Revista Romana de Boli Infectioase最新文献

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Pneumonia stafilococică, o provocare actuală în practica pediatrică – prezentare de caz 葡萄球菌性肺炎，当前儿科实践中的一个挑战——病例介绍

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.10

Nicoleta-Ana Tomșa, Lorena Elena Meliț, Gabriela Bucur, Iunius Simu, Bianca Aron, C. Mărginean

nicoleta-ana tomșa1, lorena elena meliț1,2, Gabriela Bucur1, iunius simu2,3, Bianca aron1, cristina oana mărginean1,2 1 Clinica Pediatrie, Spitalul Clinic Judeţean de Urgenţă, Tg. Mureş, România 2 Universitatea de Medicină şi Farmacie, Ştiinţe şi Tehnologie ,,G.E. Palade“, Tg. Mureş, România 3 Clinica Radiologie şi Imagistică Medicală, Spitalul Clinic Judeţean de Urgenţă, Tg. Mureş, România PREZENTĂRI DE CAZ

Nicoleta ana tomșa1，lorena elena meliț1,2，Gabriela Bucur1，June simu2,3，Bianca aron1，cristina oana mărginean 1,2 1罗马尼亚穆尔什县急诊临床医院儿科诊所2医学与药学、科学与技术大学，G。E.Palade”，Tg.Mures，罗马尼亚

引用次数: 0

Association of ulcerative colitis and Clostridium difficile infection at pediatric age – case presentation 儿童期溃疡性结肠炎与艰难梭菌感染的关系——病例介绍

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.5

A. Negrea, L. Meliț, A. Simon, Valentina Negrea, C. Mărginean, Tg. Mures Romania Tehnology

Introduction. Ulcerative colitis (UC) is a more severe pathology in children than adults, with an increasing incidence in young ages. The most common exacerbations are due to Clostridium difficile (CD) infection and can lead to severe complications. case presentation. We present the case of a 6-year-old patient diagnosed with ulcerative colitis at the age of 5, admitted in our Clinic for watery diarrheic stools with blood, abdominal pain, anorexia, and weight loss. Laboratory tests at the time of admission revealed anemia, leukocytosis with neutrophilia, hydro-electrolytic disorders, and severe hypoalbuminemia. The A and B toxin detection test for CD in feces was positive, stool culture was negative. Anamnestic, clinical and paraclinical data established the diagnosis of CD infection associated with exacerbation of UC. Initially, the evolution under pulse therapy with Solu-Medrol and Metronidazole by vein was slightly favorable, but with a period of decline 5 days after the per oral administration of corticosteroids. Therefore, it was necessary to reinitiate intravenous corticosteroids associating also Vancomycin orally. Under the established treatment the symptomatology improved, with the normalization of the laboratory parameters and after 21 days of admission the patient was discharged. conclusions. The coexistence of CD infection in pediatric patients with UC remains a real challenge, due to the high rate of recurrence and higher mortality compared to the general population. The undulating evolution under treatment, as well as the psychological profile of the patient, have customized the case.

介绍溃疡性结肠炎（UC）在儿童中是一种比成人更严重的病理，在年轻人中发病率不断增加。最常见的恶化是由于艰难梭菌（CD）感染，并可能导致严重并发症。案例介绍。我们报告了一例6岁的患者，他在5岁时被诊断为溃疡性结肠炎，因水样腹泻便伴血、腹痛、厌食和体重减轻而住进我们的诊所。入院时的实验室检查显示贫血、白细胞增多伴中性粒细胞增多症、水电解障碍和严重的低白蛋白血症。粪便中CD的A、B毒素检测呈阳性，粪便培养呈阴性。记忆、临床和临床旁数据确定了CD感染与UC恶化相关的诊断。最初，Solu Medrol和Metronidazole静脉脉冲治疗的进展稍好，但每次口服皮质类固醇后5天会有一段时间的下降。因此，有必要重新开始静脉注射皮质类固醇，同时口服万古霉素。在既定的治疗下，随着实验室参数的正常化，症状得到了改善，患者在入院21天后出院。结论。与普通人群相比，儿童UC患者CD感染的共存仍然是一个真正的挑战，因为复发率高，死亡率高。治疗过程中的起伏演变，以及患者的心理状况，都定制了这个病例。

