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COVID-19-ASSOCIATED IMMUNE THROMBOCYTOPENIA 新冠肺炎相关免疫性血小板增多症
Q4 Immunology and Microbiology Pub Date : 2021-06-30 DOI: 10.37897/rjid.2021.2.1
Mara-Andrada Plesu, G. Bejan, I. Grăjdeanu, A. Simionescu, A. Stănescu
The coronavirus disease 2019 (COVID-19) is a contagious respiratory tract infection caused by the betacoronavirus SARS-CoV-2. The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. Since the COVID-19 pandemic started, more than 166 million patients have been tested positive worldwide with more than 3.4 million related death recorded. COVID-19 has a wide range of signs and symptoms. Hematological changes such as lymphopenia, thrombocytopenia, and coagulation disturbances are not unusual in patients with COVID-19. However, the mechanisms causing these changes are partially comprehended. Immune thrombocytopenia was identified to be among the hematologic autoimmune diseases seen in patients infected with SARS-CoV-2. This review summarizes the evidence on COVID-19-associated immune thrombocytopenia and the underlying mechanisms involved in its development.
2019冠状病毒病(新冠肺炎)是一种由β冠状病毒SARS-CoV-2引起的传染性呼吸道感染。世界卫生组织于2020年3月11日宣布新冠肺炎疫情为大流行。自新冠肺炎大流行开始以来,全球已有超过1.66亿患者检测呈阳性,记录的相关死亡人数超过340万。新冠肺炎具有广泛的体征和症状。新冠肺炎患者的血液学变化,如淋巴细胞减少症、血小板减少症和凝血障碍并不罕见。然而,造成这些变化的机制被部分地理解了。免疫性血小板减少症被确定为严重急性呼吸系统综合征冠状病毒2型感染患者的血液系统自身免疫性疾病之一。这篇综述总结了COVID-19相关免疫性血小板减少症的证据及其发展的潜在机制。
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引用次数: 5
COVID-19 IN A PATIENT WITH HIV AND KAPOSI SARCOMA 艾滋病毒和卡波西肉瘤患者的COVID-19
Q4 Immunology and Microbiology Pub Date : 2021-06-30 DOI: 10.37897/rjid.2021.2.10
Maria-Andrada Corodeanu, Sorina Vasile, A. Oprea, Casa Doru” Hiv, B. Pharmacy
A 53 year old male diagnosed with HIV, SARS-CoV-2 and Kaposi sarcoma developed a purple-brown maculopapular rash on the left calf approximately 6 months before hospitalization and was diagnosed with venous ulcer. The lesions grew in size, spread on the whole body and also appeared on the palate. During this time the patient did not ask for a second opinion and was not monitored by a medical specialist. In December 2020, he developed a severe form of COVID-19 with acute respiratory failure and was admitted to the hospital. He was simultaneously diagnosed with HIV and severe immunosuppression. The skin biopsy confirmed Kaposi sarcoma in the nodular stage. Antiretroviral therapy (ART) was initiated and the patient later received liposomal doxorubicin chemotherapy. The patient slowly recovered whilst showing improvement of his clinical condition and immunological status.
一名被诊断患有艾滋病毒、SARS-CoV-2和卡波西肉瘤的53岁男性在住院前约6个月在左小腿出现紫棕色斑疹丘疹,并被诊断为静脉溃疡。病变逐渐扩大,扩散到全身,也出现在上颚。在此期间,患者没有要求第二意见,也没有接受医学专家的监测。2020年12月,他患上了严重的COVID-19,并发急性呼吸衰竭,并入院治疗。他同时被诊断出患有艾滋病毒和严重的免疫抑制。皮肤活检证实卡波西肉瘤结节期。开始抗逆转录病毒治疗(ART),随后患者接受阿霉素脂质体化疗。病人慢慢恢复,临床情况及免疫状况均有改善。
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引用次数: 0
A PARTICULAR CASE OF SARS-COV-2 INFECTION IN TWINS 双胞胎中sars-cov-2感染的特殊病例
Q4 Immunology and Microbiology Pub Date : 2021-06-30 DOI: 10.37897/rjid.2021.2.9
A. Stoenescu, G. Vancea, D. Ispas, Nicoleta Voicu-Pârvu, Nicoleta Tudor, Gabriela Scurtu, R. Popescu, C. Chirilă, E. Sandu, E. Ceaușu, S. Florescu
Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatology, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence.
