Background: The diagnosis and treatment of infective endocarditis (IE) is facing great challenges during the coronavirus disease (COVID-19) pandemic, especially in patients without valvular heart disease. Methods: The 39-year-old patient with no pertinent medical history presented with high fever for 14 days and positive nucleic acid test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for 3 hours. He denied any trauma or IV drug use. Blood culture grew MRSA. CT revealed infectious metastases in spleen, liver, kidney and brain. Transesophageal echocardiography (TEE) was performed under safety protection finding mitral valve vegetation. His senses of smell, taste, hearing and vision were weakened temporarily. The patient was treated with daptomycin in combination with fosfomycin sodium and linezolid successively. On hospital day 10, the patient was transferred to ICU due to respiratory distress and cardiac insufficiency for 5 days with high flow oxygen noninvasive ventilation. After treatment, the patient achieved remission and was discharged from hospital. Results: We encountered a typical case of IE with multiple organ infection caused by MRSA sepsis combined with COVID-19, for which combination therapy was effective. Conclusions: Obvious risk factors of IE may be absent in many cases. A high index of suspicion is required, especially with additional findings such as embolic phenomenon, focal neurologic deficit, decompensated heart failure, or new murmurs. The purpose of this case report is to help clinicians by improving awareness of IE, particularly in patients having high suspicion despite any risk factors, during COVID-19 pandemic.
背景:在冠状病毒病(COVID-19)大流行期间，感染性心内膜炎(IE)的诊断和治疗面临巨大挑战，特别是对无瓣膜性心脏病的患者。方法:患者39岁，无相关病史，表现为高热14 d, 3 h SARS-CoV-2核酸检测阳性。他否认有外伤或静脉注射毒品。血培养增加了MRSA。CT显示脾、肝、肾、脑有感染性转移灶。经食管超声心动图(TEE)在安全保护下发现二尖瓣植被。他的嗅觉、味觉、听觉和视觉都暂时减弱了。患者先后用达托霉素联合磷霉素钠、利奈唑胺治疗。住院第10天，患者因呼吸窘迫、心功能不全转至ICU, 5天高流量无创氧通气。治疗后，患者病情缓解出院。结果:我们遇到了一例典型的MRSA脓毒症合并COVID-19多器官感染的IE病例，联合治疗有效。结论:许多病例可能缺乏明显的IE危险因素。需要高度的怀疑，特别是有其他发现，如栓塞现象、局灶性神经功能缺损、失代偿性心力衰竭或新的杂音。本病例报告的目的是帮助临床医生提高对IE的认识，特别是在COVID-19大流行期间，尽管存在任何风险因素，但仍有高度怀疑的患者。
{"title":"Septic embolism in a patient with infective endocarditis and COVID-19: a case report and review of management","authors":"Jingbo Wang, Haitao Wang, Wei Wu, H. Suo","doi":"10.54844/cai.2022.0082","DOIUrl":"https://doi.org/10.54844/cai.2022.0082","url":null,"abstract":"Background: The diagnosis and treatment of infective endocarditis (IE) is facing great challenges during the coronavirus disease (COVID-19) pandemic, especially in patients without valvular heart disease. Methods: The 39-year-old patient with no pertinent medical history presented with high fever for 14 days and positive nucleic acid test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for 3 hours. He denied any trauma or IV drug use. Blood culture grew MRSA. CT revealed infectious metastases in spleen, liver, kidney and brain. Transesophageal echocardiography (TEE) was performed under safety protection finding mitral valve vegetation. His senses of smell, taste, hearing and vision were weakened temporarily. The patient was treated with daptomycin in combination with fosfomycin sodium and linezolid successively. On hospital day 10, the patient was transferred to ICU due to respiratory distress and cardiac insufficiency for 5 days with high flow oxygen noninvasive ventilation. After treatment, the patient achieved remission and was discharged from hospital. Results: We encountered a typical case of IE with multiple organ infection caused by MRSA sepsis combined with COVID-19, for which combination therapy was effective. Conclusions: Obvious risk factors of IE may be absent in many cases. A high index of suspicion is required, especially with additional findings such as embolic phenomenon, focal neurologic deficit, decompensated heart failure, or new murmurs. The purpose of this case report is to help clinicians by improving awareness of IE, particularly in patients having high suspicion despite any risk factors, during COVID-19 pandemic.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134640520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatitis E virus (HEV) infection is a global health concern, with a large number of new infections reported every year. In developing countries with poor sanitation condition, HEV1 and HEV2 are mainly transmitted by the fecal-oral route due to water contamination. HEV3 and HEV4 are zoonotic diseases in humans consuming undercooked pork, mainly in developed countries. Usually, HEV infection is an acute self-limited course, and chronic infection can occur in immunocompromised individuals. The diagnosis of HEV infection relies on sero - logical tests, including RNA and anti-HEV antibodies. Currently, ribavirin is a proven effective drug; the treatment options for immunocompromised and pregnant individuals are limited. To date, only China has approved vaccines for HEV prevention. Therefore, more research is needed to understand the etiology.
