Pub Date : 2022-04-07DOI: 10.1080/23744235.2022.2058604
Hamideh Molaei, E. Shojaeefar, E. Nemati, L. Khedmat, S. Mojtahedi, N. Jonaidi Jafari, M. Izadi, B. Einollahi
Abstract Background The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's main health challenge because infected patients become vulnerable to a variety of opportunistic diseases. Objective This study aimed to assess clinical outcomes, diagnosis, utilized drug therapies, and ongoing COVID-19 practices in Iranian cases co-infected with COVID-19 and mucormycosis. Participants and methods A case-series analysis was conducted in the presence of 10 patients with COVID-19 and mucormycosis co-infection (two men and eight women; mean age of 48.8 years) from March to October 2020. Demographic variables, signs/symptoms, and comorbidities of all patients were recorded. COVID-19 was confirmed with reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab tests and high-resolution computed tomography (HR-CT)_ scans. Results All patients had a positive RT-PCR for SARS-CoV-2. Eight patients had a history of diabetes, while three of them exhibited a hypertension history. Remarkable laboratory findings were elevated fasting blood sugar in 6 cases and anaemia in four patients. A rhino-orbital-cerebral of mucormycosis in all patients was detected based on HR-CT scans and otorhinolaryngological or ophthalmological examinations. Neurological disorders including facial, trigeminal, optic, and oculomotor nerve involvement resulted in paraesthesia, pain, ptosis, no light perception, blurred vision, and papilledema in five cases. Maxillary and ethmoid sinuses were the most common sites of involvement. Conclusion Vulnerable COVID-19 patients with comorbidities, any facial involvements, or treated by excessive doses of glucocorticoids and antibiotics should undergo precise examinations during the appearance of early signs and hospitalization to diagnose and treat mucormycosis using the standard care and antifungal treatments.
{"title":"Iranian patients co-infected with COVID-19 and mucormycosis: the most common predisposing factor, clinical outcomes, laboratory markers and diagnosis, and drug therapies","authors":"Hamideh Molaei, E. Shojaeefar, E. Nemati, L. Khedmat, S. Mojtahedi, N. Jonaidi Jafari, M. Izadi, B. Einollahi","doi":"10.1080/23744235.2022.2058604","DOIUrl":"https://doi.org/10.1080/23744235.2022.2058604","url":null,"abstract":"Abstract Background The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's main health challenge because infected patients become vulnerable to a variety of opportunistic diseases. Objective This study aimed to assess clinical outcomes, diagnosis, utilized drug therapies, and ongoing COVID-19 practices in Iranian cases co-infected with COVID-19 and mucormycosis. Participants and methods A case-series analysis was conducted in the presence of 10 patients with COVID-19 and mucormycosis co-infection (two men and eight women; mean age of 48.8 years) from March to October 2020. Demographic variables, signs/symptoms, and comorbidities of all patients were recorded. COVID-19 was confirmed with reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab tests and high-resolution computed tomography (HR-CT)_ scans. Results All patients had a positive RT-PCR for SARS-CoV-2. Eight patients had a history of diabetes, while three of them exhibited a hypertension history. Remarkable laboratory findings were elevated fasting blood sugar in 6 cases and anaemia in four patients. A rhino-orbital-cerebral of mucormycosis in all patients was detected based on HR-CT scans and otorhinolaryngological or ophthalmological examinations. Neurological disorders including facial, trigeminal, optic, and oculomotor nerve involvement resulted in paraesthesia, pain, ptosis, no light perception, blurred vision, and papilledema in five cases. Maxillary and ethmoid sinuses were the most common sites of involvement. Conclusion Vulnerable COVID-19 patients with comorbidities, any facial involvements, or treated by excessive doses of glucocorticoids and antibiotics should undergo precise examinations during the appearance of early signs and hospitalization to diagnose and treat mucormycosis using the standard care and antifungal treatments.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"600 - 613"},"PeriodicalIF":5.8,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45056327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-07DOI: 10.1080/23744235.2022.2055787