介绍。尽管SARS-CoV-2感染在成人中更为常见,但在儿科人群中也报告了许多病例。案例演示。一名8个月大的双胎婴儿确诊感染COVID-19,因鼻塞、浆液性鼻漏、罕见的咳嗽和水样便而住院。这种流行病学联系是已知的,被确诊感染COVID-19的婴儿的父母和外祖父母都是已知的。生物学上,他表现为血小板增多和离散性炎症综合征,肺部x线片未显示任何病变。与此同时,双胞胎妹妹住院治疗,症状相似,SARS-CoV-2 PCR检测阴性,但肺部x线片显示特异性COVID-19病变。住院期间又进行了2次SARS-CoV-2 PCR检测,均为阴性。在对症治疗下,分别给予抗生素和对症治疗,双胞胎的进化是有利的。结论。SARS-CoV-2感染可能是无症状的,特别是在婴儿和新生儿中,并且患病率较低。
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引用次数: 0
Profilul de rezistenţă la antimicrobiene al tulpinilor de Klebsiella pneumoniae într-o clinică de boli infecţioase 一家传染病诊所肺炎克雷伯菌菌株的耐药性分析
Q4 Immunology and Microbiology Pub Date : 2021-03-31 DOI: 10.37897/rjid.2021.1.5
Lucian Giubelan, Livia Dragonu, Andreea-Cristina Stoian, Florentina Dumitrescu
Obiective. Stabilirea profilului de rezistenţă al tulpinilor de Klebsiella pneumoniae (KP) izolate în Clinica de Boli Infecţioase Craiova. Material şi metodă. Studiu retrospectiv (ianuarie 2017-decembrie 2018); KP au fost identificate cu ajutorul sistemului automat Vitek 2, care a stabilit ulterior sensibilitatea acestora la antimicrobiene (testare uzuală la 17 antibiotice, testare extinsă la alte 9); pentru fiecare tulpină a fost calculat indicele de rezistenţă MAR (limite: 0-1); informaţiile au fost introduse într-o baza de date Excel. Au fost testate 45 de tulpini în 2017 şi 290 în 2018. Procentul de tulpini MDR a fost calculat pe baza definiţiilor internaţional acceptate. Rezultate. Au fost identificate 335 de tulpini, marea majoritatea izolate prin cultura sputei (192 tulpini – 57,31%). Date demografice: 330 tulpini (99%) au fost izolate la subiecţi adulţi, 190 (57%) la pacienţi de sex masculin, 185 (55%) la bolnavi ce trăiesc în mediul urban. Valoarea globală a MAR a fost de 0,37 (faţă de 0,32 pentru ansamblul tulpinilor germenilor Gram negativi izolaţi). Peste 80% din tulpinile de KP a fost sensibile la Amikacină şi Polimixina E; sensibilităţi între 60 şi 79% au fost observate pentru Meropenem, Gentamicină, Tobramicină, Ciprofloxacină, Ertapenem, Trimetoprim-Sulfametoxazol, Levofloxacina, Cefepima, iar între 40 şi 59% pentru Ceftriaxonă, Cefoxitină, Ceftazidimă, Minociclină şi Imipenem. Sub 39% dintre tulpini sunt sensibile la Ampicilină (±Sulbactam), Piperacilină (±Tazobactam), Ticarcilină (±Acid clavulanic), Aztreonam, Pefloxacină, Cefazolin, Nitrofurantoin. Rezistenţa la principalele clase de antibiotice arată valori mai mici faţă de datele naţionale şi europene pentru cefalosporine de generaţia a 3-a, fluorochinolone şi aminoglicozide, dar un procent mult mai mare de rezistenţă la carbapeneme. Peste 68% dintre izolate sunt multidrog-rezistente (MDR); peste 60% dintre tulpini provin din surse în care există un contact important cu substanţele antimicrobiene. Concluzii. Peste 80% dintre tulpinile izolate sunt sensibile la Amikacină sau Polimixina E.; peste 29% dintre tulpini demonstrează rezistenţă la clasa carbapenemelor în 2018; peste 68% dintre izolate sunt multidrogrezistente; peste 60% dintre tulpini provin din surse în care există un contact important cu substanţele antimicrobiene.