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引用次数: 0

New perspectives on COVID-19 and pregnancy 新冠肺炎与妊娠的新视角

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.1

Ana Duminică, V. Alexandrescu, A. Ciobanu, C. Gică, R. Botezatu, N. Gică, G. Peltecu, A. Panaitescu, B. Pharmacy

Although there have been various pandemics throughout the history of humankind, modern age was thought to be ready to face such a challenge by implementing an advanced health care system. However, epidemic outbreaks are ubiquitous, and they have a substantial potential to evolve into pandemics, hence this being the actual context of SARS-CoV-2 pandemics from 2019. The difficulty of the addressed subject consists in the fact that the majority of pharmacological clinical studies omited pregnant patients. Acknowledging the physiological changes, pregnant women represent an unique group of patients as pregnancy could embody a particular substrate for this contemporary type of infection. © 2020, Amaltea Medical Publishing House. All rights reserved.

尽管人类历史上曾发生过各种各样的流行病，但人们认为现代社会已经准备好通过实施先进的卫生保健系统来应对这种挑战。然而，疫情爆发无处不在，它们很有可能演变成大流行，因此这是2019年SARS-CoV-2大流行的实际背景。本课题的难点在于大多数药理学临床研究忽略了怀孕患者。承认生理变化，孕妇代表了一个独特的患者群体，因为怀孕可能体现了这种当代感染类型的特定基质。©2020,Amaltea医学出版社。版权所有。

引用次数: 0

The susceptibility of pregnant women during viral pandemics – A mini-review 孕妇在病毒大流行期间的易感性——一项小型综述

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-12-31 DOI: 10.37897/RJID.2020.4.2

Astrit M. Gashi, Jakup Ismajli, Arjanit Sherifi, Gent Sopa, dardan ismajli

The immune system is a system that consists of the reaction of the organism to the aggression of invading pathogens. The immune system is composed of: the innate immune system or nonspecific immunity, and the acquired immune system or specific immunity. During pregnancy, the maternal immune system changes constantly. The objective of this review is to evaluate the results from studies made in the field of reproductive immunology about the susceptibility of pregnant women to infectious diseases. Most studies show that pregnant women may be at a higher risk and more susceptible to infectious diseases. This is due to the continuous immune system modulating that occurs during pregnancy. This immunity modulated during normal pregnancy consists of decreased the acquired immune system or specific immunity (B-cells are absent, while T lymphocytes constitute about 3-10% of the decidual immune cells). We conclude that pregnant women may be at a higher risk and more susceptible to infectious diseases, including COVID-19. Therefore, we recommend special care and correct observance of measures such as social distancing, frequent hand washing, the use of masks, and all other measures that are given to the general population during viral pandemics, while pregnant women who become ill with COVID-19 should be treated aggressively. Furthermore, concrete plans must be developed (with more specific measures) for this higher-risk population, while ensuring that women receive the necessary care. © 2020, Amaltea Medical Publishing House. All rights reserved.

免疫系统是一个由机体对入侵病原体的反应组成的系统。免疫系统由先天免疫系统(即非特异性免疫)和获得性免疫系统(即特异性免疫)组成。在怀孕期间，母亲的免疫系统不断变化。本综述的目的是评价生殖免疫学领域关于孕妇对传染病易感性的研究结果。大多数研究表明，孕妇可能面临更高的风险，更容易感染传染病。这是由于怀孕期间发生的持续免疫系统调节。正常妊娠期间的这种免疫调节包括获得性免疫系统或特异性免疫的降低(b细胞缺失，而T淋巴细胞约占个体免疫细胞的3-10%)。我们的结论是，孕妇可能面临更高的风险，更容易感染包括COVID-19在内的传染病。因此，我们建议特别注意并正确遵守一些措施，如保持社交距离、勤洗手、戴口罩以及病毒大流行期间对普通人群采取的所有其他措施，而感染COVID-19的孕妇应得到积极治疗。此外，必须为这一高危人群制定具体计划(包括更具体的措施)，同时确保妇女得到必要的护理。©2020,Amaltea医学出版社。版权所有。

