M. Khoshakhlagh, Samaneh Abolbashari, Alireza Pasdar, M. Shakeri, M. Meshkat, Ahmad Ghasemifard, Amin Hooshyar Chechaklou, Soroush Yazdani, Ali Parvin, Navid Pousti, Nima Boojar, Aida Gholoobi, Z. Meshkat
Background: Varicella zoster virus (VZV) is highly contagious and can lead to two distinct diseases. Initially, it causes chickenpox, a primary infection common among children worldwide, characterized by itchy, red blisters that cover the body. After this initial outbreak, the virus can lie dormant in nerve tissues and may reactivate later in life as herpes zoster, commonly known as shingles, which presents as a painful rash. While chickenpox is generally mild and resolves on its own, it can cause severe complications, especially in vulnerable groups such as immunocompromised individuals or adults. These complications can range from bacterial superinfections and pneumonia to encephalitis. In rare cases, it may lead to life-threatening conditions like necrotizing fasciitis or toxic shock syndrome, highlighting the potential severity of what is often considered a childhood illness. Objectives: One of the main risk factors for varicella-zoster infection is the absence of immunity. Individuals who have not been vaccinated against or previously infected with the VZV are at risk of contracting chickenpox when exposed. Additionally, close contact with infected individuals increases the likelihood of transmission. People with chronic conditions or those undergoing immunosuppressive therapy are particularly vulnerable to severe complications from varicella-zoster infections. Therefore, this study was conducted to assess the seroepidemiology of antibodies against varicella zoster in the young adult population in Mashhad. Methods: This cross-sectional study was conducted in 2018 on men and women aged 15 to 35 years in Mashhad, northeast Iran. Random cluster sampling was utilized. Individuals undergoing treatment for rare diseases were excluded from the study. The enzyme-linked immunoassay (ELISA) technique was employed to assess the presence of IgG antibodies against varicella zoster in 724 serum samples. Data analysis was performed using SPSS 20, and the significance level was set at 0.05. Results: Overall, among the 724 participants aged 15 - 35 years old in Mashhad, the frequency of anti-varicella IgG seropositivity was 85.9%. Our results indicated significant associations between age (P = 0.001) and occupational status (P = 0.02) with varicella-zoster seroprevalence. Conclusions: We observed a high frequency of anti-varicella zoster IgG seroprevalence among young adults in Mashhad. Infants, pregnant women, and individuals with weakened immune systems are more likely to develop severe forms of chickenpox or experience complications from shingles, including pneumonia and encephalitis. Given the severe health problems caused by the varicella virus and its high prevalence in Mashhad, we recommend incorporating the varicella vaccine into the public vaccination program. Additionally, further examination of the burden of herpes zoster, including its impact on quality of life and healthcare utilization, can guide interventions to mitigate the consequences of th
{"title":"Assessment of the Seroprevalence of Varicella zoster Virus in Young Adults Aged 15 – 35 Years Old in Mashhad, Iran","authors":"M. Khoshakhlagh, Samaneh Abolbashari, Alireza Pasdar, M. Shakeri, M. Meshkat, Ahmad Ghasemifard, Amin Hooshyar Chechaklou, Soroush Yazdani, Ali Parvin, Navid Pousti, Nima Boojar, Aida Gholoobi, Z. Meshkat","doi":"10.5812/archcid-139800","DOIUrl":"https://doi.org/10.5812/archcid-139800","url":null,"abstract":"Background: Varicella zoster virus (VZV) is highly contagious and can lead to two distinct diseases. Initially, it causes chickenpox, a primary infection common among children worldwide, characterized by itchy, red blisters that cover the body. After this initial outbreak, the virus can lie dormant in nerve tissues and may reactivate later in life as herpes zoster, commonly known as shingles, which presents as a painful rash. While