Department of Pulmonary Medicine is a tertiary referral center for pulmonary diseases. The department has done pioneering work & benefited patients in the field of tuberculosis, asthma, allergy, COPD, lung cancers, and infectious lung diseases.
Pulmonary medicine is a broad specialty in medicine. It deals primarily with diseases afflicting the lungs. It also encompasses areas like critical care, sleeps medicine. The specialty in its formative years dealt mainly with tuberculosis. However; in recent years it has made forays into areas of diagnostics procedures & interventions like bronchoscopy & thoracoscopy. The discipline is a rapidly growing specialty with immense promise and hope for the future. It also works in tandem with the government to control tuberculosis as a part of the DOTS strategy.
Pulmonologists have made noteworthy contributions to society in dealing with the menace of tuberculosis over the years. The profile of a pulmonologist is gradually changing to combating allergies, smoking-related lung ailments & occupational lung diseases. Pulmonologists are branching into specialties like sleep medicine, critical care, bronchoscopists & allergologist.
The Department of Pulmonary Medicine at the Sri Devaraj urs medical college And university, Sri R L Jalappa hospital is unique in many ways. It is serving the people of Kolar and surrounding districts with respiratory diseases for the last 2 decades it has got a well-equipped Pulmonary Function Testing (PFT) Laboratory, Lung Cancer Clinic, RNTCP unit as well as a vast array of other facilities that are available for patient care and research. We continue to move forward with the Institute in the service of the country.
We provide comprehensive and state of the art evaluation and management of patients suffering from a broad spectrum of respiratory diseases such as asthma, COPD, bronchiectasis, bronchitis, pneumonia, tuberculosis, and other lung infections, various interstitial lung diseases, pleural diseases like pleural effusion, pneumothorax, empyema, etc, lung cancer, occupational lung diseases, respiratory failure, pulmonary vasculitis, mediastinal diseases, sleep disorders like obstructive sleep apnoea, etc.
A 42-year-old male presented with fever, productive cough with episodes of hemoptysis and breathlessness from one week, and altered sensorium and tremors for 3 days. He was a chronic alcoholic, with a history of binge drinking for 1 month and stopped for 3 days. He did not have any other significant past, personal, or drug history. On examination, he was conscious but drowsy. He was febrile with a body temperature of 1020 F, pulse rate was 124beats/min, respiratory rate was 28 cycles/min and Blood pressure was 114/70mmHg. His O2 saturation was 88%. On systemic examinations, fine crepitations were heard in all the areas of the right lung. Other systems examination was unremarkable. His blood investigations revealed TLC17,250cell/mm3. Other investigations (Hb, platelet count, RBS, RFT, LFT, FBS, PPBS, HbA1C) were normal. VCTC was negative. Chest x-ray showed non-homogenous opacities, infiltrations, and two thin-walled cavities in the right lung upper and middle zone. (fig.1) Differential diagnosis of community-acquired pneumonia or pulmonary tuberculosis in alcohol withdrawal state was made and the patient was started on Inj.Linezolid(600mg bid), Inj.meropenem (1g tid) and bronchodilators. 4hrs after admission, the patient became tachypneic and his oxygen saturation was not maintained on an oxygen face mask. Then the patient was intubated and kept on a ventilator. Despite broad-spectrum antimicrobial therapy, the patient’s condition was deteriorating. ATT was planned to start but several sputum samples collected and tested for the presence of acid-fast bacilli were negative. Sputum for GeneXpert was also negative. Sputum Gram stain revealed Gram-positive thin branching filaments (figure 2). Modified Ziehl-Neelsen staining showed branching Acid-fast bacilli consistent with the morphology of Nocardia species(Figure 3). Culture and sensitivity of tracheal aspirate identified the organism as Nocardia. Tablet Cotrimoxazole (160/800mg DS tablets bd) was added to meropenem. The patient improved clinically and radiologically and was discharged after 15 days and advised to continue Cotrimoxazole for 9 months. The patient is coming for a follow-up and is doing well.