{"title":"Promoting development of tertiary hospital by satisfaction surveys","authors":"Jinyong Wang, Y. Wang, B. Deng","doi":"10.54844/cai.2022.0079","DOIUrl":"https://doi.org/10.54844/cai.2022.0079","url":null,"abstract":"Hepatitis E virus (HEV) infection is a global health concern, with a large number of new infections reported every year. In developing countries with poor sanitation condition, HEV1 and HEV2 are mainly transmitted by the fecal-oral route due to water contamination. HEV3 and HEV4 are zoonotic diseases in humans consuming undercooked pork, mainly in developed countries. Usually, HEV infection is an acute self-limited course, and chronic infection can occur in immunocompromised individuals. The diagnosis of HEV infection relies on sero - logical tests, including RNA and anti-HEV antibodies. Currently, ribavirin is a proven effective drug; the treatment options for immunocompromised and pregnant individuals are limited. To date, only China has approved vaccines for HEV prevention. Therefore, more research is needed to understand the etiology.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132061560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ongoing coronavirus disease – 2019 (COVID-19) pandemic has changed the dynamics of all sectors and has significantly impacted the functioning of the healthcare delivery system. The purpose of the current review was to explore the significance of gatherings in COVID-19 outbreaks and the strategies to be implemented prior to organize a gathering to minimize the potential risk of a COVID-19 outbreak. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 14 articles were selected. Keywords used in the search include COVID-19 and gathering in the title alone only. As COVID-19 infection spreads via close contact, a gathering of any size carries the definite potential to amplify the risk of transmission and initiate a new chain of disease outbreaks. In conclusion, the COVID-19 pandemic is far from being yet over, and the decision to organize a gathering has to be based on the risk evaluation, risk mitigation, and establishment of a risk communication strategy. Even with all this, zero risk does not exist, and the best approach will be to strictly implement all the prevention and control measures and be responsible in all the gatherings.
{"title":"Exploring the scope of gatherings in the causation of COVID-19 outbreaks","authors":"S. Shrivastava, P. Shrivastava","doi":"10.54844/cai.2021.0046","DOIUrl":"https://doi.org/10.54844/cai.2021.0046","url":null,"abstract":"The ongoing coronavirus disease – 2019 (COVID-19) pandemic has changed the dynamics of all sectors and has significantly impacted the functioning of the healthcare delivery system. The purpose of the current review was to explore the significance of gatherings in COVID-19 outbreaks and the strategies to be implemented prior to organize a gathering to minimize the potential risk of a COVID-19 outbreak. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 14 articles were selected. Keywords used in the search include COVID-19 and gathering in the title alone only. As COVID-19 infection spreads via close contact, a gathering of any size carries the definite potential to amplify the risk of transmission and initiate a new chain of disease outbreaks. In conclusion, the COVID-19 pandemic is far from being yet over, and the decision to organize a gathering has to be based on the risk evaluation, risk mitigation, and establishment of a risk communication strategy. Even with all this, zero risk does not exist, and the best approach will be to strictly implement all the prevention and control measures and be responsible in all the gatherings.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127549074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
From the last some decades, microbial multidrug resistance (MDR) has developed one of the big treats in the many drug therapy. Due to this effect, so many sectors were get affected including the pharmaceutical sector, animal husbandry sector as well as in some way the agriculture sector too. There are so many mechanisms were developed by the microbes to developed resistance towards the medicines consisting of the development of degrading enzymes, structural modification in the microbes which is responsible to bind the drug, as well as last but not the least developing many effluxes pumps to push drug molecules outside of the microbial cell. Many studies demonstrated that lots of antibiotics and anticancer agents are majorly get affected by efflux pumps present on the cell wall. These mechanisms are observed in many common microbes including gram-positive and gram-negative microbes. As a result, efflux pumps are to be taken on top priority for the minimization of multidrug resistance. Up to date lots of work is done regarding the permeation glycoprotein (P-gp) efflux pump inhibition but still, there is a need to explore some more innovative approaches towards MDR. In this current perspective, we have discussed the key points related to pre-existing and future prospects in this regard.