C. S. Kow, D. Ramachandram, S. Hasan
{"title":"Risk of severe illness in patients infected with SARS-CoV-2 of Delta variant: a systematic review and meta-analysis","authors":"C. S. Kow, D. Ramachandram, S. Hasan","doi":"10.1080/23744235.2022.2055787","DOIUrl":"https://doi.org/10.1080/23744235.2022.2055787","url":null,"abstract":"","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"614 - 617"},"PeriodicalIF":5.8,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49171479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-05DOI: 10.1080/23744235.2022.2056242
Shinya Hasegawa, S. Kakiuchi, J. Tholany, Takaaki Kobayashi, A. Marra, M. Schweizer, Riley J Samuelson, Hiroyuki Suzuki
{"title":"Impact of infectious diseases consultation among patients with infections caused by gram-negative rod bacteria: a systematic literature review and meta-analysis","authors":"Shinya Hasegawa, S. Kakiuchi, J. Tholany, Takaaki Kobayashi, A. Marra, M. Schweizer, Riley J Samuelson, Hiroyuki Suzuki","doi":"10.1080/23744235.2022.2056242","DOIUrl":"https://doi.org/10.1080/23744235.2022.2056242","url":null,"abstract":"","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"618 - 621"},"PeriodicalIF":5.8,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47234601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-05DOI: 10.1080/23744235.2022.2057584
T. Platts-Mills
The authors report on the results of IgE assays for galactose alpha-1, 3-galactose (alpha-gal) among forest workers in the region around Balyostock in North East Poland [1]. The patients were being seen for evaluation of possible tick-borne infections primarily tick-borne encephalitis and Lyme disease. The reason for carrying out assays for IgE to a -gal was because of recognition that in many areas of the world tick bites can induce sensitisation to this oligosaccharide which in turn is associated with an unusual form of delayed allergic reactions to red meat [2]. The results show a significant association between a history of tick bites and IgE to a -gal [3]. In addition, in keeping with previous studies they found no association between evidence of a tick borne infection and positive IgE to a -gal [1,4,5]. Our data on serological evidence of Rickettsial organisms among patients with AGS in two areas of the United States showed a high prevalence of positive sera among patients and controls [6]. The most likely explanation of that result is that the positive serology reflects ‘ infection ’ with Rickettsia amblyomii which is a common symbiont of the Lone Star tick but is not really a pathogen. What matters here is that none of the published results provide evidence that the pathogens carried by ticks con-tribute to a -gal sensitisation. There are several features of the report from Dr. Rutkowski and his colleagues that require comment. In particular, there is now evidence that subjects with sensitisation as judged by IgE ab, but no symptoms are at risk for two distinct clinical complications.
{"title":"Sensitisation of Forest workers to the oligosaccharide galactose alpha-1, 3-galactose (alpha-gal) is strongly associated with tick bites but not with evidence of tick borne infections","authors":"T. Platts-Mills","doi":"10.1080/23744235.2022.2057584","DOIUrl":"https://doi.org/10.1080/23744235.2022.2057584","url":null,"abstract":"The authors report on the results of IgE assays for galactose alpha-1, 3-galactose (alpha-gal) among forest workers in the region around Balyostock in North East Poland [1]. The patients were being seen for evaluation of possible tick-borne infections primarily tick-borne encephalitis and Lyme disease. The reason for carrying out assays for IgE to a -gal was because of recognition that in many areas of the world tick bites can induce sensitisation to this oligosaccharide which