目标。克雷奥瓦传染病诊所分离的肺炎克雷伯菌(KP)菌株耐药性谱的测定。材料和方法。回顾性研究(2017年1月至2018年12月);KPs是使用Vitek 2自动化系统鉴定的,该系统随后确定了它们对抗菌药物的易感性(对17种抗生素进行常规测试,对其他9种抗生素进行扩展测试);已经计算了每个菌株的MAR抗性指数(极限:0-1);该信息被输入到Excel数据库中。2017年检测了45株,2018年检测了290株。耐多药菌株的百分比是根据国际公认的定义计算的。后果鉴定出335株,绝大多数是通过痰培养分离的(192株,占57.31%)。人口统计数据:330株(99%)在成年受试者中分离,190株(57%)在男性患者中分离,185株(55%)在城市患者中分离。总体MRL为0.37(而所有分离的革兰氏阴性菌株为0.32)。超过80%的KP菌株对阿米卡星和聚米星E敏感;对美罗培南、庆大霉素、妥布霉素、环丙沙星、埃达培烯、甲氧苄啶、磺胺甲恶唑、左氧氟沙星、头孢吡肟的敏感度在60%至79%之间,对头孢曲松、头孢肟、头孢他啶、米诺环素和亚胺培南的敏感度为40%至59%。不到39%的菌株对氨苄青霉素(±舒巴坦)、哌拉西林(±他唑巴坦)、替卡西林(±克拉维酸)、阿曲南、培氟沙星、头孢唑林、呋喃妥因敏感。第三代头孢菌素、氟喹诺酮类和氨基糖苷类抗生素对主要类别抗生素的耐药性显示出比国家和欧洲数据更低的值,但对碳青霉烯类抗生素的耐药性百分比要高得多。68%以上的分离株具有多药耐药性(MDR);超过60%的菌株来自与抗菌药物有显著接触的来源。结论。80%以上的分离株对阿米卡星或多密辛E。;2018年,超过29%的菌株表现出对碳青霉烯类的耐药性;68%以上的分离株具有多药耐药性;超过60%的菌株来自与抗菌药物有显著接触的来源。
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引用次数: 0
Efectele SARS-CoV-2 în sarcină și la nou-născuți – un nou agent TORCH?
Q4 Immunology and Microbiology Pub Date : 2021-03-31 DOI: 10.37897/rjid.2021.1.2
Andreia Florina Niță, București România Universitatea de Medicină și Farmacie „Carol Davil, Sabina Cornelia Manolescu, M. Popa, Loredana Gabriela Popa, București România Institutul Național de Cercetare-Dezvoltare Medico, București România Spitalul Clinic Colentina
Obiective. Acest studiu și-a propus să efectueze o revizuire sistematică a literaturii existente pentru a evalua efectele COVID-19 la femeile însărcinate și la nou-născuții acestora, estimând, în același timp, posibilitatea transmiterii verticale. Materiale şi metode. Am efectuat o cercetare sistematică a literaturii folosind Pubmed și Google Scholar, acoperind perioada decembrie 2019-noiembrie 2020. Revizuirea a fost efectuată în conformitate cu ghidurile PRISMA. Rezultate. Am inclus 16 studii – recenzii sistematice și metaanalize publicate între mai 2020 și noiembrie 2020 – care s-au concentrat pe rezultatele perinatale ale femeilor însărcinate cu COVID-19 și 7 prezentări de cazuri ale nou-născuților cu transmitere verticală a COVID-19. În general, rata cazurilor de COVID-19 la nou-născuții din mame COVID-19 pozitive a fost de 3% cu CI 95% [1,86, 4,24]). Rata nașterii premature a fost de 16,4%, cu CI 95% [10,5, 22,3], iar rata mortalității și a deceselor fetale a fost de 1,4% (11 studii, 0 până la 4,8%). Dintre cei 7 nou-născuți cu transmitere verticală dovedită, majoritatea s-au născut prematuri, cu greutate bună la naștere și scor APGAR, iar manifestările clinice au fost heterogene; 4 au dezvoltat simptome severe. Evoluțiile atât pentru mamă, cât și pentru nou-născuţi au fost bune în 85% dintre cazuri. Concluzii. În ceea ce privește rata prematurității și rata mortalității la femeile cu COVID-19, rezultatul este similar cu populația generală. Transmiterea verticală este posibilă și pare să aibă loc în aproximativ 3% dintre cazuri. Prognosticul matern și perinatal este favorabil, iar prezentarea clinică a transmiterii în uter a SARS-CoV-2 la nou-născuți este heterogenă.
