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Malignant syphilis: an early feature of underlying HIV infection in an MSM patient. 恶性梅毒:一名 MSM 患者潜在 HIV 感染的早期特征。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1380
Alessandro Alfieri, Yulia Eka Irmawati, Satiti Retno Pudjiati

Introduction: Co-infection of human immunodeficiency virus (HIV) with syphilis is common and has significant clinical consequences. HIV infection can change the course and clinical manifestations of syphilis, resulting in atypical syphilis. A rare feature of this infection is malignant syphilis, which frequently resembles other skin lesions and poses a challenge in diagnosis. This report aims to describe a case of malignant syphilis in an HIV-positive patient.

Case report: A 33-year-old man who has sex with men (MSM) came to the dermato-venereology outpatient clinic with chief complaints of ulcerative lesions on the face, trunk, arms, palms, and legs for the past two months. The patient complained of fever, chills, and decreased appetite two weeks prior to presentation. A dermatological examination showed numerous well-demarcated ulcerated plaques and nodules partially covered with crust. Reactive results were found on syphilis serologic tests with high titers. The test for HIV was reactive, with a CD4 cell count of 219 cells/mm3. The patient was then diagnosed with malignant syphilis and received treatment in the form of benzathine penicillin injection 2.4 million units once a week for three consecutive weeks. After treatment, the skin lesions and syphilis serologic titer improved.

Conclusions: Secondary syphilis in patients with HIV infection may present as an atypical variant. As reported in this case, malignant syphilis should always be considered in the differential diagnosis when ulcerative and necrotic lesions are observed in individuals with HIV infection.

导言:人类免疫缺陷病毒(HIV)与梅毒合并感染很常见,而且会产生严重的临床后果。艾滋病毒感染可改变梅毒的病程和临床表现,导致非典型梅毒。恶性梅毒是这种感染的一个罕见特征,它经常与其他皮肤病变相似,给诊断带来挑战。本报告旨在描述一例 HIV 阳性患者的恶性梅毒病例:一名 33 岁的男男性行为者(MSM)来到皮肤性病学门诊就诊,主诉是过去两个月中面部、躯干、手臂、手掌和腿部出现溃疡性皮损。就诊前两周,患者主诉发热、寒战和食欲减退。皮肤科检查显示,患者身上有许多界限清楚的溃疡斑块和结节,部分覆盖有结痂。梅毒血清学检测呈高滴度反应性结果。艾滋病毒检测呈反应性,CD4细胞计数为219个/立方毫米。随后,患者被诊断为恶性梅毒,并接受了苄星青霉素注射 240 万单位,每周一次,连续三周的治疗。治疗后,患者的皮损和梅毒血清滴度均有所改善:结论:HIV 感染者的继发性梅毒可能表现为非典型变异。正如本病例所报告的那样,当艾滋病病毒感染者出现溃疡性和坏死性病变时,在鉴别诊断中应始终考虑恶性梅毒。
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引用次数: 0
Clinical, biochemical and pulmonary CT imaging features for hepatobiliary involvement in COVID-19. COVID-19 中肝胆受累的临床、生化和肺部 CT 成像特征。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1375
Eduard Dumea, Ecaterina Constanţa Barbu, Cristina Emilia Chiţu, Mihai Lazăr, Daniela Adriana Ion

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a viral disease with primary pulmonary involvement and systemic impact. This article aims to assess the importance of clinical, biological, demographic and radioimaging parameters in COVID-19 patients in characterizing the incidence and severity of the hepatobiliary involvement.

Methods: We performed an observational cohort study on 132 consecutive patients, evaluating their demographics, hospitalization period, peripheral oxygen saturation (SpO2) in the ambient air, as well as biochemical markers of hepatobiliary involvement: aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB), gamma-glutamyl transferase (GGT), serum albumin, total serum proteins, D-dimers; coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR); inflammatory markers: fibrinogen, serum ferritin, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis alpha (TNF-α). Hepatobiliary involvement was further stratified by type of affection pattern: hepatocytolysis, cholestasis or mixed type. All patients received a computerized tomography (CT) chest scan in the first or second day of hospital admission.