in turn is associated with an unusual form of delayed allergic reactions to red meat [2]. The results show a significant association between a history of tick bites and IgE to a -gal [3]. In addition, in keeping with previous studies they found no association between evidence of a tick borne infection and positive IgE to a -gal [1,4,5]. Our data on serological evidence of Rickettsial organisms among patients with AGS in two areas of the United States showed a high prevalence of positive sera among patients and controls [6]. The most likely explanation of that result is that the positive serology reflects ‘ infection ’ with Rickettsia amblyomii which is a common symbiont of the Lone Star tick but is not really a pathogen. What matters here is that none of the published results provide evidence that the pathogens carried by ticks con-tribute to a -gal sensitisation. There are several features of the report from Dr. Rutkowski and his colleagues that require comment. In particular, there is now evidence that subjects with sensitisation as judged by IgE ab, but no symptoms are at risk for two distinct clinical complications.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"580 - 582"},"PeriodicalIF":5.8,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45307001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-05DOI: 10.1080/23744235.2022.2057583
K. Rutkowski, P. Sowa, B. Mroczko, S. Pancewicz, R. Rutkowski, P. Czupryna, Magdalena Groblewska, M. Łukaszewicz-Zając, Anna M. Moniuszko-Malinowska
Abstract Purpose Ticks transmit several pathogens and seem implicated in the production of specific IgE antibodies to alpha-1,3-galactose (α-gal sIgE). They cause delayed and immediate allergy to mammalian meat and medication including antivenoms, vaccines and monoclonal antibodies. Methods We assessed the prevalence of α-gal sIgE in forest workers and healthy controls in the Podlasie voivodeship, north-eastern Poland; the relationship between α-gal sIgE and allergy to α-gal-containing products; the correlation between α-gal sIgE and anti-Borrelia burgdorferi and anti-tick-borne encephalitis virus (TBEV) antibodies; the relationship between α-gal sIgE and markers of infection with lesser-known pathogens transmitted by ticks such as Anaplasma phagocytophilum. Results Production of α-gal sIgE was closely related to tick bites. The odds ratio for detectable α-gal sIgE was 9.31 times higher among people with a history of tick bites (OR 9.3; p < .05). There was no correlation with the history of TBE, Lyme disease or human granulocytic anaplasmosis. However, serum α-gal sIgE correlated with anti-TBEV IgM antibodies in CSF. There was a strong correlation between α-gal sIgE and total IgE and sIgE to pork and beef. Conclusions Our data support the link between I.ricinus ticks and the production of α-gal sIgE and confirm that the pathogens carried by ticks we examined for do not seem implicated in this immune response.
{"title":"Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections","authors":"K. Rutkowski, P. Sowa, B. Mroczko, S. Pancewicz, R. Rutkowski, P. Czupryna, Magdalena Groblewska, M. Łukaszewicz-Zając, Anna M. Moniuszko-Malinowska","doi":"10.1080/23744235.2022.2057583","DOIUrl":"https://doi.org/10.1080/23744235.2022.2057583","url":null,"abstract":"Abstract Purpose Ticks transmit several pathogens and seem implicated in the production of specific IgE antibodies to alpha-1,3-galactose (α-gal sIgE). They cause delayed and immediate allergy to mammalian meat and medication including antivenoms, vaccines and monoclonal antibodies. Methods We assessed the prevalence of α-gal sIgE in forest workers and healthy controls in the Podlasie voivodeship, north-eastern Poland; the relationship between α-gal sIgE and allergy to α-gal-containing products; the correlation between α-gal sIgE and anti-Borrelia burgdorferi and anti-tick-borne encephalitis virus (TBEV) antibodies; the relationship between α-gal sIgE and markers of infection with lesser-known pathogens transmitted by ticks such as Anaplasma phagocytophilum. Results Production of α-gal sIgE was closely related to tick bites. The odds ratio for detectable α-gal sIgE was 9.31 times higher among people with a history of tick bites (OR 9.3; p < .05). There was no correlation with the history of TBE, Lyme disease or human granulocytic anaplasmosis. However, serum α-gal sIgE correlated with anti-TBEV IgM antibodies in CSF. There was a strong correlation between α-gal sIgE and total IgE and sIgE to pork and beef. Conclusions Our data support the link between I.ricinus ticks and the production of α-gal sIgE and confirm that the pathogens carried by ticks we examined for do not seem implicated in this immune response.