目标。本研究旨在对现有文献进行系统回顾,以评估新冠肺炎对孕妇及其新生儿的影响,同时估计垂直传播的可能性。材料和方法。我们使用Pubmed和Google Scholar进行了一项系统的文献研究,涵盖2019年12月至2020年11月。审查是根据PRISMA指南进行的。后果我们纳入了16项研究——2020年5月至2020年11月发表的系统综述和荟萃分析——这些研究侧重于新冠肺炎孕妇的围产期结果,以及7项新冠肺炎垂直传播新生儿病例。总体而言,新冠肺炎阳性母亲新生儿的COVID-19]病例率为3%,CI为95%[1.86,4.24])。早产率为16.4%,CI为95%[10.5,22.3],死亡率和胎儿死亡率为1.4%(11项研究,0至4.8%)。在已证实垂直传播的7名新生儿中,大多数早产,出生体重和APGAR评分良好,临床表现异质;4人出现严重症状。85%的病例中,母亲和新生儿的发育情况良好。结论。关于新冠肺炎女性的早产率和死亡率,结果与普通人群相似。垂直传播是可能的,并且似乎发生在大约3%的病例中。孕产妇和围产期预后良好,新生儿子宫内传播严重急性呼吸系统综合征冠状病毒2型的临床表现是异质性的。
{"title":"Efectele SARS-CoV-2 în sarcină și la nou-născuți – un nou agent TORCH?","authors":"Andreia Florina Niță, București România Universitatea de Medicină și Farmacie „Carol Davil, Sabina Cornelia Manolescu, M. Popa, Loredana Gabriela Popa, București România Institutul Național de Cercetare-Dezvoltare Medico, București România Spitalul Clinic Colentina","doi":"10.37897/rjid.2021.1.2","DOIUrl":"https://doi.org/10.37897/rjid.2021.1.2","url":null,"abstract":"Obiective. Acest studiu și-a propus să efectueze o revizuire sistematică a literaturii existente pentru a evalua efectele COVID-19 la femeile însărcinate și la nou-născuții acestora, estimând, în același timp, posibilitatea transmiterii verticale. Materiale şi metode. Am efectuat o cercetare sistematică a literaturii folosind Pubmed și Google Scholar, acoperind perioada decembrie 2019-noiembrie 2020. Revizuirea a fost efectuată în conformitate cu ghidurile PRISMA. Rezultate. Am inclus 16 studii – recenzii sistematice și metaanalize publicate între mai 2020 și noiembrie 2020 – care s-au concentrat pe rezultatele perinatale ale femeilor însărcinate cu COVID-19 și 7 prezentări de cazuri ale nou-născuților cu transmitere verticală a COVID-19. În general, rata cazurilor de COVID-19 la nou-născuții din mame COVID-19 pozitive a fost de 3% cu CI 95% [1,86, 4,24]). Rata nașterii premature a fost de 16,4%, cu CI 95% [10,5, 22,3], iar rata mortalității și a deceselor fetale a fost de 1,4% (11 studii, 0 până la 4,8%). Dintre cei 7 nou-născuți cu transmitere verticală dovedită, majoritatea s-au născut prematuri, cu greutate bună la naștere și scor APGAR, iar manifestările clinice au fost heterogene; 4 au dezvoltat simptome severe. Evoluțiile atât pentru mamă, cât și pentru nou-născuţi au fost bune în 85% dintre cazuri. Concluzii. În ceea ce privește rata prematurității și rata mortalității la femeile cu COVID-19, rezultatul este similar cu populația generală. Transmiterea verticală este posibilă și pare să aibă loc în aproximativ 3% dintre cazuri. Prognosticul matern și perinatal este favorabil, iar prezentarea clinică a transmiterii în uter a SARS-CoV-2 la nou-născuți este heterogenă.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42414340","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}
引用次数: 0
Management of SARS-CoV-2 infection in pregnancy 妊娠期SARS-CoV-2感染的管理
Q4 Immunology and Microbiology Pub Date : 2021-01-01 DOI: 10.37897/rjid.2021.1.3
C. Stănică, R. Sima, Raluca Gabriela Ioan, C. Nanu, A. Neacșu
The SARS-CoV-2 infection, which originated from a market in Wuhan, China, spread rapidly, so on March 11, 2020, the WHO decreed that the outbreak became a pandemic. Over 90% of people infected with SARS-CoV-2 are either asymptomatic or have mild symptoms. However, there are cases that develop severe forms of the disease, from acute respiratory distress syndrome to septic shock with multiorgan failure and exitus. However, reports of pregnant women diagnosed with Covid-19 are low. Changes in the maternal organism in pregnancy, including immunity, respiratory system and hypercoagulability, but also various comorbidities, could be a risk factor for pregnant women to develop complications associated with COVID-19, with increased morbidity and mortality compared to the general population. The effects of SARS-CoV-2 infection on pregnancy are not sufficiently understood, nor are the effects of pregnancy on disease progression. Although the existence of the virus has been shown in biological samples such as the placenta, umbilical cord, or amniotic fluid, the maternal and fetal effects of the virus are not well known. Recent studies confirm the possibility of intrauterine maternal-fetal transmission of the virus, but also of specific antibodies. The possibility of infection by breastfeeding is not yet sufficiently investigated. We looked for data on the treatment and prophylaxis of SARS-CoV-2 infection during pregnancy, as well as on the choice of the optimal birth pathway in these women. The aim of this paper was to conduct a systematic review of the literature on pregnancy and birth management in patients infected with SARS-CoV-2 that could lead to an improvement in the quality of their medical care.
