Abstract Introduction Cytomegalovirus (CMV) pneumonitis is classically associated with immunocompromised patients, including transplant recipients or those with HIV or prolonged immunosuppression. Its occurrence in immunocompetent adults is exceedingly rare and often leads to diagnostic delay. We present a case of severe CMV pneumonitis in an immunocompetent patient with progressive hypoxemia despite standard therapies. Case Presentation 72-year-old man with coronary artery disease (status post CABG and PCI), left carotid stent, COPD, chronic interstitial lung disease, and obesity presented with right-sided weakness, numbness, and visual changes. During hospitalization, he developed worsening shortness of breath and hypoxia. Imaging revealed bilateral pulmonary infiltrates, and initial management targeted multifocalpneumonia and COPD exacerbation with antibiotics and corticosteroids (methylprednisolone 40 mgIV every 6 hours for 5 days, followed by a gradual taper). Despite therapy, his respiratory status deteriorated, requiring NIV with HFNC. COVID-19 and influenza PCR tests were negative. CTA chest ruled out pulmonary embolism. Urine pneumococcal and Legionella antigens were negative, and blood, sputum, and BAL cultures showed no growth. Bronchoscopy demonstrated multinucleatedgiant cells, raising suspicion for a viral etiology. CMV PCR and serology (IgM and IgG) were positive,confirming CMV pneumonitis. The patient had no history of immunosuppression or HIV infection.Given his worsening respiratory failure, ganciclovir was initiated after infectious disease consultation.His oxygenation gradually improved with supportive care and antiviral therapy. Discussion This case illustrates that CMV pneumonitis can occur in immunocompetent hosts, particularly in the setting of critical illness. The diagnosis should be considered when pneumonia fails to improve with standard antimicrobial or steroid therapy. While the role of antivirals such as ganciclovir remains uncertain in immunocompetent patients, treatment may be warranted in severe or progressive cases. Conclusion CMV pneumonitis, though rare in immunocompetent individuals, should remain in the differential diagnosis of refractory pneumonia. Early recognition and consideration of antiviral therapy can be crucial for recovery in severe presentations. This abstract is funded by: None
Granulomatous cheilitis, a localized subset of orofacial granulomatosis, can rarely be the presenting symptom of Crohn's disease. It can appear before any gastrointestinal (GI) symptoms develop. Orofacial granulomatosis has been associated with more widespread granulomatous Crohn's disease, which tends to be more aggressive. We present a case of isolated granulomatous cheilitis progressing to diffuse granulomatous involvement of multiple portions of the upper and lower GI tract with eventual secondary loss of response to initial anti-tumor necrosis factor-α therapy, underscoring the need for these patients to be monitored very closely even in the absence of GI symptoms.
Background and Objective:Artificial intelligence (AI) has transformed cardiovascular healthcare by influencing multimodal imaging, interventional procedures, and remote patient monitoring systems. The rapid growth of available evidence presents challenges for researchers to evaluate the quality of AI systems and their readiness for clinical application. The review examines current AI uses in cardiology by assessing methodological quality to pinpoint key factors for implementing effective AI models. Methods:We performed extensive search on MEDLINE/PubMed, Web of Science, Scopus, EMBASE for original research, clinical trials, and consensus/guideline statements, published in English from January 2015 through December 2025. Key Content and Findings:AI applied to electrocardiography (AI-ECG) technology shows practical success in clinical trials for detecting left ventricular systolic dysfunction (LVSD) and predicting atrial fibrillation (AF) from normal heart rhythms. AI in echocardiography performs automated view detection, chamber measurement, and assists novice users. Cardiac magnetic resonance (CMR) uses deep learning (DL) for reconstruction and inline perfusion analysis. Coronary computed tomography angiography (CCTA) employs automated coronary artery calcium (CAC)/plaque analysis and machine learning (ML)-based fractional flow reserve computed tomography (FFRct), while nuclear cardiology uses AI to reduce doses and enhance image quality. The cath lab benefits from AI-assisted intravascular imaging, which helps optimize percutaneous coronary intervention (PCI) planning, robotics systems that lower operator radiation exposure, and angiography-derived physiology [e.g., quantitative flow ratio (QFR)], enabling wire-free ischemia assessment with context-dependent value. Challenges to AI adoption include limited external validation data, unclear calibration methods, and gaps in addressing subgroup fairness, decision impact, and post-deployment performance monitoring. Conclusions:AI technology has advanced from experimental development to practical solutions for specific cardiology procedures that improve operational efficiency and standardization. Turning accuracy into patient benefits requires researchers to conduct external validation studies, prospective impact assessments, cost-effectiveness evaluations, equity-focused design, workflow integration, and ongoing governance systems. Implementing AI as an assistive tool will enhance healthcare accessibility, reduce unnecessary treatment disparities, and improve outcomes through clinical support, while automation continues to streamline routine tasks.
Acute hypoxemic respiratory failure (AHRF) is a major cause of morbidity and mortality and often requires advanced respiratory support. Awake prone positioning (APP) has emerged as a simple, low-cost intervention to improve oxygenation in non-intubated patients; however, its clinical effectiveness and safety remain uncertain. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of awake prone positioning in non-intubated adult patients with acute hypoxemic respiratory failure. A systematic search of PubMed, Scopus, and Web of Science was conducted from database inception to February 2026. Randomized controlled trials and observational comparative studies evaluating APP versus usual care were included. Primary outcomes were mortality, intubation, and length of hospital stay. Secondary outcomes included ICU stay, invasive mechanical ventilation, ICU admission, escalation of respiratory support, time to invasive ventilation, and adverse events. Risk of bias was assessed using ROB 2 for randomized trials and the Newcastle–Ottawa Scale for observational studies. Meta-analysis was performed using a random-effects model. Twenty-four studies involving 6,164 patients were included. APP significantly reduced mortality (OR = 0.60, 95