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"572 - 579"},"PeriodicalIF":5.8,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44006642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-30DOI: 10.1080/23744235.2022.2055786
E. Forsblom, Hanna Helanne, E. Kortela, Suvi Silén, A. Meretoja, A. Järvinen
Abstract Background Male sex predicts case-fatality in SARS-CoV-2 (COVID-19) – a phenomenon linked to systemic inflammation. We compared sex-related associations of inflammation parameters and outcome in a population-based setting with low case-fatality prior to wide use of immunosuppressives. Methods A population-based quality registry with laboratory-confirmed COVID-19 cases of specialized hospitals of the Capital Province of Finland were analysed to compare inflammatory parameters by sex during the first COVID-19 wave February–June 2020. Results Altogether, 585 hospitalized patients (54% males) were included. Males required more often intensive care unit (ICU) treatment (26.9 vs. 17.5%) and had higher 90-d case-fatality (14.9 vs. 7.8%) compared with females. Highest association with case-fatality in males was seen for high neutrophil counts (median; interquartile range) (8.70; 7.10–9.10 vs. 5.60; 3.90–7.80) (E9/l), low monocyte (0.50; 0.20–1.50 vs. 0.70; 0.50–0.90) (E9/l) and lymphocyte (0.90; 0.70-1.40 vs. 1.50; 1.10-2.00) (E9/l) counts, and high levels of d-dimer (3.80; 1.80–5.30 vs. 1.10; 0.60–2.75) (mg/l) and C-reactive protein (CRP) (190; 85.5–290 vs. 77.0; 49.0–94.0) (mg/l). In females, low lymphocyte (0.95; interquartile range 0.60–1.28 vs. 1.50; 1.10–2.00) (E9/l) and thrombocyte counts (196; 132–285 vs. 325; 244–464) (E9/l) and high CRP values (95.0; 62.0–256 vs. 66.0; 42.5–89.0) (mg/l) were associated with case-fatality. In multivariable analysis for males, lymphocyte cut-off 0.85 (E9/l) (OR 0.02; 95% CI 0.002–0.260), d-dimer cut-off 1.15 (mg/l) (OR 7.29; 1.01–52.6) and CRP cut-off 110 (mg/l) (OR 15.4; 1.87–127) were independently associated with case-fatality. In female multivariable analysis, CRP cut-off 81 (mg/l) (OR 7.32; 1.44–37.2) was the only inflammatory parameter associated with case-fatality. Conclusions COVID-19 results in higher inflammation parameter levels in male vs. female patients irrespective of outcome. This study suggests that low lymphocyte, high d-dimer and high CRP cut-off values may serve as potential markers for risk stratification in male patients.
男性性别预测SARS-CoV-2 (COVID-19)的病死率，这一现象与全身性炎症有关。在广泛使用免疫抑制剂之前，我们比较了基于人群的低病死率的炎症参数和结果的性别相关关系。方法对芬兰首都省专科医院实验室确诊的COVID-19病例进行基于人群的质量登记，比较2020年2月至6月第一波COVID-19期间按性别划分的炎症参数。结果共纳入住院患者585例，其中男性占54%。与女性相比，男性更需要重症监护病房(ICU)治疗(26.9%比17.5%)，90天病死率(14.9%比7.8%)更高。中性粒细胞计数高与男性病死率的相关性最高(中位数;四分位数间距)(8.70;7.10-9.10 vs. 5.60;3.90-7.80) (E9/l)，低单核细胞(0.50;0.20-1.50 vs. 0.70;0.50-0.90) (E9/l)和淋巴细胞(0.90;0.70-1.40 vs. 1.50;1.10-2.00) (E9/l)计数，d-二聚体高水平(3.80;1.80-5.30 vs. 1.10;0.60-2.75) (mg/l)和c反应蛋白(CRP) (190;85.5-290 vs. 77.0;49.0 - -94.0)(毫克/升)。女性淋巴细胞低(0.95;四分位数区间0.60-1.28 vs. 1.50;1.10-2.00) (E9/l)和血小板计数(196;132-285 vs. 325;244-464) (E9/l)和高CRP值(95.0;62.0-256 vs. 66.0;42.5-89.0) (mg/l)与病死率相关。在多变量分析中，男性淋巴细胞临界值为0.85 (E9/l) (OR 0.02;95% CI 0.002-0.260)， d-二聚体临界值1.15 (mg/l) (OR 7.29;1.01-52.6)， CRP临界值110 (mg/l) (OR 15.4;1.87-127)与病死率独立相关。在女性多变量分析中，CRP临界值为81 (mg/l) (OR 7.32;1.44-37.2)是唯一与病死率相关的炎症参数。结论COVID-19导致男性患者的炎症参数水平高于女性患者，无论结果如何。本研究提示低淋巴细胞、高d-二聚体和高CRP临界值可能作为男性患者危险分层的潜在标志。