SARS-CoV-2感染起源于中国武汉的一个市场,传播迅速,因此世界卫生组织于2020年3月11日宣布疫情成为大流行。超过90%的SARS-CoV-2感染者要么无症状,要么症状轻微。然而,也有病例发展为严重形式的疾病,从急性呼吸窘迫综合征到脓毒性休克伴多器官衰竭和排泄。然而,被诊断患有Covid-19的孕妇的报告很少。妊娠期母体机体的变化,包括免疫力、呼吸系统和高凝性,以及各种合并症,可能是孕妇发生与COVID-19相关并发症的危险因素,与普通人群相比,发病率和死亡率都有所增加。SARS-CoV-2感染对妊娠的影响尚不清楚,妊娠对疾病进展的影响也不清楚。虽然在胎盘、脐带或羊水等生物样本中已发现该病毒的存在,但该病毒对母体和胎儿的影响尚不清楚。最近的研究证实了宫内母婴传播病毒的可能性,但也有特异性抗体。母乳喂养感染的可能性尚未得到充分调查。我们寻找有关怀孕期间SARS-CoV-2感染的治疗和预防的数据,以及这些妇女选择最佳分娩途径的数据。本文的目的是对SARS-CoV-2感染患者妊娠和分娩管理方面的文献进行系统综述,以提高其医疗质量。
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引用次数: 0
Outcome of SARS-CoV-2 in pregnancy and newborns – is there a new kid in the TORCH block? SARS-CoV-2在妊娠和新生儿中的结局——TORCH区块中是否有新成员?
Q4 Immunology and Microbiology Pub Date : 2021-01-01 DOI: 10.37897/rjid.2021.1.1
A. Niţă, Sabina Cornelia Manolescu, M. Popa, L. Popa
Objective. This study aimed to perform a systematic review of existing literature to assess the outcomes of pregnancy in women with COVID-19 infection and their newborns while estimating the possibility of vertical transmission. Materials and methods. We conducted a systematic literature research using Pubmed and Google Scholar covering the period from December 2019 to 20th of November 2020. The review was conducted in accordance with PRISMA guidelines. Outcomes. We included 16 studies – systematic reviews and meta-analyses published between May 2020 and November 2020 – which focused on perinatal outcomes of pregnant women with COVID-19 and 7 case reports of neonates with congenital transmission of COVID-19. Overall, the rate of COVID-19 cases in neonates of COVID-19 positive mothers was 3% with 95% CI [1.86, 4.24]). The preterm birth rate was 16.4% with 95% CI [10.5, 22.3] and the rate of stillbirths and foetal deaths was 1.4% (11 studies, 0 to 4.8%). From the 7 newborns with proved vertical transmission, majority were born preterm, with good birth weight and APGAR score and heterogenous symptoms; 4 developed severe symptoms. Overall progress and evolution for both mother and newborn was good. Conclusions. COVID-19 impact on pregnancy outcome is similar to general population in regard to preterm rate and stillbirth rate. Vertical transmission is possible and it seems to occur in about 3% of cases. Overall maternal and perinatal outcome is favourable and clinical presentation of in utero transmission of SARSCoV-2 in newborns is heterogenous.