Results: We observed lower SaO2 and longer hospitalization days in patients with hepatobiliary involvement, as well as longer coagulation times (PT and INR), lower serum albumin and higher serum ferritin (p<0.05). No significant correlations have been found between the degree or type of pattern of lung involvement as seen on CT scans performed and biochemical liver changes.

Conclusions: Hepatobiliary involvement occurred in 72% of patients in the study group, associated with longer hospitalization period, prolonged coagulation parameters, lower serum albumin levels, raised serum ferritin and CRP levels. Cholestatic and mixed types of injury were associated with higher ferritin levels, while mixed type alone presented higher D-dimers levels compared with the cholestatic or hepatocytolysis groups. No significant correlation was found between lung involvement by CT evaluation and hepatobiliary involvement.

导言严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染是一种病毒性疾病,主要累及肺部和全身。本文旨在评估 COVID-19 患者的临床、生物学、人口统计学和放射影像学参数在描述肝胆受累的发生率和严重程度方面的重要性:我们对 132 名连续患者进行了观察性队列研究,评估了他们的人口统计学特征、住院时间、环境空气中的外周血氧饱和度(SpO2)以及肝胆受累的生化指标:天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TB)、直接胆红素(DB)、γ-谷氨酰转移酶(GGT)、血清白蛋白、血清总蛋白、D-二聚体;凝血试验,如凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)和国际标准化比值(INR);炎症指标:纤维蛋白原、血清铁蛋白、C 反应蛋白 (CRP)、白细胞介素 6 (IL-6) 和肿瘤坏死α (TNF-α)。肝胆受累情况按病变类型进一步分层:溶肝、胆汁淤积或混合型。所有患者均在入院第一天或第二天接受了计算机断层扫描(CT)胸部扫描:结果:我们观察到肝胆受累患者的 SaO2 更低,住院天数更长,凝血时间(PT 和 INR)更长,血清白蛋白更低,血清铁蛋白更高(pC):研究组中有 72% 的患者出现肝胆受累,这与住院时间延长、凝血参数延长、血清白蛋白水平降低、血清铁蛋白和 CRP 水平升高有关。胆汁淤积型和混合型损伤与较高的铁蛋白水平有关,而与胆汁淤积型或肝细胞溶解型损伤组相比,混合型损伤组的 D-二聚体水平较高。CT 评估发现肺部受累与肝胆受累之间没有明显的相关性。
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引用次数: 0
Bacterial vaginosis, vulvovaginal candidiasis, trichomonal vaginitis and aerobic vaginitis in women from Egypt. 埃及妇女的细菌性阴道病、外阴阴道念珠菌病、滴虫性阴道炎和需氧性阴道炎。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1376
Shahinda Rezk, Omar Alqabbasi

Introduction: Infectious vaginitis is prevalent in developing countries. Most of the females suffer from vaginal infections at least once per lifetime. Due to limited resources, many infections are misdiagnosed or undiagnosed. Good diagnosis of these infections is critically important and will definitely help to guide treatment and prevent recurrence.

Methods: A total of 1080 vaginal swabs were collected from symptomatic females. Nugent's score and Amsel's criteria were applied to diagnose bacterial vaginosis (BV). A rapid test was used to identify Gardnerella vaginalis. Trichomonal vaginitis (TV) was diagnosed through microscopic examination. Vulvovaginal candidiasis (VVC) was also identified microscopically and using conventional culture. Finally, aerobic vaginitis (AV) was detected using Donder's scale combined with conventional culture and biochemical tests.

Results: There was no statistically significant association between age and type of vaginal infection (p=0.130). Vulvovaginal inflammation, itching and redness were significantly associated with VVC (p≤0.012). BV was detected as single infection in 43.8%, followed by VVC 24.2%. On the contrary, AV and TV were scarcely detected among the participants; 4.9% and 0.5% respectively. Mixed infections between BV and VVC were noted in 26.6%.