chickenpox is generally mild and resolves on its own, it can cause severe complications, especially in vulnerable groups such as immunocompromised individuals or adults. These complications can range from bacterial superinfections and pneumonia to encephalitis. In rare cases, it may lead to life-threatening conditions like necrotizing fasciitis or toxic shock syndrome, highlighting the potential severity of what is often considered a childhood illness. Objectives: One of the main risk factors for varicella-zoster infection is the absence of immunity. Individuals who have not been vaccinated against or previously infected with the VZV are at risk of contracting chickenpox when exposed. Additionally, close contact with infected individuals increases the likelihood of transmission. People with chronic conditions or those undergoing immunosuppressive therapy are particularly vulnerable to severe complications from varicella-zoster infections. Therefore, this study was conducted to assess the seroepidemiology of antibodies against varicella zoster in the young adult population in Mashhad. Methods: This cross-sectional study was conducted in 2018 on men and women aged 15 to 35 years in Mashhad, northeast Iran. Random cluster sampling was utilized. Individuals undergoing treatment for rare diseases were excluded from the study. The enzyme-linked immunoassay (ELISA) technique was employed to assess the presence of IgG antibodies against varicella zoster in 724 serum samples. Data analysis was performed using SPSS 20, and the significance level was set at 0.05. Results: Overall, among the 724 participants aged 15 - 35 years old in Mashhad, the frequency of anti-varicella IgG seropositivity was 85.9%. Our results indicated significant associations between age (P = 0.001) and occupational status (P = 0.02) with varicella-zoster seroprevalence. Conclusions: We observed a high frequency of anti-varicella zoster IgG seroprevalence among young adults in Mashhad. Infants, pregnant women, and individuals with weakened immune systems are more likely to develop severe forms of chickenpox or experience complications from shingles, including pneumonia and encephalitis. Given the severe health problems caused by the varicella virus and its high prevalence in Mashhad, we recommend incorporating the varicella vaccine into the public vaccination program. Additionally, further examination of the burden of herpes zoster, including its impact on quality of life and healthcare utilization, can guide interventions to mitigate the consequences of th","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141129310","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}
M. Shabani, Mobin Fathy, Hassan Pourmoshtagh, Faeze Maghsudloo
Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, severe demyelinating disease of the central nervous system predominantly found in patients with acquired human immunodeficiency syndrome (AIDS). Case Presentation: This report details a case involving a male HIV-positive patient with PML who discontinued his highly active antiretroviral therapy (HAART) treatment 10 days after being diagnosed with HIV. The patient had no history of neurological symptoms either before or after his HIV diagnosis until he was administered corticosteroids. Notably, he began experiencing ataxia shortly after starting dexamethasone. Progressive multifocal leukoencephalopathy was diagnosed through polymerase chain reaction (PCR) testing for the John Cunningham virus (JCV) in the cerebrospinal fluid (CSF). The PML lesions were confined to the cerebellum. Conclusions: The occurrence of neurological symptoms (activation of JCV) after administering corticosteroids to a patient with HIV-who had not received any antiretroviral treatment for 4 years-raises a critical question: Is the use of corticosteroids, which are a primary treatment for immune reconstitution inflammatory syndrome (IRIS), a double-edged sword in CNS-IRIS?