目标。本研究旨在对现有文献进行系统回顾,评估COVID-19感染妇女及其新生儿的妊娠结局,同时估计垂直传播的可能性。材料和方法。我们使用Pubmed和谷歌Scholar进行了系统的文献研究,时间为2019年12月至2020年11月20日。审查是按照PRISMA的指导方针进行的。结果。我们纳入了16项研究——2020年5月至2020年11月期间发表的系统综述和荟萃分析——这些研究关注的是感染COVID-19的孕妇的围产期结局和7例新生儿先天性传播COVID-19的病例报告。总体而言,COVID-19阳性母亲的新生儿COVID-19病例率为3%,95% CI[1.86, 4.24])。早产率为16.4%,95% CI[10.5, 22.3],死产和胎儿死亡率为1.4%(11项研究,0 - 4.8%)。经证实为垂直传播的7例新生儿中,多数为早产儿,出生体重、APGAR评分良好,症状异质性强;4人出现严重症状。母亲和新生儿的总体进展和进化都是好的。结论。在早产率和死产率方面,COVID-19对妊娠结局的影响与一般人群相似。垂直传播是可能的,似乎发生在约3%的病例中。总体的孕产妇和围产期结局是有利的,新生儿SARSCoV-2在子宫内传播的临床表现是异质性的。
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引用次数: 0
Asocierea dintre colita ulcerativă şi infecţia cu Clostridium difficile la vârsta pediatrică – prezentare de caz 溃疡性结肠炎合并艰难梭菌感染的儿童年龄病例
Q4 Immunology and Microbiology Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.6
Alina Negrea, Lorena Elena Meliț, Ana-Maria Șimon, V. Negrea, C. Mărginean
Dr. alina Negrea1, şef lucr. dr. lorena elena Meliţ1,2, dr. Ana-Maria şimon1, Dr. valentina Negrea3, prof. dr. cristina oana Mărginean1,2 1 Clinica Pediatrie I, Spitalul Clinic Judeţean de Urgenţă, Tg. Mureş, România 2 Universitatea de Medicină, Farmacie, Ştiinţe şi Tehnologie „G.E. Palade“, Tg. Mureş, România 3 Clinica Boli Infecţioase I, Spitalul Clinic Judeţean Mureş, Tg. Mureş, România PREZENTĂRI DE CAZ
Alina Negrea1博士,工作负责人。lorena elena Meliţ1,2,Ana Mariaşimon1,valentina Negrea3,cristina oana Mărginean教授1,2 1罗马尼亚穆尔什县急诊临床医院第一儿科诊所2穆尔什医学、药学、科学与技术大学“G.E.Palade”。罗马尼亚穆雷斯病例报告
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引用次数: 0
Sarcom Kaposi cu evoluţie trenantă la un caz nou diagnosticat cu infecţie HI
Q4 Immunology and Microbiology Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.8
E. Marcu, Craiova România Universitatea de Medicină și Farmacie, Amalia Romanescu, Florentina Dumitrescu
REZUMAT Introducere. Sarcomul Kaposi (SK) este o neoplazie multicentrică vasculară, care apare, de obicei, în contextul imunodeficienţei. Deși introducerea terapiei antiretrovirale combinate (TARVc) a determinat o scădere remarcabilă a incidenţei SK asociat infecţiei cu HIV și o îmbunătăţire semnificativă a prognosticului, rămâne o cauză importantă de morbiditate și mortalitate în rândul pacienţilor HIV pozitivi. Prezentarea cazului. Pacient în vârstă de 34 de ani, se internează în Clinica de Dermatologie a Spitalului Clinic Judeţean de Urgenţă Craiova pentru apariţia unor placarde infiltrate, dureroase, localizate la nivelul mâinii stângi, inghinal și la nivelul piciorului stâng, ce au debutat în urmă cu aproximativ 3 ani. Se efectuează test ELISA-HIV 1,2, cu rezultat pozitiv și pacientul este internat la Compartimentul HIV/SIDA – Spitalul Clinic de Boli Infecţioase și Pneumoftiziologie „Victor Babeș“ din Craiova. Se instituie TARVc, tratament antibiotic, antimicotic, anticoagulant și simptomatic. Pe parcursul internării, pacientul prezintă extinderea leziunilor la nivelul cavităţii bucale, feţei plantare a piciorului drept și la nivelul lobului urechii stângi. Se efectuează biopsie de la nivelul leziunilor cutanate, iar examenul histopatologic confirmă diagnosticul de SK. După circa 2 luni, se iniţiază și tratament citostatic, evoluţia pacientului fiind favorabilă, cu remisiunea leziunilor cutaneo-mucoase în proporţie mai mare de 50%. Concluzii. Leziunile cutanate persistente la un pacient tânăr pot fi marker indicator de SIDA, întârzierea diagnosticului influenţând prognosticul infecţiei cu HIV.