{"title":"Inflammation parameters predict fatal outcome in male COVID-19 patients in a low case-fatality area – a population-based registry study","authors":"E. Forsblom, Hanna Helanne, E. Kortela, Suvi Silén, A. Meretoja, A. Järvinen","doi":"10.1080/23744235.2022.2055786","DOIUrl":"https://doi.org/10.1080/23744235.2022.2055786","url":null,"abstract":"Abstract Background Male sex predicts case-fatality in SARS-CoV-2 (COVID-19) – a phenomenon linked to systemic inflammation. We compared sex-related associations of inflammation parameters and outcome in a population-based setting with low case-fatality prior to wide use of immunosuppressives. Methods A population-based quality registry with laboratory-confirmed COVID-19 cases of specialized hospitals of the Capital Province of Finland were analysed to compare inflammatory parameters by sex during the first COVID-19 wave February–June 2020. Results Altogether, 585 hospitalized patients (54% males) were included. Males required more often intensive care unit (ICU) treatment (26.9 vs. 17.5%) and had higher 90-d case-fatality (14.9 vs. 7.8%) compared with females. Highest association with case-fatality in males was seen for high neutrophil counts (median; interquartile range) (8.70; 7.10–9.10 vs. 5.60; 3.90–7.80) (E9/l), low monocyte (0.50; 0.20–1.50 vs. 0.70; 0.50–0.90) (E9/l) and lymphocyte (0.90; 0.70-1.40 vs. 1.50; 1.10-2.00) (E9/l) counts, and high levels of d-dimer (3.80; 1.80–5.30 vs. 1.10; 0.60–2.75) (mg/l) and C-reactive protein (CRP) (190; 85.5–290 vs. 77.0; 49.0–94.0) (mg/l). In females, low lymphocyte (0.95; interquartile range 0.60–1.28 vs. 1.50; 1.10–2.00) (E9/l) and thrombocyte counts (196; 132–285 vs. 325; 244–464) (E9/l) and high CRP values (95.0; 62.0–256 vs. 66.0; 42.5–89.0) (mg/l) were associated with case-fatality. In multivariable analysis for males, lymphocyte cut-off 0.85 (E9/l) (OR 0.02; 95% CI 0.002–0.260), d-dimer cut-off 1.15 (mg/l) (OR 7.29; 1.01–52.6) and CRP cut-off 110 (mg/l) (OR 15.4; 1.87–127) were independently associated with case-fatality. In female multivariable analysis, CRP cut-off 81 (mg/l) (OR 7.32; 1.44–37.2) was the only inflammatory parameter associated with case-fatality. Conclusions COVID-19 results in higher inflammation parameter levels in male vs. female patients irrespective of outcome. This study suggests that low lymphocyte, high d-dimer and high CRP cut-off values may serve as potential markers for risk stratification in male patients.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"558 - 571"},"PeriodicalIF":5.8,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46821996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-29DOI: 10.1080/23744235.2022.2055136
I. Maan, Stavroula M. Paraskevopoulou, K. Cwynarski, Meena Shrestha, L. Waters, Robert Miller, N. Ahmed
Abstract Background The global spread of SARS-CoV-2 has necessitated case isolation, with recommended isolation times based on mean time to viral clearance. Case study We present a 28-year-old female living with vertically acquired HIV, undergoing chemotherapy for lymphoma who tested SARS-CoV-2-PCR positive for 164 days. The patient had a history of difficulty taking ARVs, with detectable HIV-RNA and CD4 count below 200 × 106 for the 8 years prior to presentation with symptoms. She stopped ARVs 10 months prior to experiencing fevers, night sweats and loose stool, with a viral load of 354,000 copies/ml and CD4 count of 30 × 106. Following no yield on basic investigations, positron emission tomography scan showed diffuse colonic and oesophageal avidity and a caecal biopsy showed diffuse large B-cell lymphoma. She re-started ARVs and underwent five cycles of R-CHOP chemotherapy. Her first positive SARS-CoV-2 PCR test was detected through routine asymptomatic screening. She self-isolated due to repeated positive tests on a further 8 swabs for a total of 164 days until a negative PCR test. She reported feeling low in mood and frustrated by repeated positive tests and the associated lack of social contact or ability to work. Her positive tests prevented in-person review by her HIV team, which impacted her ARV adherence leading to an unplanned break in therapy. Conclusions Our case highlights the challenges to physical and mental health faced by patients with prolonged SARS-CoV-2 shedding and the need to develop surrogate markers for infectivity to enable prompt medical and psychological support and accurate advice about the need for isolation.