{"title":"New Hope in Microbial Multidrug Resistance","authors":"Eknath D. Ahire, S. Kshirsagar","doi":"10.54844/cai.2022.0077","DOIUrl":"https://doi.org/10.54844/cai.2022.0077","url":null,"abstract":"From the last some decades, microbial multidrug resistance (MDR) has developed one of the big treats in the many drug therapy. Due to this effect, so many sectors were get affected including the pharmaceutical sector, animal husbandry sector as well as in some way the agriculture sector too. There are so many mechanisms were developed by the microbes to developed resistance towards the medicines consisting of the development of degrading enzymes, structural modification in the microbes which is responsible to bind the drug, as well as last but not the least developing many effluxes pumps to push drug molecules outside of the microbial cell. Many studies demonstrated that lots of antibiotics and anticancer agents are majorly get affected by efflux pumps present on the cell wall. These mechanisms are observed in many common microbes including gram-positive and gram-negative microbes. As a result, efflux pumps are to be taken on top priority for the minimization of multidrug resistance. Up to date lots of work is done regarding the permeation glycoprotein (P-gp) efflux pump inhibition but still, there is a need to explore some more innovative approaches towards MDR. In this current perspective, we have discussed the key points related to pre-existing and future prospects in this regard.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125416421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The coronavirus disease-2019 (COVID-19) pandemic continues to claim lives of the infected people and disrupt the routine functioning of all domains of lives. The development of a vaccine seems the only major tool which can prevent the acquisition of cases and bring an end to the pandemic. As on 11 November 2021, eight different vaccine manufacturers have been given permission to roll out their vaccines in different nations, with the first priority being offered to those who belong to vulnerable population groups. Considering the fact that the number of available vaccines will be less in initial time, it is essential to give priority to some specific groups and then gradually expand the reach of vaccine to everyone, once the supply increases. In conclusion, the ultimate aim of policy makers should be to ensure the availability and accessibility of COVID-19 vaccines to all those who could be benefited by the vaccine. However, it is a challenging task and a lot of planning and preparedness are required in each nation to ensure the safety of people.
{"title":"Ensuring fair allocation of COVID-19 vaccines: Recommended strategies and justification","authors":"S. Shrivastava, P. Shrivastava","doi":"10.54844/cai.2021.0033","DOIUrl":"https://doi.org/10.54844/cai.2021.0033","url":null,"abstract":"The coronavirus disease-2019 (COVID-19) pandemic continues to claim lives of the infected people and disrupt the routine functioning of all domains of lives. The development of a vaccine seems the only major tool which can prevent the acquisition of cases and bring an end to the pandemic. As on 11 November 2021, eight different vaccine manufacturers have been given permission to roll out their vaccines in different nations, with the first priority being offered to those who belong to vulnerable population groups. Considering the fact that the number of available vaccines will be less in initial time, it is essential to give priority to some specific groups and then gradually expand the reach of vaccine to everyone, once the supply increases. In conclusion, the ultimate aim of policy makers should be to ensure the availability and accessibility of COVID-19 vaccines to all those who could be benefited by the vaccine. However, it is a challenging task and a lot of planning and preparedness are required in each nation to ensure the safety of people.