Conclusions: BV showed the highest prevalence followed by VVC. Mixed infections between BV and VVC were evidently noted, therefore good reliable diagnosis using cost-effective methods is crucial for proper treatment. Aerobic vaginitis showed low prevalence and most of the Streptococcus spp. were isolated from pregnant females. The low prevalence of Trichomonas vaginalis may be due to the dependance on conventional methods for diagnosis, and thus more advanced diagnostic tools are required.

简介传染性阴道炎在发展中国家很普遍。大多数女性一生中至少患一次阴道炎。由于资源有限,许多感染被误诊或未被诊断。对这些感染进行良好的诊断至关重要,这无疑有助于指导治疗和防止复发:方法:共收集了 1080 份有症状女性的阴道拭子。方法:共收集了 1080 份有症状女性的阴道拭子,并采用 Nugent 评分和 Amsel 标准来诊断细菌性阴道病(BV)。采用快速检测法鉴定阴道加德纳菌。毛滴虫性阴道炎(TV)通过显微镜检查进行诊断。外阴阴道念珠菌病(VVC)也是通过显微镜检查和传统培养方法确定的。最后,通过唐德量表结合常规培养和生化测试检测需氧性阴道炎(AV):结果:年龄与阴道感染类型之间没有统计学意义(P=0.130)。外阴阴道炎症、瘙痒和发红与 VVC 显著相关(p≤0.012)。43.8%的阴道炎为单一感染,24.2%的阴道炎为VVC。相反,参与者中很少发现 AV 和 TV,分别为 4.9% 和 0.5%。有 26.6% 的人发现 BV 和 VVC 混合感染:结论:BV 感染率最高,其次是 VVC。结论:BV 感染率最高,其次是 VVC,BV 和 VVC 混合感染现象明显,因此采用经济有效的方法进行可靠诊断对正确治疗至关重要。需氧性阴道炎的发病率较低,大多数链球菌都是从孕妇身上分离出来的。阴道毛滴虫的发病率较低可能是由于依赖于传统的诊断方法,因此需要更先进的诊断工具。
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引用次数: 0
Clinical and bacteriological profiles of neonatal sepsis in a tertiary hospital, south-western Nigeria. 尼日利亚西南部一家三级医院新生儿败血症的临床和细菌学概况。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1377
Temitope O Obadare, Ebunoluwa A Adejuyigbe, Adeyemi T Adeyemo, Adewale A Amupitan, Osagie J Ugowe, Chinemere H Anyabolu, Aaron O Aboderin

Introduction: Antibiotic-resistant bacteria complicate treatment options in neonatal sepsis, especially in developing countries. This study determined the epidemiology and bacteriological characteristics of neonatal sepsis at a tertiary hospital, in southwest Nigeria.

Methods: This was a cross-sectional study from December 2017 to April 2019 among admitted babies with clinical neonatal sepsis. Blood culture was performed by semi-automated system, sepsis biomarker assay (serum procalcitonin) by a semi-quantitative kit while proforma was used to capture clinico-demographic data. Bacterial identification, antibiotic susceptibility patterns, determination of genetic elements mediating resistance, were performed by standard methods and polymerase chain reaction protocols, respectively. Quantitative data were expressed as frequencies, mean; bivariate and multivariate analyses were performed by Chi-square or Fishers' exact test and logistic regression.

Results: Of the 192 cases of neonatal sepsis enrolled, 42.7% (82/192) were blood culture positive. Factors associated with blood culture positivity included respiratory rate ≥60 bpm (60/82; p<0.03), lethargy/unconsciousness (59/82; FE=7.76; p<0.001), grunting respiration (54/82; p=0.04), meconium passage before birth (17/82; p=0.03) and prolonged rupture of membranes ≥24 hours (50/82; FE=6.90; p=0.01). On the other hand, mortality in the neonates was associated with elevated serum procalcitonin assay (>0.5 ng/mL) χ2=13.58; p=0.03] and Gram-negative bacteremia (χ2=24.64; p<0.001). The most common bacterial isolates were Staphylococcus aureus (42/82), coagulase-negative Staphylococcus spp. (17/82), Enterobacter spp. (8/82), and Acinetobacter spp. (6/82). Methicillin resistance was present in 85.7% (36/42) of Staphylococcus aureus and 52.9% (9/17) of coagulase-negative Staphylococcus, while extended-spectrum beta-lactamase (ESBL) and AmpC enzymes were present in (21.1%; 4/19) of the Gram-negative bacilli.

