A document by Ashish Tamang. Click on the document to view its contents.

A document by Tina Shrestha. Click on the document to view its contents.

A document by Ashish Tamang. Click on the document to view its contents.

Title : Shiitake mushroom-induced Flagellate Dermatoses A Rare Presentation In a Tertiary Hospital in Nepal: A Case ReportCorresponding author : Ashish TamangIntroductionShiitake mushroom-induced flagellate dermatoses, also known as flagellate erythema, is an intriguing rash associated with the consumption of raw or undercooked shiitake mushrooms (Lentinula edodes).1 While these mushrooms are widely appreciated for their culinary and potential health benefits, they can occasionally trigger an immune-mediated skin reaction in susceptible individuals. The characteristic rash manifests as intensely pruritic linear streaks, resembling whiplash marks, and typically appears within 24 hours to 5 days after mushroom ingestion.2The pathogenesis of shiitake flagellate dermatoses centers around a thermolabile polysaccharide called lentinan, which is present in shiitake mushrooms. Lentinan activates interleukin-1 secretion, leading to vasodilation, hemorrhage, and the distinctive rash.3 Notably, this flagellate dermatosis is not observed when mushrooms are thoroughly cooked at temperatures exceeding 145°C.4 As mushroom consumption continues to rise globally, recognizing this etiology becomes crucial, preventing diagnostic challenges and the recurrence of this characteristic rash.

Title: ‘Hydropneumothorax as an Rare Manifestation of Secondary Hypereosinophilic Syndrome - A Case Report’Prakash Sapkota, Bhuwan Thapa, Aseem Bhattarai, Sujata Chalise, Sajana K C, Ashish TamangAbstract :We present a case of a young man who presented with cough and shortness of breath for two weeks with peripheral eosinophilia of unknown cause leading to left-sided pleural effusion. He was initially administered antiparasitic drugs (Ivermectin and Praziquantel). After one week the patient presented with an acute increase in SOB and was diagnosed with bilateral hydropneumothorax. A bilateral pigtail was inserted. Pleural fluid analysis was done which was purulent with lymphocyte predominance and high adenosine deaminase. The patient was treated with anti-tubercular therapy and steroids. After six months of therapy, the patient was asymptomatic. The hypereosinophilic syndrome can be presented in several ways and this study presented in a distinct way via hydropneumothorax.

Title: ‘Hydropneumothorax as a Rare Complication of Secondary Hypereosinophilic Syndrome: A Case Report’Prakash Sapkota, Bhuwan Thapa, Aseem Bhattarai, Sujata Chalise, Sajana K C, Ashish TamangAbstract :We present a case of a young man who presented with cough and shortness of breath for two weeks with peripheral eosinophilia of unknown cause leading to left-sided pleural effusion. He was initially administered antiparasitic drugs (Ivermectin and Praziquantel). After one week the patient presented with an acute increase in SOB and was diagnosed with bilateral hydropneumothorax. A bilateral pigtail was inserted. Pleural fluid analysis was done which was purulent with lymphocyte predominance and high adenosine deaminase. The patient was treated with anti-tubercular therapy and steroids. After six months of therapy, the patient was asymptomatic. The hypereosinophilic syndrome can be presented in several ways and this study presented in a distinct way via hydropneumothorax.