28-08-2025
THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.
[28-08-2025 16:35] PPM 1: @PPM3 @PPM4 this is a similar patient of viral fever precipitating cardiogenic pulmonary edema often mistaken for pneumonia we had earlier discussed and archived here : https://pajrcasereporter.blogspot.com/2025/08/projr-viral-fever-heart-failure.html?m=1 as well as one of the cases in the Narketpally syn report.
[28-08-2025 16:37] PPM 1: 24/08
[28-08-2025 16:43] PPM 1: 👆 looking at these events, another common differential for such patients in Narketpally is wet beri beri!
[28-08-2025 16:53] PPM 3: @PPM1sir once again quite interesting how increasingly it resembles patchy consolidation on the xray. It does seem to have cleared over the 2 days in the right lung, and some remains in the left lung. Also I noticed that the costophrenic angles are again clear on 24/08. I can't quite help feel like I'm missing something here.
If it responded to antibiotics could the xray findings just have been fluid accumulation due to localized inflammation instead of being cardiogenic in nature?
Just to rule out other factors by playing the devil's advocate here: is it possible that xray exposure varying on 2 different days could be impacting how clearly we see the findings?
[28-08-2025 16:54] PPM 3: That would actually fit! But I don't think all these cases have been patients with chronic alcohol use, I might be wrong.
[28-08-2025 16:56] PPM 1: Have asked @PPM6 @PPM5 to get another chest X-ray now. The rapidity of the resolution in chest X-ray is what makes us put our money on cardiogenic pulmonary edema. Confounding by beri beri due to alcohol intake is another factor we need to deal with in resolving if it's a single point viral fever etiology precipitating the process or multifactorial with alcohol too as a major factor
[28-08-2025 16:58] PPM 1: 👆@PPM5 there's no mental of fever in his history!?
[28-08-2025 17:03] PPM 3: The time factor in resolution is certainly quite significant!
Continuing on the antibiotics thread perhaps they are suppressing local inflammation and reducing fluid extravasation in those areas as a result, which could also take effect across a few days.
Also a thought I had just now, could BNP levels help us further identify this as cardiogenic pulmonary edema??
[28-08-2025 17.06] PPM 5: No sir. There was only one fever spike since admission