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127496709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objective: A total of 86.9 million persons worldwide are infected with Neisseria gonorrhoeae (Ng). Although Gram-stained smears (GSS) provide a timeand cost-saving alternative to conventional laboratory tests, their global uptake partly depends on their performance. This study aimed to meta-analyze the diagnostic accuracy of GSS to screen for Ng. Materials and Methods: A literature search was conducted using the MEDLINE (1980 to 2020). Studies were included if they employed GSS to detect Ng in humans and compared the results with reference tests. Results: Eleven studies were reviewed and meta-analyzed and stratified by specimen type (Gram-stained urethral smears and Gram-stained endocervical, urethral swabs and urine smears.) and reference test type (culture method or NAAT). Sensitivity was similarly high in GSS versus NAAT (93% [CI, 64% to 99 %]) and GSS versus culture methods (87% [CI, 74% to 94%]), followed by Gram-stained urethral smears (97% [95% CI, 86% to 100%]) and Gram-stained endocervical, urethral swabs and urine smears (81% [CI, 67% to 90%]). Specificity was also high in GSS versus culture methods (98% [CI, 95% to 100%]) and GSS versus NAAT (94% [CI, 73% to 99%]), followed Gram-stained endocervical, urethral swabs and urine smears (98% [CI, 93% to 99%]) and Gram-stained urethral smears (96% [CI, 78% to 99%]). Conclusions: Data suggest that GSS have the highest accuracy when investigated against reference culture methods, and Gram-stained urethral smears have the highest accuracy, followed by Gram-stained endocervical, urethral swabs and urine smears. Given their accuracy, convenience, and quick turnaround time, GSS may be useful in expanding first-line screening Ng.
{"title":"Accuracy of Gram-stained Smears as Screening Tests for Neisseria gonorrhoeae: A Systematic Review and Meta-analysis","authors":"Mohamed Khalid","doi":"10.54844/cai.2021.0014","DOIUrl":"https://doi.org/10.54844/cai.2021.0014","url":null,"abstract":"Background and Objective: A total of 86.9 million persons worldwide are infected with Neisseria gonorrhoeae (Ng). Although Gram-stained smears (GSS) provide a timeand cost-saving alternative to conventional laboratory tests, their global uptake partly depends on their performance. This study aimed to meta-analyze the diagnostic accuracy of GSS to screen for Ng. Materials and Methods: A literature search was conducted using the MEDLINE (1980 to 2020). Studies were included if they employed GSS to detect Ng in humans and compared the results with reference tests. Results: Eleven studies were reviewed and meta-analyzed and stratified by specimen type (Gram-stained urethral smears and Gram-stained endocervical, urethral swabs and urine smears.) and reference test type (culture method or NAAT). Sensitivity was similarly high in GSS versus NAAT (93% [CI, 64% to 99 %]) and GSS versus culture methods (87% [CI, 74% to 94%]), followed by Gram-stained urethral smears (97% [95% CI, 86% to 100%]) and Gram-stained endocervical, urethral swabs and urine smears (81% [CI, 67% to 90%]). Specificity was also high in GSS versus culture methods (98% [CI, 95% to 100%]) and GSS versus NAAT (94% [CI, 73% to 99%]), followed Gram-stained endocervical, urethral swabs and urine smears (98% [CI, 93% to 99%]) and Gram-stained urethral smears (96% [CI, 78% to 99%]). Conclusions: Data suggest that GSS have the highest accuracy when investigated against reference culture methods, and Gram-stained urethral smears have the highest accuracy, followed by Gram-stained endocervical, urethral swabs and urine smears. Given their accuracy, convenience, and quick turnaround time, GSS may be useful in expanding first-line screening Ng.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129985307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) with nonspecific clinical manifestations. Most cases are found in patients with diabetes mellitus (DM). Early diagnosis and treatment are important for the prognosis. Objective: The purpose of our study is to analyze the features of patients with EC for the epidemiology, microbiology, clinical symptoms, imaging examination, treatment, prognosis, and prevention. Materials and Methods: We summarized the clinical data of 13 patients with EC for medical history, laboratory and radiological examinations, treatments, and results. We analyzed the reported risk factors to determine whether these factors were related to the failure of conservative treatment. Results: All but one of the patients were women, and all but one had DM. All patients were diagnosed using computed tomography (CT). Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the two major microbes identified in our series, accounting for 69.3%. Twelve (92.3%) patients received conservative management, and one underwent partial cystectomy. All the patients recovered and no death was recorded. Conclusion: EC is a gas-forming UTI common in women with DM. Early diagnosis and appropriate treatment are required to prevent surgical intervention.
