Challenges of diagnosing and managing bronchiectasis in resource-limited settings: a case study

Bronchiectasis, once an orphan disease is now gaining renewed attention as a significant cause of morbidity and mortality. It is a morphologic term used to describe abnormal, irreversibly dilated and thick-walled bronchi, with many etiologies. The management of bronchiectasis can be challenging because its pathogenetic mechanisms is still evolving. Its diagnosis and management is particularly more demanding especially in resource-limited settings like Nigeria because of delayed diagnosis and improper management with devastating consequences, hence this case study

Yellow nail syndrome – report of a rare disorder

Background: The Yellow Nail Syndrome (YNS) is a rare disorder of unknown cause characterized by the trail of yellow and thickened nails, lymphoedema and respiratory manifestation. We have no record of any case report of yellow nail syndrome in our setting.Methods: We reviewed the records of an 80 year old woman who presented with two weeks history of exacerbation in her three months history of cough, leg swelling, shortness of breath and left sided chest pain.Results: She was found to have thickened and yellow nails, lymphoedema and pleural effusion. The pleural fluid had an acellular smear with Lactate dehydrogenase(LDH) of 2,214U/L, glucose was 11.9mmol/L and protein of 59g/L and culture yielded growth of streptococcus pneumoniae.Conclusion: This case report highlights the need for a high index of suspicion in making such a diagnosis.Keywords: Yellow nail syndrome, pleural effusion, leg swellin