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引用次数: 0

Hepatita A, o patologie amenințătoare de viață la copiii mici cu boală Wilson – prezentare de caz 甲型肝炎，Wilson病幼儿的一种危及生命的病理学——病例介绍

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.3.12

Cristian Dan Mărginean, Nicoleta-Ana Tomșa, Bianca Aron, Daniela Ciobanu, Lorena Elena Meliț, Spitalul Clinic Județean de Urgență Tg. Mureş România Clinica Pediatrie

hepatomegalie, ecostructură hepatică inomogenă, ecogenitate granulară, cu micronoduli, diametrul venei porte 9 mm, pulsatilitate alterată venei porte, splenomegalie și ascită. En- doscopia digestivă superioară a arătat hiperemie și edem la nivelul mucoasei gastrice, cu cheaguri aderente la suprafața mucoasei și varice incipiente la nivelul fornixului gastric. Ecocardiografia a evidențiat colecție pleurală și pericardică în cantitate mică. exclus hepatita și C, toxoplasma, rubeola, herpes virus, Epstein Barr, citomegalovirusul hepatita autoimună. nivelurilor și cuprului seric, asociate cu testul pozitiv la D-penicilamină, împreună cu varicele gastrice și hipertensiunea portală, am stabilit diagnosticul de BW. Consultul oftalmologic și cel neurologic fost în relații normale. Evoluția clinică paraclinică pacientei fost favorabile după inițierea terapiei chelatoare. hepatita poate duce insuficiență hepatică special copiii antecedente patologice.

肝肿大，内源性肝生态结构，颗粒微调制回声，门静脉直径9mm，门静脉搏动性改变，脾肿大和腹水。上消化道内窥镜检查显示胃粘膜充血和水肿，粘膜表面粘附有血块，胃穹窿早期静脉曲张。超声心动图显示少量胸膜和心包积液。不包括丙型肝炎、弓形虫、风疹、疱疹病毒、EB病毒、巨细胞病毒自身免疫性肝炎。水平和血清铜，与D-青霉素试验阳性相关，以及胃静脉曲张和门静脉高压，我们确定了BW的诊断。在开始螯合治疗后，患者的临床辅助发展是有利的。肝炎可导致肝功能衰竭，尤其是儿童的病理病史。

引用次数: 0

Main epidemiological features of COVID-19 cases admitted in a first line defence hospital from Bucharest, Romania 罗马尼亚布加勒斯特一家一线防御医院收治的新冠肺炎病例的主要流行病学特征

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.3.7

N. Nedelcu, “Dr. Victor Babes” Infectious, R. Mateescu, E. Ceaușu, P. Calistru, S. Florescu, B. Pharmacy

In this retrospective unicenter study we aimed to outline the key features of the first 100 cases of COVID-19 hospitalized in our clinic after designation of it as front line unit for hospitalization of these cases. Thus, the average age of cases was 44.7 years (SD: 15.9) and the prevalence of female was 57.4%. By age groups, prevalence of young patients (7.8%) was significantly (p < 0.05) lower than the prevalence of adult patients (77.2%). The most prevalent occupation (31.7%) was healthcare worker. The most frecvent exposure to source of infection was represented by attending healthcare facilities (44.6%), followed by having contact with COVID-19 confirmed/suspect case (30.7%), and recent international travel (18.8%). Of the 30% of cases in which at least one health precondition was recorded the most prevalent (13.9%) of such condition was chronic cardiovascular disease including high blood presure. In regard with severity, to note that 6 patients died within 14 days of hospital admission, all fatalities have occurred in very old patients and 83.3% of them had chronic kidney disease. In the end, we express the hope that data outlined in this paper will help for better management of COVID-19 pandemic. © 2020, Amaltea Medical Publishing House. All rights reserved.

