ORIGINAL ARTICLE Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 39/ September 30, 2013 Page 7548 GLYCEMIC PROFILE OF CRITICALLY ILL PEDIATRIC PATIENTS Rohit Rai 1 , S.P. Goel 2 , Ashish Prakash 3 , Archana Dubey 4 , Kshitij Bansal 5 HOW TO CITE THIS ARTICLE: Rohit Rai, SP Goel, Ashish Prakash, Archana Dubey, Kshitij Bansal . “Glycemic profile of critically ill pediatric patients”. Journal of Evolution of Medical and Dental Sciences 2013; Vol2, Issue 39, September 30; Page: 7548- 7554. ABSTRACT: Chronic necrotizing pulmonary aspergillosis or semi-invasive pulmonary aspergillosis is one of the forms of pulmonary aspergillosis typically found in mildly immunocompromised patients. It is an indolent, cavitary and infectious process of the lung parenchyma secondary to local invasion by aspergillus species. We report a case of a male patient aged 55 years with complaints of chronic productive cough with blood tinged sputum, orthopnea, acute episode of hemoptysis and post percutaneous transluminal coronary angioplasty status 6 weeks back. X-ray and computed tomography of the chest revealed consolidation with interposed cavitation in the right upper lobe and pleural thickening. Computed tomography guided fine needle aspiration cytology smears showed aspergillus hyphae with abundant necrotic material and inflammatory cells. Fungal stains were positive for aspergillus. Based on the clinical, radiological and cytological findings, the patient was diagnosed with chronic necrotizing pulmonary aspergillosis and treated successfully with oral itraconazole. In view of difficult diagnosis of chronic necrotizing pulmonary aspergillosis, fine needle aspiration cytology plays important role when biopsy is not possible, contributing to early treatment with systemic antifungal therapy and preventing its morbidity and mortality. Surgery plays a small role in the treatment because of poor overall lung function in many patients. KEYWORDS: Pulmonary aspergillosis, Immunocompromised, FNAC Lung. INTRODUCTION: Healthy individuals regulate blood glucose (BG) levels within a narrow range. 1 Critical illness is associated with disruptions of homeostatic mechanisms resulting in hyper- and hypoglycemia, both of which are associated with poor outcomes in critically ill neonates, children, and adults. 2–11 With increasing facilities for intensive care becoming available in India, a large number of pediatricians are looking after critically ill children. The prevalence, consequences and management of hypoglycemia have been highlighted in pediatric literature but there is a lack of awareness regarding the prevalence and adverse effects of hyperglycemia among sick children. 12 Hyperglycemia occurs frequently among critically ill adults, with prevalence rates reported from 3% to 71%. 13 During the acutely stressed state, hyperglycemia is thought to be advantageous, 14 providing the glucose-dependent organs such as the brain and blood cells adequate supply for their energy needs. 15,16 Hyperglycemia has also been postulated to compensate for volume loss by promoting the movement of cellular fluid into the intravascular compartment or liberating water bound to glycogen. 16 Despite potential positive effects, prolonged hyperglycemia in critically ill adults has been shown to be associated with a number of deleterious consequences 5 contributing to greater risks of morbidity and mortality, even in the absence of pre-existing diabetes mellitus. 13,18,19 Elevated glucose concentrations have been associated with increased risks of congestive heart failure, 13 cardiogenic shock, 13 and poor functional recovery after stroke 18 as well as increased risks