简介进行性多灶性白质脑病（PML）是一种罕见的中枢神经系统严重脱髓鞘疾病，主要见于获得性免疫缺陷综合征（AIDS）患者。病例介绍：本报告详细介绍了一例男性艾滋病病毒（HIV）阳性患者的 PML 病例，该患者在确诊感染 HIV 10 天后停止了高效抗逆转录病毒疗法（HAART）治疗。该患者在确诊为艾滋病病毒感染者之前和之后都没有神经系统症状病史，直到使用了皮质类固醇。值得注意的是，在开始使用地塞米松后不久，他开始出现共济失调。通过对脑脊液（CSF）中的约翰-坎宁安病毒（JCV）进行聚合酶链反应（PCR）检测，诊断出了进行性多灶性白质脑病。PML 病变局限于小脑。结论一名 4 年未接受任何抗逆转录病毒治疗的艾滋病患者在使用皮质类固醇后出现神经系统症状（JCV 激活），这提出了一个关键问题：皮质类固醇是治疗免疫重建炎症综合征（IRIS）的主要药物，在中枢神经系统-IRIS中使用皮质类固醇是否是一把双刃剑？
{"title":"Steroid-Induced Progressive Multifocal Leukoencephalopathy (PML) in HIV Patient: A Paradoxical Effect","authors":"M. Shabani, Mobin Fathy, Hassan Pourmoshtagh, Faeze Maghsudloo","doi":"10.5812/archcid-140933","DOIUrl":"https://doi.org/10.5812/archcid-140933","url":null,"abstract":"Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, severe demyelinating disease of the central nervous system predominantly found in patients with acquired human immunodeficiency syndrome (AIDS). Case Presentation: This report details a case involving a male HIV-positive patient with PML who discontinued his highly active antiretroviral therapy (HAART) treatment 10 days after being diagnosed with HIV. The patient had no history of neurological symptoms either before or after his HIV diagnosis until he was administered corticosteroids. Notably, he began experiencing ataxia shortly after starting dexamethasone. Progressive multifocal leukoencephalopathy was diagnosed through polymerase chain reaction (PCR) testing for the John Cunningham virus (JCV) in the cerebrospinal fluid (CSF). The PML lesions were confined to the cerebellum. Conclusions: The occurrence of neurological symptoms (activation of JCV) after administering corticosteroids to a patient with HIV-who had not received any antiretroviral treatment for 4 years-raises a critical question: Is the use of corticosteroids, which are a primary treatment for immune reconstitution inflammatory syndrome (IRIS), a double-edged sword in CNS-IRIS?","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"27 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243252","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: Pneumothorax (PTX), pneumomediastinum (PM), and subcutaneous emphysema (SE) are complications associated with COVID-19. It is crucial to study these risk factors, complications, and their prognosis for early diagnosis amidst the rising number of cases today. Methods: We conducted a case-control study involving 81 pairs of patients diagnosed with SARS-CoV-2 pneumonia complicated by Pneumothorax and pneumomediastinum, comparing them with patients who did not have these complications to assess the risk factors for and prognosis of pulmonary complications in COVID-19. Results: The demographic data and medical history of comorbid diseases did not show an association with PTX, PM, and SE in COVID-19 pneumonia (all P-values > 0.05). However, laboratory data such as white blood cell count, lymphocyte count, C-reactive protein, lactate dehydrogenase, troponin, and D-dimer levels were significantly higher in the group with complications (P < 0.05). Additionally, the length of hospital stay was significantly longer in the group with complications, and intubation further extended this duration. The mortality rate was significantly higher in the case group (70% vs. 14%, P < 0.0001), with a significant odds ratio in comparison to patients without complications in the regression model (B = 2.61, Exp(B) = 13.65 with a 95% CI of 6.28 - 29.69). Conclusions: Pulmonary complications worsen the prognosis of COVID-19. The pathophysiology of COVID-19 pneumonia can lead to mechanical barotrauma, regardless of intubation status. Ventilator settings should be adjusted below the confidence level. Acute phase reactants and certain inflammatory markers, except for the erythrocyte sedimentation rate (ESR), are elevated in patients with complications, though they do not significantly predict outcomes.
背景：气胸（PTX）、气胸（PM）和皮下气肿（SE）是与 COVID-19 相关的并发症。研究这些危险因素、并发症及其预后对于在病例数量不断增加的今天及早诊断至关重要。研究方法我们对 81 对确诊为 SARS-CoV-2 肺炎并发气胸和气胸的患者进行了病例对照研究，将他们与未出现这些并发症的患者进行比较，以评估 COVID-19 肺部并发症的危险因素和预后。研究结果人口统计学数据和合并症病史与 COVID-19 肺炎的 PTX、PM 和 SE 无关（所有 P 值均大于 0.05）。然而，实验室数据，如白细胞计数、淋巴细胞计数、C 反应蛋白、乳酸脱氢酶、肌钙蛋白和 D-二聚体水平，在有并发症的组别中明显更高（P < 0.05）。此外，出现并发症组的住院时间明显更长，插管进一步延长了住院时间。病例组的死亡率明显更高（70% vs. 14%，P < 0.0001），与无并发症患者相比，回归模型中的几率比较大（B = 2.61，Exp(B) = 13.65，95% CI 为 6.28 - 29.69）。结论：肺部并发症会恶化预后：肺部并发症会恶化 COVID-19 的预后。COVID-19 肺炎的病理生理学可导致机械气压创伤，与插管状态无关。应将呼吸机设置调整到置信度以下。并发症患者的急相反应物和某些炎症指标（红细胞沉降率（ESR）除外）会升高，但它们并不能显著预测预后。