Conclusions: Almost half of the cases of clinically diagnosed neonatal sepsis have bacterial etiologic confirmation of sepsis. Gram-negative bacteremia and high serum procalcitonin predict mortality in neonatal sepsis. There was high resistance to common antibiotics for the treatment of neonatal sepsis in our settings.

导言:抗生素耐药菌使新生儿败血症的治疗方案复杂化,尤其是在发展中国家。本研究确定了尼日利亚西南部一家三级医院新生儿败血症的流行病学和细菌学特征:这是一项横断面研究,研究时间为 2017 年 12 月至 2019 年 4 月,研究对象为患有临床新生儿败血症的入院婴儿。采用半自动化系统进行血液培养,用半定量试剂盒进行败血症生物标志物检测(血清降钙素原),同时使用原形表采集临床人口学数据。细菌鉴定、抗生素敏感性模式、介导耐药性的遗传因子测定分别采用标准方法和聚合酶链反应方案进行。定量数据以频率、平均值表示;采用Chi-square或Fishers'exact检验和Logistic回归进行双变量和多变量分析:在 192 例新生儿败血症病例中,42.7%(82/192)为血培养阳性。与血培养阳性相关的因素包括呼吸频率≥60 bpm(60/82;p0.5 ng/mL)χ2=13.58;p=0.03]和革兰氏阴性菌血症(χ2=24.64;p金黄色葡萄球菌(42/82)、凝固酶阴性葡萄球菌属(17/82)、肠杆菌属(8/82)和不动杆菌属(6/82)。85.7%(36/42)的金黄色葡萄球菌和52.9%(9/17)的凝固酶阴性葡萄球菌对甲氧西林产生耐药性,而21.1%(4/19)的革兰氏阴性杆菌对广谱β-内酰胺酶(ESBL)和AmpC酶产生耐药性:结论:在临床诊断的新生儿败血症病例中,近一半的败血症病因是细菌感染。革兰氏阴性菌血症和高血清降钙素原可预测新生儿败血症的死亡率。在我们的病例中,治疗新生儿败血症的常用抗生素耐药性很高。
{"title":"Clinical and bacteriological profiles of neonatal sepsis in a tertiary hospital, south-western Nigeria.","authors":"Temitope O Obadare, Ebunoluwa A Adejuyigbe, Adeyemi T Adeyemo, Adewale A Amupitan, Osagie J Ugowe, Chinemere H Anyabolu, Aaron O Aboderin","doi":"10.18683/germs.2023.1377","DOIUrl":"https://doi.org/10.18683/germs.2023.1377","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic-resistant bacteria complicate treatment options in neonatal sepsis, especially in developing countries. This study determined the epidemiology and bacteriological characteristics of neonatal sepsis at a tertiary hospital, in southwest Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study from December 2017 to April 2019 among admitted babies with clinical neonatal sepsis. Blood culture was performed by semi-automated system, sepsis biomarker assay (serum procalcitonin) by a semi-quantitative kit while proforma was used to capture clinico-demographic data. Bacterial identification, antibiotic susceptibility patterns, determination of genetic elements mediating resistance, were performed by standard methods and polymerase chain reaction protocols, respectively. Quantitative data were expressed as frequencies, mean; bivariate and multivariate analyses were performed by Chi-square or Fishers' exact test and logistic regression.</p><p><strong>Results: </strong>Of the 192 cases of neonatal sepsis enrolled, 42.7% (82/192) were blood culture positive. Factors associated with blood culture positivity included respiratory rate ≥60 bpm (60/82; p<0.03), lethargy/unconsciousness (59/82; FE=7.76; p<0.001), grunting respiration (54/82; p=0.04), meconium passage before birth (17/82; p=0.03) and prolonged rupture of membranes ≥24 hours (50/82; FE=6.90; p=0.01). On the other hand, mortality in the neonates was associated with elevated serum procalcitonin assay (>0.5 ng/mL) χ<sup>2</sup>=13.58; p=0.03] and Gram-negative bacteremia (χ<sup>2</sup>=24.64; p<0.001). The most common bacterial isolates were <i>Staphylococcus aureus</i> (42/82), coagulase-negative <i>Staphylococcus</i> spp. (17/82), <i>Enterobacter</i> spp. (8/82), and <i>Acinetobacter</i> spp. (6/82). Methicillin resistance was present in 85.7% (36/42) of <i>Staphylococcus aureus</i> and 52.9% (9/17) of coagulase-negative <i>Staphylococcus</i>, while extended-spectrum beta-lactamase (ESBL) and AmpC enzymes were present in (21.1%; 4/19) of the Gram-negative bacilli.</p><p><strong>Conclusions: </strong>Almost half of the cases of clinically diagnosed neonatal sepsis have bacterial etiologic confirmation of sepsis. Gram-negative bacteremia and high serum procalcitonin predict mortality in neonatal sepsis. There was high resistance to common antibiotics for the treatment of neonatal sepsis in our settings.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges in the implementation of mother-to-child HIV/AIDS prevention programs in Indonesia. 在印度尼西亚实施母婴艾滋病毒/艾滋病预防计划面临的挑战。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1379
Iin Khoiriyah Ulfah, Renaldy Raditya Indrawan, Novi Anggraeni, Afif Nurul Hidayati, Nasronudin, Siti Qamariyah Khairunisa