{"title":"Prolonged SARS-CoV-2 shedding in a person living with advanced HIV and diffuse large B-cell lymphoma: a case report","authors":"I. Maan, Stavroula M. Paraskevopoulou, K. Cwynarski, Meena Shrestha, L. Waters, Robert Miller, N. Ahmed","doi":"10.1080/23744235.2022.2055136","DOIUrl":"https://doi.org/10.1080/23744235.2022.2055136","url":null,"abstract":"Abstract Background The global spread of SARS-CoV-2 has necessitated case isolation, with recommended isolation times based on mean time to viral clearance. Case study We present a 28-year-old female living with vertically acquired HIV, undergoing chemotherapy for lymphoma who tested SARS-CoV-2-PCR positive for 164 days. The patient had a history of difficulty taking ARVs, with detectable HIV-RNA and CD4 count below 200 × 106 for the 8 years prior to presentation with symptoms. She stopped ARVs 10 months prior to experiencing fevers, night sweats and loose stool, with a viral load of 354,000 copies/ml and CD4 count of 30 × 106. Following no yield on basic investigations, positron emission tomography scan showed diffuse colonic and oesophageal avidity and a caecal biopsy showed diffuse large B-cell lymphoma. She re-started ARVs and underwent five cycles of R-CHOP chemotherapy. Her first positive SARS-CoV-2 PCR test was detected through routine asymptomatic screening. She self-isolated due to repeated positive tests on a further 8 swabs for a total of 164 days until a negative PCR test. She reported feeling low in mood and frustrated by repeated positive tests and the associated lack of social contact or ability to work. Her positive tests prevented in-person review by her HIV team, which impacted her ARV adherence leading to an unplanned break in therapy. Conclusions Our case highlights the challenges to physical and mental health faced by patients with prolonged SARS-CoV-2 shedding and the need to develop surrogate markers for infectivity to enable prompt medical and psychological support and accurate advice about the need for isolation.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"529 - 533"},"PeriodicalIF":5.8,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42555423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-17DOI: 10.1080/23744235.2022.2050423
Parvathi Parappil, Sushant Ghimire, A. Saxena, S. Mukherjee, B. John, V. Sondhi, P. Sengupta, S. Acharya
Abstract Background Coronavirus disease 2019 (COVID 19) usually causes a mild illness among children. However, in a minority of children, it may be associated with the life-threatening multisystem inflammatory syndrome (MIS-C), or thrombotic microangiopathy, or sequelae like type-1 diabetes mellitus (T1DM). We describe a previously healthy, 12-year-old boy with new-onset T1DM with diabetic ketoacidosis (DKA) in the setting of MIS-C, with a course complicated by thrombotic microangiopathy. Case presentation The patient presented with four days history of fever, non-bilious vomiting, polyuria and polydipsia. On evaluation, he was noted to have diabetic ketoacidosis. Although Diabetic ketoacidosis with insulin and intravenous fluids, his hospital course was notable for shock requiring vasopressor, purpura fulminans with eschar formation, neurological manifestations (left hemiparesis due to right middle cerebral artery territory infarct, mononeuritis multiplex) and thrombotic microangiopathy. MIS-C-like illness secondary to COVID-19 was suspected due to diabetic ketoacidosis, thrombotic microangiopathy, elevated inflammatory markers, history of contact with COVID-19-infected individual and detectable COVID-19 IgG antibodies. He improved following management with methylprednisolone, intravenous immunoglobulin, low-molecular-weight heparin and aspirin, and was discharged on hospital day 48. Conclusion MIS-C-like illness should be considered in children and adolescents presenting with complex multisystem involvement in this era of COVID 19. Management with immunomodulatory agents can be lifesaving.