简介。卡波西肉瘤(SK)是一种多中心血管肿瘤,通常发生在免疫缺陷的情况下。尽管联合抗逆转录病毒治疗(VVC)显著降低了HIV相关SK的发病率,并显著改善了预后,但它仍然是HIV阳性患者发病率和死亡率的主要原因。案例介绍。34岁的患者因左手、腹股沟和左脚出现浸润性疼痛斑块而住进了克雷奥瓦县急诊临床医院皮肤科诊所,该斑块始于约3年前。进行1,2 HIV ELISA试验,结果呈阳性,患者被送入艾滋病毒/艾滋病科——传染病和肺生理学临床医院“Victor Babes”“来自Craiova。TARVc是一种抗生素、抗真菌、抗凝血剂和对症治疗药物。在入院期间,患者表现出病变扩展到口腔、右脚跖面和左耳垂。在皮肤病变的水平上进行活检,组织病理学检查证实了SK的诊断。大约2个月后,开始细胞抑制治疗,患者的发育良好,皮肤粘膜病变的缓解率超过50%。结论。年轻患者的持续性皮肤病变可能是艾滋病的一个指标,延迟诊断会影响HIV感染的预后。
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引用次数: 0
An intermediate analysis of moderate and severe forms of COVID-19 treated in Craiova Infectious Disease Clinic 克拉约瓦传染病门诊治疗中、重度COVID-19的中间分析
Q4 Immunology and Microbiology Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.3
L. Giubelan, C. Pharmacy, L. Dragonu, A. Stoian, F. Dumitrescu
Objective. Description and differentiation of moderate and severe forms of COVID-19 diagnosed and treated in Infectious Diseases Clinic, „Victor Babeş“ Infectious Diseases and Pneumology Hospital from Craiova. Material and method. Retrospective study (March 2020 – July 2020) of the first 300 hospitalized cases comparing the moderate and severe forms of COVID-19 from a clinical and biological point of view. Results. 56 moderate and 33 severe cases were recorded;between them there are a series of differences with statistical significance: age of patients (49.5 ± 16.13, p < 0.0001), number of obese patients (12 vs. 14, p = 0.06), with cardiovascular suffering, (8 vs. 18, p < 0.0001), diabetes (9 vs. 15, p = 0.005) or neoplasms (2 vs. 7, p = 0.02). Several severely ill patients have dyspnoea (14 vs. 24, p < 0.0001), pulmonary rales (8 vs. 13, p = 0.01), elevated systolic blood pressure (2 vs. 9, p = 0.01), coma (0 vs. 5, p = 0.01) or radio-logical image of bronchopneumonia (0 vs. 6, p = 0.004). Critically ill patients have a higher leukocyte count (6,176.07±2,512.05 vs. 8,666.67±4,565.88, p=0.01), higher ESR at 1 hour (43.05±18.09 vs. 71.18±30.8 mm, p < 0.0001), higher level of C-reactive protein (29.62±19.81 vs. 43.46±18.01 mg/l, p = 0.01), serum lactate (1.19±0.91 vs. 3.47±3.84 mEq/l, p = 0.006), blood glucose (112.5±25.01 vs. 304.45±273.58 mg/ dl, p < 0.0001), D dimers (518.7±455.32 vs. 1,314.22±1,347.54 µg/ml, p < 0.0001), troponin (1.8±4.02 vs. 90.81±202.08 mg/l, p < 0.0001);the neutrophil-to-lymphocyte ratio is higher in severe forms (3.66±1.2 vs. 6.21±4.21, p < 0.0001). Of the 33 patients with severe forms 16 (approximately 50% of them, respectively 5.33% of the 300 cases) died. Conclusions. Patients with severe forms of COVID-19 are much older and have more comorbidities (es-pecially obesity, cardiovascular disease, diabetes or malignancies). For the early detection of severe forms, physicians should detect dyspnea, low oxygen saturation or the presence of pulmonary rales, more com-monly encountered in severe forms. Tests for inflammation and procoagulant status are significantly better expressed in patients with severe forms. At the level of the studied group, the glycemic control was subop-timal for severe forms of the disease. Despite the intensive care support, about half of those admitted with severe forms (5.33% of all cases) died. © 2020, Amaltea Medical Publishing House. All rights reserved.