Introduction: The HIV/AIDS prevention program among pregnant mothers aims to reduce the risk of HIV transmission from mother to baby. It also aims to reduce stigma and discrimination, as well as deaths due to HIV/AIDS. This paper aimed to find out obstacles that occur in the implementation of HIV/AIDS transmission program in Indonesia.

Methods: Online literature search was done on Google Scholar, Science Direct and PubMed databases with the keywords related to "HIV/AIDS" and transmission prevention program among mothers to children. The search resulted in a total of 343 articles.

Results: After the abstracts were reviewed, there were only 16 articles selected.

Conclusions: The implementation of the program in Indonesia has been run but is not yet optimal because of several obstacles i.e., the insufficient number of health workers and poor knowledge of health workers. Figuring out solutions to the obstacles could ease the program implementation to reduce the cases of HIV/AIDS. Obstacles were found in the implementation of the HIV/AIDS prevention program among mothers and children in Indonesia.

导言:孕妇艾滋病毒/艾滋病预防计划旨在降低母婴传播艾滋病毒的风险。该计划还旨在减少羞辱和歧视,以及因艾滋病毒/艾滋病导致的死亡。本文旨在找出印度尼西亚在实施艾滋病毒/艾滋病传播计划过程中遇到的障碍:在 Google Scholar、Science Direct 和 PubMed 数据库中以 "HIV/AIDS "和母婴传播预防计划为关键词进行了在线文献检索。搜索结果共涉及 343 篇文章:结果:在对摘要进行审查后,仅有 16 篇文章入选:结论:该计划已在印度尼西亚实施,但由于保健人员数量不足和保健人员知识贫乏等障碍,实施效果尚不理想。找出解决这些障碍的办法可以促进计划的实施,从而减少艾滋病毒/艾滋病的发病率。印度尼西亚在实施母婴艾滋病毒/艾滋病预防计划时发现了一些障碍。
{"title":"Challenges in the implementation of mother-to-child HIV/AIDS prevention programs in Indonesia.","authors":"Iin Khoiriyah Ulfah, Renaldy Raditya Indrawan, Novi Anggraeni, Afif Nurul Hidayati, Nasronudin, Siti Qamariyah Khairunisa","doi":"10.18683/germs.2023.1379","DOIUrl":"https://doi.org/10.18683/germs.2023.1379","url":null,"abstract":"<p><strong>Introduction: </strong>The HIV/AIDS prevention program among pregnant mothers aims to reduce the risk of HIV transmission from mother to baby. It also aims to reduce stigma and discrimination, as well as deaths due to HIV/AIDS. This paper aimed to find out obstacles that occur in the implementation of HIV/AIDS transmission program in Indonesia.</p><p><strong>Methods: </strong>Online literature search was done on Google Scholar, Science Direct and PubMed databases with the keywords related to \"HIV/AIDS\" and transmission prevention program among mothers to children. The search resulted in a total of 343 articles.</p><p><strong>Results: </strong>After the abstracts were reviewed, there were only 16 articles selected.</p><p><strong>Conclusions: </strong>The implementation of the program in Indonesia has been run but is not yet optimal because of several obstacles i.e., the insufficient number of health workers and poor knowledge of health workers. Figuring out solutions to the obstacles could ease the program implementation to reduce the cases of HIV/AIDS. Obstacles were found in the implementation of the HIV/AIDS prevention program among mothers and children in Indonesia.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The occurrence of a fatal tuberculous pancreatic abscess simulating a pancreatic tumor in an immunocompromised patient. 一名免疫力低下的患者发生了类似胰腺肿瘤的致命结核性胰腺脓肿。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1382
Elmostafa Benaissa, Adil Maleb, Mostafa Elouennass