{"title":"Emphysematous cystitis: a 6-year experience with 13 cases","authors":"June-Tse Yang, Kefang Wang","doi":"10.54844/cai.2021.0012","DOIUrl":"https://doi.org/10.54844/cai.2021.0012","url":null,"abstract":"Background: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) with nonspecific clinical manifestations. Most cases are found in patients with diabetes mellitus (DM). Early diagnosis and treatment are important for the prognosis. Objective: The purpose of our study is to analyze the features of patients with EC for the epidemiology, microbiology, clinical symptoms, imaging examination, treatment, prognosis, and prevention. Materials and Methods: We summarized the clinical data of 13 patients with EC for medical history, laboratory and radiological examinations, treatments, and results. We analyzed the reported risk factors to determine whether these factors were related to the failure of conservative treatment. Results: All but one of the patients were women, and all but one had DM. All patients were diagnosed using computed tomography (CT). Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the two major microbes identified in our series, accounting for 69.3%. Twelve (92.3%) patients received conservative management, and one underwent partial cystectomy. All the patients recovered and no death was recorded. Conclusion: EC is a gas-forming UTI common in women with DM. Early diagnosis and appropriate treatment are required to prevent surgical intervention.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134640178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hao Bing, Dan Li, B. Chang, Yiling Li, Xiang-dong He, J. Tong, Ying Wang, R. Ao, Ningning Wang
Background PA-HSOS is a rare disease and there is no specific treatment for PA-HSOS. Anticoagulant, antithrombotic and microcirculation therapy can alleviate the progression of PA-HSOS. The application of rivaroxaban in patients with PA-HSOS has not yet been reported. The aim of this study was to analyze the efficacy and safety of rivaroxaban in the treatment of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndromecaused by Gynura segetum (PA-HSOS) . Methods A retrospective analysis was conducted with the clinical data of patients with PA-HSOS in the acute/subacute phase caused by taking Gynura segetum. The patients were divided into warfarin and rivaroxaban groups according to the anticoagulant therapy they received. Related biochemical indicators were monitored during hospitalization. Liver ultrasound, liver elastography and related biochemical indicators were reviewed every two weeks or one month after discharge. The patients were followed until 1 year after complete remission or death. The efficacy and safety of rivaroxaban was compared with that of warfarin according to the patients’ hepatic venous recanalization rates and the occurrence of bleeding events. Results The study included 20 patients, with 10 patients in the warfarin group and 10 patients in the rivaroxaban group. The results showed that the average anticoagulant course in the rivaroxaban group was significantly shorter than that in the warfarin group (P=0.007). With treatment, the remission rates of the rivaroxaban group and the warfarin group reached 90%. There was no significant difference in the incidence of adverse reactions or bleeding events between the two groups (P>0.05). Conclusions Compared with warfarin, rivaroxaban, a new oral anticoagulant, is convenient and safe for clinical use. It has an obvious effect on PA-HSOS and a low risk of bleeding. It provides a new anticoagulant treatment for PA-HSOS.