{"title":"Risk Factors of Pulmonary Complications in Patients with COVID-19: A Case-Control Study","authors":"Mohammad Eslamian, Hamidreza Zefreh, Erfan Sheikhbahaei, Maryam Ghasemi, Amirhossein Fasahat, Hamid Talebzade, Koorosh Parchami, Behzad Nazemroaya, M. Tarrahi, Alireza Firoozfar, Fatemeh Esfahanian","doi":"10.5812/archcid-139483","DOIUrl":"https://doi.org/10.5812/archcid-139483","url":null,"abstract":"Background: Pneumothorax (PTX), pneumomediastinum (PM), and subcutaneous emphysema (SE) are complications associated with COVID-19. It is crucial to study these risk factors, complications, and their prognosis for early diagnosis amidst the rising number of cases today. Methods: We conducted a case-control study involving 81 pairs of patients diagnosed with SARS-CoV-2 pneumonia complicated by Pneumothorax and pneumomediastinum, comparing them with patients who did not have these complications to assess the risk factors for and prognosis of pulmonary complications in COVID-19. Results: The demographic data and medical history of comorbid diseases did not show an association with PTX, PM, and SE in COVID-19 pneumonia (all P-values > 0.05). However, laboratory data such as white blood cell count, lymphocyte count, C-reactive protein, lactate dehydrogenase, troponin, and D-dimer levels were significantly higher in the group with complications (P < 0.05). Additionally, the length of hospital stay was significantly longer in the group with complications, and intubation further extended this duration. The mortality rate was significantly higher in the case group (70% vs. 14%, P < 0.0001), with a significant odds ratio in comparison to patients without complications in the regression model (B = 2.61, Exp(B) = 13.65 with a 95% CI of 6.28 - 29.69). Conclusions: Pulmonary complications worsen the prognosis of COVID-19. The pathophysiology of COVID-19 pneumonia can lead to mechanical barotrauma, regardless of intubation status. Ventilator settings should be adjusted below the confidence level. Acute phase reactants and certain inflammatory markers, except for the erythrocyte sedimentation rate (ESR), are elevated in patients with complications, though they do not significantly predict outcomes.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"34 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266721","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}
L. Abbasian, S. D. Dehghan Manshadi, Malihe Hassan Nezhad, N. Masoumzadeh, Sara Ghaderkhani, Amirreza Keyvanfar, S. Tehrani
Introduction: Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain. Case Presentation: A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging. Conclusions: Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.
{"title":"A Case Report of Disseminated Nocardiosis in a Patient with HIV Infection: Concurrent Liver, Pulmonary, and Brain Involvements","authors":"L. Abbasian, S. D. Dehghan Manshadi, Malihe Hassan Nezhad, N. Masoumzadeh, Sara Ghaderkhani, Amirreza Keyvanfar, S. Tehrani","doi":"10.5812/archcid-140527","DOIUrl":"https://doi.org/10.5812/archcid-140527","url":null,"abstract":"Introduction: Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain. Case Presentation: A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging. Conclusions: Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"42 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139846025","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}
L. Abbasian, S. D. Dehghan Manshadi, Malihe Hassan Nezhad, N. Masoumzadeh, Sara Ghaderkhani, Amirreza Keyvanfar, S. Tehrani
Introduction: Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain. Case Presentation: A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging. Conclusions: Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.