Introduction: Tuberculosis is currently undergoing a worrying recovery in Morocco. It is becoming a tropical disease again and can take deceptive clinical forms and involve unusual localizations. We report a rare case of pancreatic abscess due to Mycobacterium tuberculosis in an immunocompromised patient.

Case report: The patient was 48 years old and was diagnosed with HIV infection 16 months previously during a systematic check-up. He had no notable pathological history, no notion of tuberculosis contagion and no signs of tuberculosis impregnation, and was admitted for the management of epigastric pain associated with an altered general condition. Abdominal CT scan showed a bulbar perforation and multiple deep necrotic adenopathies of infectious or tumoral origin. Direct examination of the pus with Ziehl Neelsen stain was positive (1-10 BAAR/field). Molecular study using the GeneXpert MTB/RIF technique revealed M. tuberculosis complex without rifampicin resistance. The patient was put on antibacillary treatment based on isoniazid, rifampicin, ethambutol and pyrazinamide. The patient died of septic shock with multiple organ failure.

Conclusions: The diagnosis of a tuberculous pancreatic abscess may be overlooked because of its rarity and its clinical state simulating a pancreatic tumor, so it should be considered especially in endemic countries like ours.

导言:结核病目前在摩洛哥的恢复情况令人担忧。结核病正重新成为一种热带疾病,其临床表现具有欺骗性,且发病部位不寻常。我们报告了一例罕见的免疫功能低下患者因结核分枝杆菌引起的胰腺脓肿病例:患者 48 岁,16 个月前在一次系统检查中被诊断出感染了艾滋病毒。他没有明显的病史,没有结核传染的概念,也没有结核浸渍的迹象,因上腹疼痛伴有全身状况改变而入院治疗。腹部 CT 扫描显示有一个球部穿孔和多个感染性或肿瘤性深部坏死腺体。用齐氏染色法直接检查脓液呈阳性(1-10 BAAR/场)。使用 GeneXpert MTB/RIF 技术进行的分子研究显示,结核杆菌为复合型,对利福平无耐药性。患者接受了基于异烟肼、利福平、乙胺丁醇和吡嗪酰胺的抗生素治疗。患者死于脓毒性休克和多器官功能衰竭:结论:结核性胰腺脓肿的诊断可能会被忽视,因为它非常罕见,而且其临床状态类似于胰腺肿瘤,所以尤其是在像我国这样的结核病流行国家,应考虑到这一点。
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引用次数: 0
Achieving pre-eminence of antimicrobial resistance among non-fermenting Gram-negative bacilli causing septicemia in intensive care units: A single center study of a tertiary care hospital. 在重症监护病房引起脓毒血症的非发酵革兰氏阴性杆菌中,抗菌药耐药性占据主导地位:一家三甲医院的单中心研究。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1374
Harit Kumar, Narinder Kaur, Nitin Kumar, Jyoti Chauhan, Rosy Bala, Shubham Chauhan

Introduction: Bloodstream infections in the intensive care unit have always been a global healthcare challenge. The present study was conducted with the aim to evaluate the yearly trend of antibiotic resistance in non-fermenting Gram-negative bacilli (NFGNB) causing septicemia in intensive care units.