{"title":"New-onset diabetic ketoacidosis with purpura fulminans in a child with COVID-19-related multisystem inflammatory syndrome","authors":"Parvathi Parappil, Sushant Ghimire, A. Saxena, S. Mukherjee, B. John, V. Sondhi, P. Sengupta, S. Acharya","doi":"10.1080/23744235.2022.2050423","DOIUrl":"https://doi.org/10.1080/23744235.2022.2050423","url":null,"abstract":"Abstract Background Coronavirus disease 2019 (COVID 19) usually causes a mild illness among children. However, in a minority of children, it may be associated with the life-threatening multisystem inflammatory syndrome (MIS-C), or thrombotic microangiopathy, or sequelae like type-1 diabetes mellitus (T1DM). We describe a previously healthy, 12-year-old boy with new-onset T1DM with diabetic ketoacidosis (DKA) in the setting of MIS-C, with a course complicated by thrombotic microangiopathy. Case presentation The patient presented with four days history of fever, non-bilious vomiting, polyuria and polydipsia. On evaluation, he was noted to have diabetic ketoacidosis. Although Diabetic ketoacidosis with insulin and intravenous fluids, his hospital course was notable for shock requiring vasopressor, purpura fulminans with eschar formation, neurological manifestations (left hemiparesis due to right middle cerebral artery territory infarct, mononeuritis multiplex) and thrombotic microangiopathy. MIS-C-like illness secondary to COVID-19 was suspected due to diabetic ketoacidosis, thrombotic microangiopathy, elevated inflammatory markers, history of contact with COVID-19-infected individual and detectable COVID-19 IgG antibodies. He improved following management with methylprednisolone, intravenous immunoglobulin, low-molecular-weight heparin and aspirin, and was discharged on hospital day 48. Conclusion MIS-C-like illness should be considered in children and adolescents presenting with complex multisystem involvement in this era of COVID 19. Management with immunomodulatory agents can be lifesaving.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"522 - 528"},"PeriodicalIF":5.8,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41857656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-17DOI: 10.1080/23744235.2022.2050942
Urban Johansson Kostenniemi, S. Silfverdal
Abstract Backgrounds Psychiatric disabilities affect one in three survivors of bacterial meningitis. Since current guidelines do not recommend psychiatric follow-up in all children, disabilities are often detected late. Identifying children with elevated risk of psychiatric disabilities using predictive scores could be one strategy for detecting psychiatric disabilities without having to conduct psychiatric evaluations in all children. Therefore, we searched for existing predictive scores and later tested five predictive scores’ ability to predict psychiatric disabilities following childhood bacterial meningitis. Methods From an existing dataset, we selected 73 children with bacterial meningitis of whom 22 later developed psychiatric disease and 15 experienced concentration or learning difficulties. Using these, we tested each predictive score’s sensitivity at their cut-off level for predicting psychiatric disease and concentration or learning difficulties using a chi-square test. Furthermore, we performed a receiver operating characteristic curve (ROC) analysis to assert the area under the curve (AUC) as a measure of overall predictive performance. Results The sensitivity of each predictive score’ ranged from 6 to 38% for psychiatric disease and from 8 to 57% for concentration or learning difficulties. In the ROC-analysis, the AUC was 0.59–0.73 and 0.53–0.72, respectively. Conclusions All predictive score failed at identifying children later developing psychiatric disabilities, excluding this as a feasible strategy for detecting psychiatric disabilities. Hence, current guidelines for bacterial meningitis need to be revised to recommend psychiatric evaluations in all children. KEY NOTES Current guidelines not recommending psychiatric evaluations in all children following bacterial meningitis may result in late detection of psychiatric disabilities. We tested predictive scores’ ability to identify children later developing psychiatric disabilities following bacterial meningitis. All predictive score failed at identifying children later developing psychiatric disabilities, excluding this as a feasible strategy. Hence, current guidelines for bacterial meningitis need to be revised to recommend psychiatric evaluations in all children.