{"title":"A Case Report of Disseminated Nocardiosis in a Patient with HIV Infection: Concurrent Liver, Pulmonary, and Brain Involvements","authors":"L. Abbasian, S. D. Dehghan Manshadi, Malihe Hassan Nezhad, N. Masoumzadeh, Sara Ghaderkhani, Amirreza Keyvanfar, S. Tehrani","doi":"10.5812/archcid-140527","DOIUrl":"https://doi.org/10.5812/archcid-140527","url":null,"abstract":"Introduction: Disseminated nocardiosis is a rare but life-threatening infectious disease that occurs most often in immunocompromised individuals. This report presents a human immunodeficiency virus (HIV)-infected patient with disseminated nocardiosis in the liver, lung, and brain. Case Presentation: A 38-year-old woman who had recently been diagnosed with HIV infection complained of fever, abdominal pain, productive coughs, and occasional headaches from 2 months ago. Imaging findings of her abdomen and lungs displayed evidence of pyogenic liver abscess and lobar pneumonia with abscess formation, respectively. The patient underwent percutaneous liver abscess drainage and bronchoalveolar lavage (BAL). Using reverse transcription-polymerase chain reaction (RT-PCR), the genome of Nocardia farcinica was detected in the specimens obtained from both procedures. Besides, she had seizures during hospitalization. Based on cerebrospinal fluid (CSF) analysis, the specimen was positive for N. farcinica. Brain imaging also revealed evidence of multiple bacterial abscess formation. She was diagnosed with disseminated nocardiosis and treated with intravenous imipenem, trimethoprim/sulfamethoxazole, and amikacin, followed by appropriate oral agents. After a 6-month follow-up, the patient had no symptoms. Additionally, the lesions improved on brain imaging. Conclusions: Patients who are HIV-positive are particularly prone to opportunistic infections. Health care providers should consider all pathogens, even rare ones, like Nocardia spp., to establish a diagnosis if they're present. Furthermore, in cases initially diagnosed with localized nocardiosis, other body organs should also be reviewed so that the disseminated form of the disease can be diagnosed and treated immediately.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"105 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139786166","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}
Muhammadhosein Moradi, M. Shabani, Afshin Saboorizadeh
Introduction: Introduction: Rabies is a zoonotic viral infection with a worldwide distribution, primarily found in Asia and Africa, leading to an annual mortality rate of approximately 60 000 cases. The rabies virus is an RNA virus primarily transmitted through mucosal surfaces or contact with compromised skin. In this study, we present a case of rabies associated with acute respiratory distress syndrome (ARDS). Case Presentation: A 64-year-old male who had been bitten by a dog three weeks prior to admission presented to our emergency department with restlessness. A lung CT scan revealed nearly complete opacification of both lungs, indicative of ARDS. Unfortunately, the patient passed away within 5 hours of admission. An autopsy was conducted, and brain samples tested positive for rabies using the direct fluorescent antibody technique. Conclusions: ARDS is a rare but fatal extra-neural complication of rabies, potentially linked to cytokine storms and nitric oxide as etiological factors. Nevertheless, further investigations are warranted to gain a more precise understanding of the pathogenesis.
{"title":"Acute Respiratory Distress Syndrome Secondary to Rabies: A Case Report and Review of the Literature","authors":"Muhammadhosein Moradi, M. Shabani, Afshin Saboorizadeh","doi":"10.5812/archcid-140484","DOIUrl":"https://doi.org/10.5812/archcid-140484","url":null,"abstract":"Introduction: Introduction: Rabies is a zoonotic viral infection with a worldwide distribution, primarily found in Asia and Africa, leading to an annual mortality rate of approximately 60 000 cases. The rabies virus is an RNA virus primarily transmitted through mucosal surfaces or contact with compromised skin. In this study, we present a case of rabies associated with acute respiratory distress syndrome (ARDS). Case Presentation: A 64-year-old male who had been bitten by a dog three weeks prior to admission presented to our emergency department with restlessness. A lung CT scan revealed nearly complete opacification of both lungs, indicative of ARDS. Unfortunately, the patient passed away within 5 hours of admission. An autopsy was conducted, and brain samples tested positive for rabies using the direct fluorescent antibody technique. Conclusions: ARDS is a rare but fatal extra-neural complication of rabies, potentially linked to cytokine storms and nitric oxide as etiological factors. Nevertheless, further investigations are warranted to gain a more precise understanding of the pathogenesis.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139801158","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}
Context: Liver transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities. Results: Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following liver transplantation pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population. Conclusions: This mini-review aims to explore the incidence of CNS fungal infections in liver transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.
{"title":"CNS Fungal Infections in Liver Transplantation","authors":"Rozita Khodashahi, Kambiz Akhavan Rezayat, Aref Abdollahzade, Mohammad-Hassan Arjmand, Ebrahim Bidi, H. Rahimi, Mohsen Aliakbarian","doi":"10.5812/archcid-138411","DOIUrl":"https://doi.org/10.5812/archcid-138411","url":null,"abstract":"Context: Liver transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities. Results: Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following liver transplantation pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population. Conclusions: This mini-review aims to explore the incidence of CNS fungal infections in liver transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"39 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139862044","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}
Context: Liver transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities. Results: Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following liver transplantation pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population. Conclusions: This mini-review aims to explore the incidence of CNS fungal infections in liver transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.