Methods: Blood samples were collected from the patients admitted in various intensive care units and processed for isolation and identification of non-fermenting Gram-negative bacilli. The isolated bacterial strains were subjected to antibiotic susceptibility testing as per standard operating procedures.

Results: Out of 3632 blood samples, 977 (26.9%) samples showed microbial growth, of which 10.1% were Gram positive cocci, 8.7% were Gram negative bacilli (Enterobacterales), 7% were NFGNB and 1% were Candida spp. Increasing resistance among Acinetobacter baumannii complex was observed to ceftazidime, cefepime, amikacin, ciprofloxacin, levofloxacin, meropenem and trimethoprim-sulfamethoxazole. Moreover, Pseudomonas aeruginosa strains were found to be associated with increased resistance to ciprofloxacin, levofloxacin, ceftazidime and meropenem. A substantial increase in resistance levels was observed among Stenotrophomonas maltophilia and Sphingomonas paucimobilis as well.

Conclusions: An increasing trend of antimicrobial resistance in NFGNB envisages the worst consequences in ICUs in the coming years. Therefore, reviewing and strict implementation of the antimicrobial policies including 'rational use of antibiotics' is recommended.

简介重症监护室中的血流感染一直是全球医疗保健领域面临的挑战。本研究旨在评估引起重症监护病房脓毒血症的非发酵革兰氏阴性杆菌(NFGNB)的抗生素耐药性的年度趋势:方法:从各重症监护室的住院患者身上采集血液样本,并对样本进行处理,以分离和鉴定非发酵革兰氏阴性杆菌。按照标准操作程序对分离出的细菌菌株进行抗生素药敏试验:结果:在 3632 份血液样本中,977 份(26.9%)样本出现微生物生长,其中 10.1%为革兰氏阳性球菌,8.7%为革兰氏阴性杆菌(肠杆菌科),7%为非发酵革兰氏阴性杆菌,1%为白色念珠菌属。此外,还发现铜绿假单胞菌菌株对环丙沙星、左氧氟沙星、头孢他啶和美罗培南的耐药性增加。此外,还观察到嗜麦芽僵化单胞菌(Stenotrophomonas maltophilia)和嗜水单胞菌(Sphingomonas paucimobilis)的耐药性水平也大幅上升:结论:NFGNB 中抗菌药耐药性呈上升趋势,预计未来几年 ICU 将面临最严重的后果。因此,建议审查并严格执行抗菌药物政策,包括 "合理使用抗生素"。
{"title":"Achieving pre-eminence of antimicrobial resistance among non-fermenting Gram-negative bacilli causing septicemia in intensive care units: A single center study of a tertiary care hospital.","authors":"Harit Kumar, Narinder Kaur, Nitin Kumar, Jyoti Chauhan, Rosy Bala, Shubham Chauhan","doi":"10.18683/germs.2023.1374","DOIUrl":"https://doi.org/10.18683/germs.2023.1374","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infections in the intensive care unit have always been a global healthcare challenge. The present study was conducted with the aim to evaluate the yearly trend of antibiotic resistance in non-fermenting Gram-negative bacilli (NFGNB) causing septicemia in intensive care units.</p><p><strong>Methods: </strong>Blood samples were collected from the patients admitted in various intensive care units and processed for isolation and identification of non-fermenting Gram-negative bacilli. The isolated bacterial strains were subjected to antibiotic susceptibility testing as per standard operating procedures.</p><p><strong>Results: </strong>Out of 3632 blood samples, 977 (26.9%) samples showed microbial growth, of which 10.1% were Gram positive cocci, 8.7% were Gram negative bacilli (Enterobacterales), 7% were NFGNB and 1% were <i>Candida</i> spp. Increasing resistance among <i>Acinetobacter baumannii</i> complex was observed to ceftazidime, cefepime, amikacin, ciprofloxacin, levofloxacin, meropenem and trimethoprim-sulfamethoxazole. Moreover, <i>Pseudomonas aeruginosa</i> strains were found to be associated with increased resistance to ciprofloxacin, levofloxacin, ceftazidime and meropenem. A substantial increase in resistance levels was observed among <i>Stenotrophomonas maltophilia</i> and <i>Sphingomonas paucimobilis</i> as well.</p><p><strong>Conclusions: </strong>An increasing trend of antimicrobial resistance in NFGNB envisages the worst consequences in ICUs in the coming years. Therefore, reviewing and strict implementation of the antimicrobial policies including 'rational use of antibiotics' is recommended.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk mitigation for vaccine-preventable diseases in the dental clinic. 在牙科诊所降低疫苗可预防疾病的风险。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1373
Oana Săndulescu, Mihai Săndulescu
{"title":"Risk mitigation for vaccine-preventable diseases in the dental clinic.","authors":"Oana Săndulescu, Mihai Săndulescu","doi":"10.18683/germs.2023.1373","DOIUrl":"https://doi.org/10.18683/germs.2023.1373","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical challenge of co-infection of SARS-CoV-2 with influenza during the influenza circulation season: suggestions for prevention. 在流感流行季节,SARS-CoV-2 与流感同时感染所带来的临床挑战:预防建议。
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1384
Shabnam Dehghan Tarzjani, Sara Kamalzadeh, Majid Taati Moghadam, Mohammad Taghi Ashoobi
{"title":"Clinical challenge of co-infection of SARS-CoV-2 with influenza during the influenza circulation season: suggestions for prevention.","authors":"Shabnam Dehghan Tarzjani, Sara Kamalzadeh, Majid Taati Moghadam, Mohammad Taghi Ashoobi","doi":"10.18683/germs.2023.1384","DOIUrl":"https://doi.org/10.18683/germs.2023.1384","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genotyping of Whipple's disease presenting as sclerosing mesenteritis: A case report. 对表现为硬化性肠系膜炎的惠普尔病进行基因分型:病例报告
IF 2 Q2 Medicine Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.18683/germs.2023.1383
Areti Kalfoutzou, Sofia Makka, Theodora Stivarou, Myrto Koutantou, Panagiota Kelidi, Maria Papanikolaou, Nikolaos Chaleplidis, Christos Tekedis, Eleni Mostratou, Emmanouil Angelakis, Panagiotis Petrikkos