{"title":"Predictive scores failing at identifying psychiatric disabilities following childhood bacterial meningitis calls for revision of current follow-up guidelines","authors":"Urban Johansson Kostenniemi, S. Silfverdal","doi":"10.1080/23744235.2022.2050942","DOIUrl":"https://doi.org/10.1080/23744235.2022.2050942","url":null,"abstract":"Abstract Backgrounds Psychiatric disabilities affect one in three survivors of bacterial meningitis. Since current guidelines do not recommend psychiatric follow-up in all children, disabilities are often detected late. Identifying children with elevated risk of psychiatric disabilities using predictive scores could be one strategy for detecting psychiatric disabilities without having to conduct psychiatric evaluations in all children. Therefore, we searched for existing predictive scores and later tested five predictive scores’ ability to predict psychiatric disabilities following childhood bacterial meningitis. Methods From an existing dataset, we selected 73 children with bacterial meningitis of whom 22 later developed psychiatric disease and 15 experienced concentration or learning difficulties. Using these, we tested each predictive score’s sensitivity at their cut-off level for predicting psychiatric disease and concentration or learning difficulties using a chi-square test. Furthermore, we performed a receiver operating characteristic curve (ROC) analysis to assert the area under the curve (AUC) as a measure of overall predictive performance. Results The sensitivity of each predictive score’ ranged from 6 to 38% for psychiatric disease and from 8 to 57% for concentration or learning difficulties. In the ROC-analysis, the AUC was 0.59–0.73 and 0.53–0.72, respectively. Conclusions All predictive score failed at identifying children later developing psychiatric disabilities, excluding this as a feasible strategy for detecting psychiatric disabilities. Hence, current guidelines for bacterial meningitis need to be revised to recommend psychiatric evaluations in all children. KEY NOTES Current guidelines not recommending psychiatric evaluations in all children following bacterial meningitis may result in late detection of psychiatric disabilities. We tested predictive scores’ ability to identify children later developing psychiatric disabilities following bacterial meningitis. All predictive score failed at identifying children later developing psychiatric disabilities, excluding this as a feasible strategy. Hence, current guidelines for bacterial meningitis need to be revised to recommend psychiatric evaluations in all children.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"514 - 521"},"PeriodicalIF":5.8,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41951929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-14DOI: 10.1080/23744235.2022.2047777
Frederikke Bach, C. Wejse, M. Storgaard, C. B. Patsche
{"title":"Is body height a prognostic marker for outcome of tuberculosis treatment?","authors":"Frederikke Bach, C. Wejse, M. Storgaard, C. B. Patsche","doi":"10.1080/23744235.2022.2047777","DOIUrl":"https://doi.org/10.1080/23744235.2022.2047777","url":null,"abstract":"","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"538 - 541"},"PeriodicalIF":5.8,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45178030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：