS: Our presented hemoptysis, fever, radiological manifestation multiple ill defined centrilobular nodular opacities bilateral fields(Fig 1) .Dengue NS1and IgM was positive BAL revealed hemosiderin laden macrophages.BAL workup infections were negative.Vasculitis Connective tissue work up negative.Thrombocytopenia not our patient.He initiated steroids had good outcome. CONCLUSIONS: Dengue has become highly prevalent subtropical areas. Imaging findings are non-specific must be distinguished from other infections. CLINICAL IMPLICATIONS: Infectious diseases should considered as hemorrhage Thoracic bronchoscopy useful early detection can help clinicians initiate prompt treatment prevent mortality. DISCLOSURE: Nothing declare. KEYWORD: diffuse hemorrhage(DAH)