Introduction: There are very few reported cases of Whipple disease (WD), a rare chronic disease in Greece. In this report, we present a classic WD case in a Greek firefighter and the detection of an autochthonous Tropheryma whipplei genotype in this Greek autochthonous citizen.

Case report: We describe a patient with chronic diarrhea and arthritis who was misdiagnosed with sclerosing mesenteritis three years previously and was unsuccessfully treated with corticosteroids. After the effectuation of histopathologic examination and PCR against T. whipplei, he was diagnosed with classic WD. Moreover, for the first time in Greece, we proceeded with T. whipplei genotyping targeting four highly variable genomic sequences and we concluded that the patient was infected by T. whipplei genotype 120.

Conclusions: We highlight the necessity to explore T. whipplei presence and its genotypes through the Greek population and to identify if genotype 120 is the predominant strain in the Hellenic territory.

导言:惠普尔病(WD)在希腊是一种罕见的慢性疾病,目前报道的病例很少。在本报告中,我们介绍了一名希腊消防员的典型 WD 病例,并在这名希腊本土公民中检测到了自体 Tropheryma whipplei 基因型:我们描述了一名患有慢性腹泻和关节炎的患者,三年前他被误诊为硬化性肠系膜炎,接受皮质类固醇治疗未果。经过组织病理学检查和针对白喉杆菌的 PCR 检测,他被确诊为典型的 WD。此外,我们还在希腊首次针对四个高度可变的基因组序列进行了T.whipplei基因分型,并得出结论:该患者感染的是T.whipplei基因型120:结论:我们强调有必要在希腊人口中调查白喉杆菌的存在及其基因型,并确定基因型 120 是否是希腊境内的主要菌株。
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