目标。克拉约瓦“维克多·巴贝茨”传染病与肺炎医院传染病门诊诊治的中、重度新冠肺炎描述与区分材料和方法。对首批300例住院病例(2020年3月至2020年7月)进行回顾性研究,从临床和生物学角度比较中度和重度COVID-19。结果:中度患者56例,重度患者33例,患者年龄(49.5±16.13,p < 0.0001)、肥胖患者数(12例vs. 14例,p = 0.06)、合并心血管疾病患者数(8例vs. 18例,p < 0.0001)、糖尿病患者数(9例vs. 15例,p = 0.005)、肿瘤患者数(2例vs. 7例,p = 0.02)等差异均有统计学意义。一些重症患者有呼吸困难(14比24,p < 0.0001)、肺音(8比13,p = 0.01)、收缩压升高(2比9,p = 0.01)、昏迷(0比5,p = 0.01)或支气管肺炎的影像学表现(0比6,p = 0.004)。危重患者有更高的白细胞计数(vs 8666 .67 2512 .05 6176 .07点±±4565 .88点,p = 0.01),更高的ESR 1小时(43.05±18.09和71.18±30.8毫米,p < 0.0001),高c反应蛋白水平(29.62±19.81和43.46±18.01 mg / l, p = 0.01),血清乳酸(1.19±0.91和3.47±3.84毫克当量/ l, p = 0.006),血糖(112.5±25.01和304.45±273.58 mg / dl, p < 0.0001), D二聚体(518.7±455.32 vs 1314 .22±1347点µg / ml, p < 0.0001),肌钙蛋白(1.8±4.02和90.81±202.08 mg / l,中性粒细胞与淋巴细胞的比值在严重形式中较高(3.66±1.2比6.21±4.21,P < 0.0001)。在33例重症患者中,16例死亡(约占50%,分别占300例的5.33%)。结论。严重形式的COVID-19患者年龄大得多,并有更多合并症(特别是肥胖、心血管疾病、糖尿病或恶性肿瘤)。对于早期发现的严重形式,医生应发现呼吸困难,低氧饱和度或肺部啰音的存在,更常见的严重形式。炎症和促凝状态测试在严重形式的患者中明显更好地表达。在研究组的水平上,对于严重形式的疾病,血糖控制是次优的。尽管有重症监护支持,但约有一半的重症患者(占所有病例的5.33%)死亡。©2020,Amaltea医学出版社。版权所有。
{"title":"An intermediate analysis of moderate and severe forms of COVID-19 treated in Craiova Infectious Disease Clinic","authors":"L. Giubelan, C. Pharmacy, L. Dragonu, A. Stoian, F. Dumitrescu","doi":"10.37897/RJID.2020.4.3","DOIUrl":"https://doi.org/10.37897/RJID.2020.4.3","url":null,"abstract":"Objective. Description and differentiation of moderate and severe forms of COVID-19 diagnosed and treated in Infectious Diseases Clinic, „Victor Babeş“ Infectious Diseases and Pneumology Hospital from Craiova. Material and method. Retrospective study (March 2020 – July 2020) of the first 300 hospitalized cases comparing the moderate and severe forms of COVID-19 from a clinical and biological point of view. Results. 56 moderate and 33 severe cases were recorded;between them there are a series of differences with statistical significance: age of patients (49.5 ± 16.13, p < 0.0001), number of obese patients (12 vs. 14, p = 0.06), with cardiovascular suffering, (8 vs. 18, p < 0.0001), diabetes (9 vs. 15, p = 0.005) or neoplasms (2 vs. 7, p = 0.02). Several severely ill patients have dyspnoea (14 vs. 24, p < 0.0001), pulmonary rales (8 vs. 13, p = 0.01), elevated systolic blood pressure (2 vs. 9, p = 0.01), coma (0 vs. 5, p = 0.01) or radio-logical image of bronchopneumonia (0 vs. 6, p = 0.004). Critically ill patients have a higher leukocyte count (6,176.07±2,512.05 vs. 8,666.67±4,565.88, p=0.01), higher ESR at 1 hour (43.05±18.09 vs. 71.18±30.8 mm, p < 0.0001), higher level of C-reactive protein (29.62±19.81 vs. 43.46±18.01 mg/l, p = 0.01), serum lactate (1.19±0.91 vs. 3.47±3.84 mEq/l, p = 0.006), blood glucose (112.5±25.01 vs. 304.45±273.58 mg/ dl, p < 0.0001), D dimers (518.7±455.32 vs. 1,314.22±1,347.54 µg/ml, p < 0.0001), troponin (1.8±4.02 vs. 90.81±202.08 mg/l, p < 0.0001);the neutrophil-to-lymphocyte ratio is higher in severe forms (3.66±1.2 vs. 6.21±4.21, p < 0.0001). Of the 33 patients with severe forms 16 (approximately 50% of them, respectively 5.33% of the 300 cases) died. Conclusions. Patients with severe forms of COVID-19 are much older and have more comorbidities (es-pecially obesity, cardiovascular disease, diabetes or malignancies). For the early detection of severe forms, physicians should detect dyspnea, low oxygen saturation or the presence of pulmonary rales, more com-monly encountered in severe forms. Tests for inflammation and procoagulant status are significantly better expressed in patients with severe forms. At the level of the studied group, the glycemic control was subop-timal for severe forms of the disease. Despite the intensive care support, about half of those admitted with severe forms (5.33% of all cases) died. © 2020, Amaltea Medical Publishing House. All rights reserved.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48159893","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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Revista Romana de Boli Infectioase
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