{"title":"Retrospective analysis of the efficacy and safety of rivaroxaban in the treatment of hepatic sinus obstruction syndrome caused by Gynura segetum","authors":"Hao Bing, Dan Li, B. Chang, Yiling Li, Xiang-dong He, J. Tong, Ying Wang, R. Ao, Ningning Wang","doi":"10.21203/rs.2.12785/v1","DOIUrl":"https://doi.org/10.21203/rs.2.12785/v1","url":null,"abstract":"\u0000 Background\u0000\u0000PA-HSOS is a rare disease and there is no specific treatment for PA-HSOS. Anticoagulant, antithrombotic and microcirculation therapy can alleviate the progression of PA-HSOS. The application of rivaroxaban in patients with PA-HSOS has not yet been reported. The aim of this study was to analyze the efficacy and safety of rivaroxaban in the treatment of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndromecaused by Gynura segetum (PA-HSOS) .\u0000\u0000Methods\u0000\u0000A retrospective analysis was conducted with the clinical data of patients with PA-HSOS in the acute/subacute phase caused by taking Gynura segetum. The patients were divided into warfarin and rivaroxaban groups according to the anticoagulant therapy they received. Related biochemical indicators were monitored during hospitalization. Liver ultrasound, liver elastography and related biochemical indicators were reviewed every two weeks or one month after discharge. The patients were followed until 1 year after complete remission or death. The efficacy and safety of rivaroxaban was compared with that of warfarin according to the patients’ hepatic venous recanalization rates and the occurrence of bleeding events.\u0000\u0000Results\u0000\u0000The study included 20 patients, with 10 patients in the warfarin group and 10 patients in the rivaroxaban group. The results showed that the average anticoagulant course in the rivaroxaban group was significantly shorter than that in the warfarin group (P=0.007). With treatment, the remission rates of the rivaroxaban group and the warfarin group reached 90%. There was no significant difference in the incidence of adverse reactions or bleeding events between the two groups (P>0.05).\u0000\u0000Conclusions\u0000\u0000Compared with warfarin, rivaroxaban, a new oral anticoagulant, is convenient and safe for clinical use. It has an obvious effect on PA-HSOS and a low risk of bleeding. It provides a new anticoagulant treatment for PA-HSOS.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133619244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In human history, there have been several times of influenza raging, which have caused tens of millions of deaths and brought serious social and economic burdens. Although with the development of science, the emergence of vaccines has significantly reduced the incidence and mortality of influenza, due to the high variability of viruses, there is still a lack of effective treatment. More and more studies have found that bacterial pneumonia secondary to influenza was an important cause of the progression to critical illness or even death. Hence, diagnosis and treatment timely of secondary bacterial pneumonia are valuable. Therefore, we discuss the pathogens of bacterial pneumonia secondary to influenza, associated morbidity, mortality, and risk factors. Hopefully, it can provide some valuable references for clinical practice. Since some clinical studies have not separated pneumonia from lower respiratory tract infections, we will discuss these two situations together.
{"title":"Pathogen analysis of bacterial pneumonia secondary to influenza","authors":"Fei Wang, B. He","doi":"10.4103/cai.cai_4_20","DOIUrl":"https://doi.org/10.4103/cai.cai_4_20","url":null,"abstract":"In human history, there have been several times of influenza raging, which have caused tens of millions of deaths and brought serious social and economic burdens. Although with the development of science, the emergence of vaccines has significantly reduced the incidence and mortality of influenza, due to the high variability of viruses, there is still a lack of effective treatment. More and more studies have found that bacterial pneumonia secondary to influenza was an important cause of the progression to critical illness or even death. Hence, diagnosis and treatment timely of secondary bacterial pneumonia are valuable. Therefore, we discuss the pathogens of bacterial pneumonia secondary to influenza, associated morbidity, mortality, and risk factors. Hopefully, it can provide some valuable references for clinical practice. Since some clinical studies have not separated pneumonia from lower respiratory tract infections, we will discuss these two situations together.","PeriodicalId":107566,"journal":{"name":"Community Acquired Infection","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114406885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rajesh Kumar, Yasir Rizvi, C. Kumar, Pal Singh Athwal
Idiopathic CD4 lymphocytopenia (ICL) is a rare entity of immune deficit of CD4+ T cells (below 300/mm3) which was first defined in 1992, unrelated to human immunodeficiency virus (HIV) syndrome without predefined clinical presentation and natural history. The etiology, pathogenesis, and management of ICL remains poorly understood and inadequately defined. The clinical presentation can range from serious opportunistic infections to incidentally diagnosed asymptomatic individuals. Cryptococcal and nontuberculous mycobacterial infections and progressive multifocal leukoencephalopathy are the most significant presenting infections, although the spectrum of opportunistic diseases can be similar to that in patients with lymphopenia and HIV infection. The prognosis is influenced by the accompanying opportunistic infections and response to the treatment. This rare disease invites uncountable opportunistic infections sometimes leading to lethal outcome. We report a case of ICL in an immunocompetent 18-year-old male with a history of intermittent epistaxis, fungal nasal polyp diagnosed to have Rhizopus with drug-induced acute kidney injury during the course of treatment, a rarest diagnosis as underlying main disease entity. To the best of our knowledge, ICL presenting with opportunistic infection of Rhizopus is the first case to be reported here from a tertiary care center of India, a developing country where a major population lives with poor hygiene and low socioeconomic status.
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