{"title":"CNS Fungal Infections in Liver Transplantation","authors":"Rozita Khodashahi, Kambiz Akhavan Rezayat, Aref Abdollahzade, Mohammad-Hassan Arjmand, Ebrahim Bidi, H. Rahimi, Mohsen Aliakbarian","doi":"10.5812/archcid-138411","DOIUrl":"https://doi.org/10.5812/archcid-138411","url":null,"abstract":"Context: Liver transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities. Results: Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following liver transplantation pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population. Conclusions: This mini-review aims to explore the incidence of CNS fungal infections in liver transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139802222","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}
Muhammadhosein Moradi, M. Shabani, Afshin Saboorizadeh
Introduction: Introduction: Rabies is a zoonotic viral infection with a worldwide distribution, primarily found in Asia and Africa, leading to an annual mortality rate of approximately 60 000 cases. The rabies virus is an RNA virus primarily transmitted through mucosal surfaces or contact with compromised skin. In this study, we present a case of rabies associated with acute respiratory distress syndrome (ARDS). Case Presentation: A 64-year-old male who had been bitten by a dog three weeks prior to admission presented to our emergency department with restlessness. A lung CT scan revealed nearly complete opacification of both lungs, indicative of ARDS. Unfortunately, the patient passed away within 5 hours of admission. An autopsy was conducted, and brain samples tested positive for rabies using the direct fluorescent antibody technique. Conclusions: ARDS is a rare but fatal extra-neural complication of rabies, potentially linked to cytokine storms and nitric oxide as etiological factors. Nevertheless, further investigations are warranted to gain a more precise understanding of the pathogenesis.
{"title":"Acute Respiratory Distress Syndrome Secondary to Rabies: A Case Report and Review of the Literature","authors":"Muhammadhosein Moradi, M. Shabani, Afshin Saboorizadeh","doi":"10.5812/archcid-140484","DOIUrl":"https://doi.org/10.5812/archcid-140484","url":null,"abstract":"Introduction: Introduction: Rabies is a zoonotic viral infection with a worldwide distribution, primarily found in Asia and Africa, leading to an annual mortality rate of approximately 60 000 cases. The rabies virus is an RNA virus primarily transmitted through mucosal surfaces or contact with compromised skin. In this study, we present a case of rabies associated with acute respiratory distress syndrome (ARDS). Case Presentation: A 64-year-old male who had been bitten by a dog three weeks prior to admission presented to our emergency department with restlessness. A lung CT scan revealed nearly complete opacification of both lungs, indicative of ARDS. Unfortunately, the patient passed away within 5 hours of admission. An autopsy was conducted, and brain samples tested positive for rabies using the direct fluorescent antibody technique. Conclusions: ARDS is a rare but fatal extra-neural complication of rabies, potentially linked to cytokine storms and nitric oxide as etiological factors. Nevertheless, further investigations are warranted to gain a more precise understanding of the pathogenesis.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"77 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860971","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}
Shahrzad Matinfar, Sahar Mortezagholi, Darya Amiri, Hossein Pashaiefar, Maryam Eskandarian, Somayeh Ghadimi, Mohammad Farzad Nazari, Shole Tavakoli, Melika Valizadeh, Saeed Namaki, P. Tabarsi, Mehdi Boutrabi, Mahdi Shabani
Background: Inducing a humoral response to SARS-CoV-2 may partially control virus dissemination. However, there is a lack of consistency in the reported kinetics of IgM and IgG responses to SARS-CoV-2. Additionally, the humoral response to SARS-CoV-2 may differ from that elicited by vaccination. Therefore, we were motivated to evaluate the kinetics of antibodies against SARS-CoV-2 in both infected and vaccinated individuals. Objectives: This study aimed to investigate the seroconversion patterns of specific antibodies against various antigens of SARS-CoV-2 in hospitalized COVID-19 patients and vaccinated individuals, focusing specifically on comparing the humoral responses elicited by infection and vaccination. Methods: Serial blood and swab samples were collected from 134 COVID-19 patients at six time points following admission. Real-time RT-PCR specific for SARS-CoV-2, as well as anti-SARS-CoV-2 IgM and IgG, were tested using ELISA. Additionally, 141 serum samples were obtained from vaccinated individuals. Anti-SARS-CoV-2 spike and RBD IgGs, along with neutralizing antibodies (NAs), were assessed using ELISA in both the vaccinated group and 96 COVID-19 patients. Results: Anti-SARS-CoV-2 IgM was found positive in 23.3% of patients at 0 - 7 days after symptom onset, with seropositivity increasing to 71.7% at 15 - 21 days. Subsequently, IgM positivity gradually decreased to 62.7% at > 28 days post-symptom onset. Meanwhile, anti-SARS-CoV-2 IgG was positive in 28.3% of patients at 0 -7 days, rising to 83.7% at 22 - 28 days after symptom onset, and remained constant thereafter. Anti-spike and RBD IgGs, along with NAs, were detected in 89.7%, 87.4%, and 87.9% of vaccinated individuals, respectively, and in 37.5%, 32.3%, and 32.3% of COVID-19 patients, respectively. There was a significant correlation between anti-spike IgG and anti-RBD IgG levels and NAs in both COVID-19-infected and vaccinated individuals. The mean concentrations of anti-spike and RBD IgGs were higher in vaccinated individuals with a history of COVID-19 infection compared to those without prior infection. Conclusions: The antibody profile for IgM and IgG against SARS-CoV-2 suggests that as time passes after the onset of disease symptoms, the seropositivity in COVID-19 patients increases. Furthermore, antibodies against SARS-CoV-2 are produced more efficiently through COVID-19 vaccination than natural infection.
