A 25-year-old previously healthy man presented with a productive cough for 2 months and progressive dyspnea for 1 week. He did not respond to initial anti-infective treatment at a local hospital. Chest computed tomography (CT) demonstrated diffuse miliary nodules, ground-glass opacities throughout both lungs, and bilateral pleural effusion (more prominent on the right). Laboratory tests revealed type I respiratory failure, elevated inflammatory markers, hyponatremia, hypoproteinemia, and raised tumor markers (NSE, CYFRA21-1, SCC, CA125). Sputum acid-fast bacilli smears were negative, but pleural fluid analysis showed elevated adenosine deaminase and interferon-gamma, suggestive of tuberculous pleurisy. Percutaneous lung biopsy confirmed epithelioid granulomas with positive acid-fast staining, establishing the diagnosis of miliary tuberculosis, tuberculous pleurisy, severe pulmonary infection, and acute respiratory distress syndrome (ARDS). Anti-tuberculosis therapy was withheld initially due to elevated liver enzymes and was initiated once liver function normalized. High-dose methylprednisolone (160 mg/day) combined with noninvasive positive pressure ventilation (NIPPV) was added, yielding initial improvement. However, complications arose after 8 days of NIPPV, including pneumothorax, subcutaneous and mediastinal emphysema, and suspected disseminated intravascular coagulation (DIC). NIPPV was discontinued, subcutaneous incision and xiphoid puncture drainage performed, and supportive measures (cryoprecipitate, immunoglobulin, continued glucocorticoids) instituted. Symptoms and imaging gradually resolved. After 1 year of anti-tuberculosis treatment, the patient achieved complete clinical and radiological recovery. This case highlights that, alongside potent anti-tuberculosis therapy, high-dose glucocorticoids combined with NIPPV (with cautious management of barotrauma risks) can effectively control life-threatening miliary tuberculosis complicated by ARDS.

Hepatic hemangioma may be detected in patients with systemic lupus erythematosus (SLE). This study aimed to determine the frequency, radiological characteristics, and potential associated factors of hepatic hemangioma in SLE patients undergoing abdominal imaging. We retrospectively evaluated 221 of 402 SLE patients followed at a tertiary university hospital who underwent abdominal imaging for clinical indications. Demographic, clinical, laboratory, and radiological data were collected from medical records. Factors associated with hepatic hemangioma were analyzed. A total of 221 SLE patients who underwent abdominal imaging were included. All patients underwent abdominal ultrasound as the primary imaging modality. The mean age was 49.62 ± 13.75 years, 86.4% were female, mean age at SLE diagnosis was 36.29 ± 14.48 years, and mean disease duration was 12.81 ± 8.14 years. The most common indication for abdominal imaging was asymptomatic/routine screening/pre-renal biopsy evaluation (n = 117, 53%). Hepatic hemangioma was detected in 11.8% (n = 26) of the imaged SLE patients. Among these, 69.2% were identified after SLE diagnosis, 27% concurrently, and 3.8% before diagnosis. Most hemangiomas were solitary (65.4%), with a mean diameter of 2.57 ± 2.22 cm. Patients with hepatic hemangioma had significantly longer disease duration (15.85 ± 7.82 vs. 12.40 ± 8.12 years; p = 0.043) and follow-up duration (15.38 ± 7.98 vs. 11.61 ± 7.89 years; p = 0.030) compared to those without. At SLE diagnosis, pleuritis (19.2% vs. 5.6%; p = 0.035), autoimmune hemolytic anemia (AIHA) (38.5% vs. 18.6%; p = 0.037), and C3 hypocomplementemia (80.8% vs. 55.4%; p = 0.014) were significantly more common in the hemangioma group. Multivariate logistic regression analysis revealed that longer SLE disease duration (OR 1.06 per year; 95% CI 1.01-1.12; p = 0.020) and presence of AIHA at diagnosis (OR 3.42; 95% CI 1.32-8.88; p = 0.011) were independently associated with hepatic hemangioma. Hepatic hemangiomas may be incidentally detected in SLE patients undergoing abdominal imaging. They were significantly more frequent in patients with longer disease duration and in those with AIHA at SLE diagnosis. However, these findings should be interpreted cautiously due to the retrospective design and selected nature of the study population. Prospective longitudinal studies with unselected SLE cohorts and appropriate control groups are needed to better define the true frequency and their associated factors of hepatic hemangiomas in SLE.

Actinobacillus pleuropneumoniae (APP) is the bacterial agent associated with porcine pleuropneumonia, a severe respiratory disease with significant economic impact due to increased mortality and elevated therapeutic costs, whose progression may be exacerbated by environmental factors. This study evaluates the impact of climatic factors, particularly temperature and relative humidity, on mortality in finishing pigs during the fattening phase within a herd with endemic porcine pleuropneumonia. Data were collected from a commercial swine farm between January 2021 and December 2024, including records of local climatic conditions (daily average temperature and relative humidity) and pig mortality rates. Statistical analysis revealed a positive correlation between periods of elevated temperature or humidity and increased mortality associated with respiratory diseases, suggesting that climatic stress contributes to higher mortality in this herd with endemic APP.

A 49-year-old male presented with acute dyspnea and hydropneumothorax. Imaging and biopsy confirmed pleural tuberculosis. Despite atypical features and no risk factors, anti-tuberculosis therapy led to rapid improvement. This case highlights the diagnostic challenge of distinguishing tuberculosis-related hydropneumothorax from necrotizing bacterial pneumonia and empyema in the presence of complex radiological findings.

Long-standing pleural effusions may rarely progress to pleural fibrosis, and when no identifiable etiology is present, this entity is termed cryptogenic fibrosing pleuritis (also referred to as organizing pleuritis, fibrous pleurisy, or fibrosing pleurisy). This condition is characterized by persistent exudative effusions and progressive pleural thickening, often leading to diagnostic uncertainty and therapeutic challenges. Due to its rarity, only a limited number of cases have been described in the literature, and an evidence-based management strategy has yet to be established. Reported treatments have included glucocorticoids and surgical decortication, with variable success and unclear long-term benefits. The authors have presented the case of an older man with recurrent unilateral lymphocytic exudative pleural effusion, extensive occupational asbestos exposure, and imaging findings concerning for pleural disease, in whom repeated thoracenteses failed to provide durable resolution. Given concern for an underlying malignant process, medical thoracoscopy was pursued, allowing direct pleural visualization and diagnostic biopsy. Histopathology confirmed organizing pleuritis without malignancy. Rapid protocol pleurodesis and placement of a tunneled pleural catheter were performed simultaneously. This case highlighted the diagnostic value and therapeutic potential of thoracoscopy combined with pleural drainage strategies as a less invasive alternative to surgical decortication in carefully selected patients with cryptogenic fibrosing pleuritis.

A 72-year-old man developed Aspergillus infection within a postoperative thoracic cavity after lobectomy. Imaging showed cavity wall thickening with bronchopleural communication. Fenestration revealed characteristic purulent pleural debris and fungal masses. This case highlights Aspergillus pleurisy as a postoperative complication.

Digital droplet PCR (ddPCR) offers high sensitivity and absolute quantification without standard curves, making it promising for tuberculosis (TB) detection in paucibacillary samples. This study evaluated the diagnostic performance of a ddPCR assay targeting IS6110 and 23S rRNA for pulmonary tuberculosis (PTB) and tuberculous pleurisy (TP).

Reactive oxygen species (ROS) are key drivers of oxidative stress and inflammation. They damage cells and trigger pathways that further amplify the inflammatory response. To examine the dual antioxidant and anti-inflammatory effects of a series of benzopyran-2-one derivatives (2-10) by a combination of experimental and computational methods, a new series of benzopyran-2-one derivatives were designed, synthesized, and characterized. Carrageenan induced paw edema, formaldehyde induced arthritis, turpentine induced pleurisy, and biochemical tests like lipid peroxidation inhibition, SOD activity and DPPH radical scavenging were used as screening assays. Of all the congeners, compound 6b repeatedly demonstrated the best anti-inflammatory and antioxidant properties, better than diclofenac sodium and quercetin with minimal ulcerogenic or toxicity. Further, Molecular docking showed strong binding of 6b to inflammation and ROS related targets. Molecular dynamics simulations further confirmed its stable binding, with MM/PBSA free energy suggesting a more favorable binding energy than quercetin. Moreover, Steered Molecular Dynamics (SMD) pull-force analysis revealed that 6b had a greater rupture force to dissociate indicating stronger intermolecular forces and increased mechanical stability in the binding pocket. SwissADME/StopTox predictions suggested a favorable pharmacokinetic and predicted safety profile within the evaluated parameters. Overall, these combined computational and experimental results identify compound 6b as a promising dual antioxidant and anti-inflammatory lead candidate in preclinical models, which can serve as a promising scaffold in designing next generation therapeutics against ROS mediated inflammatory disease.