{"title":"Investigating the Seroconversion Patterns of Specific Antibodies Against Various Antigens of SARS-CoV-2 in Hospitalized COVID-19 Patients and Vaccinated Individuals","authors":"Shahrzad Matinfar, Sahar Mortezagholi, Darya Amiri, Hossein Pashaiefar, Maryam Eskandarian, Somayeh Ghadimi, Mohammad Farzad Nazari, Shole Tavakoli, Melika Valizadeh, Saeed Namaki, P. Tabarsi, Mehdi Boutrabi, Mahdi Shabani","doi":"10.5812/archcid-140414","DOIUrl":"https://doi.org/10.5812/archcid-140414","url":null,"abstract":"Background: Inducing a humoral response to SARS-CoV-2 may partially control virus dissemination. However, there is a lack of consistency in the reported kinetics of IgM and IgG responses to SARS-CoV-2. Additionally, the humoral response to SARS-CoV-2 may differ from that elicited by vaccination. Therefore, we were motivated to evaluate the kinetics of antibodies against SARS-CoV-2 in both infected and vaccinated individuals. Objectives: This study aimed to investigate the seroconversion patterns of specific antibodies against various antigens of SARS-CoV-2 in hospitalized COVID-19 patients and vaccinated individuals, focusing specifically on comparing the humoral responses elicited by infection and vaccination. Methods: Serial blood and swab samples were collected from 134 COVID-19 patients at six time points following admission. Real-time RT-PCR specific for SARS-CoV-2, as well as anti-SARS-CoV-2 IgM and IgG, were tested using ELISA. Additionally, 141 serum samples were obtained from vaccinated individuals. Anti-SARS-CoV-2 spike and RBD IgGs, along with neutralizing antibodies (NAs), were assessed using ELISA in both the vaccinated group and 96 COVID-19 patients. Results: Anti-SARS-CoV-2 IgM was found positive in 23.3% of patients at 0 - 7 days after symptom onset, with seropositivity increasing to 71.7% at 15 - 21 days. Subsequently, IgM positivity gradually decreased to 62.7% at > 28 days post-symptom onset. Meanwhile, anti-SARS-CoV-2 IgG was positive in 28.3% of patients at 0 -7 days, rising to 83.7% at 22 - 28 days after symptom onset, and remained constant thereafter. Anti-spike and RBD IgGs, along with NAs, were detected in 89.7%, 87.4%, and 87.9% of vaccinated individuals, respectively, and in 37.5%, 32.3%, and 32.3% of COVID-19 patients, respectively. There was a significant correlation between anti-spike IgG and anti-RBD IgG levels and NAs in both COVID-19-infected and vaccinated individuals. The mean concentrations of anti-spike and RBD IgGs were higher in vaccinated individuals with a history of COVID-19 infection compared to those without prior infection. Conclusions: The antibody profile for IgM and IgG against SARS-CoV-2 suggests that as time passes after the onset of disease symptoms, the seropositivity in COVID-19 patients increases. Furthermore, antibodies against SARS-CoV-2 are produced more efficiently through COVID-19 vaccination than natural infection.","PeriodicalId":505511,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"40 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139865693","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}
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