在这项回顾性单中心研究中，我们旨在概述在我诊所被指定为这些病例住院一线单位后，前100例COVID-19住院患者的主要特征。平均年龄44.7岁(SD: 15.9)，女性患病率为57.4%。按年龄组分，青年患者患病率(7.8%)显著低于成年患者患病率(77.2%)(p < 0.05)。最常见的职业是卫生保健工作者(31.7%)。最常见的传染源接触是前往医疗机构(44.6%)，其次是与COVID-19确诊/疑似病例接触(30.7%)和最近的国际旅行(18.8%)。在记录至少有一种健康先决条件的30%的病例中，这种情况最普遍(13.9%)是慢性心血管疾病，包括高血压。关于严重程度，值得注意的是，6名患者在入院后14天内死亡，所有死亡都发生在非常老的患者中，其中83.3%患有慢性肾脏疾病。最后，我们希望本文概述的数据将有助于更好地管理COVID-19大流行。©2020,Amaltea医学出版社。版权所有。

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引用次数: 0

Cutaneous involvement in COVID-19 patients 新冠肺炎患者的皮肤受累

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.3.1

C. Beiu, B. Pharmacy, E. Ceaușu, M. Popa, M. Mihai, L. Popa, M. Popescu, C. Giurcaneanu

The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Health organization in early March 2020. The disease typically presents with viral respiratory symptoms that could progress to acute respiratory dis-tress syndrome. Emerging evidence suggests different possible dermatologic manifestations of COVID-19, including: acral lesions (pernio-like, pseudo-chillblain), vesicular eruptions, macular and papular exanthema, urticaria, livedoid, purpuric and petechial rashes. However, specific skin manifestations of the COVID-19 disease have not yet been clearly established and the relationship between the appearance of skin lesions and SARS-CoV-2 infection is still unclear. These highly variable skin changes could represent a direct con-sequence of the viral infection, an immunological response to viral nucleotides, adverse reactions to drugs frequently used for the treatment of COVID-19, or other disorders. In a global effort to comprehend the exact cutaneous features of COVID-19, several international dermatological societies have initiated nationwide studies to analyze COVID-19 cutaneous manifestations during this pandemic. This paper represents a literature review of the scientific data available on the clinical characteristics and symptoms of the cutaneous manifestations associated with COVID-19. Such findings are extremely useful in establishing if dermatological manifestations in COVID-19 patients could harbor a diagnostic significance and subsequently be used as prognostic factors for outcomes of COVID-19. © 2020, Amaltea Medical Publishing House. All rights reserved.

2020年3月初，世界卫生组织宣布正在爆发的2019冠状病毒病（新冠肺炎）为大流行。这种疾病通常表现为病毒性呼吸道症状，可能发展为急性呼吸道应激综合征。新出现的证据表明，新冠肺炎可能有不同的皮肤病表现，包括：肢端病变（perniolike，pseudo-chillblain）、水疱性出疹、黄斑和乳头状皮疹、荨麻疹、livedoid、紫色和点状皮疹。然而，新冠肺炎疾病的具体皮肤表现尚未明确，皮肤病变的出现与SARS-CoV-2感染之间的关系仍不清楚。这些高度可变的皮肤变化可能代表病毒感染的直接序列、对病毒核苷酸的免疫反应、对常用于治疗新冠肺炎的药物的不良反应或其他疾病。为了了解新冠肺炎的确切皮肤特征，几个国际皮肤病学会发起了全国性研究，以分析这场大流行期间新冠肺炎的皮肤表现。本文对新冠肺炎相关皮肤表现的临床特征和症状的科学数据进行了文献综述。这些发现非常有助于确定新冠肺炎患者的皮肤学表现是否具有诊断意义，并随后被用作新冠肺炎预后的预后因素。©2020，Amaltea医学出版社。保留所有权利。

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引用次数: 0

Radiological aspects in patients diagnosed with SARS-CoV-2 infection – a literature review SARS-CoV-2感染患者的影像学特征——文献综述

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.2.3

M. Hoara, “Dr. Victor Babes” Infectious, A. Stoenescu, Nedeea Duță, P. Calistru, E. Ceaușu, S. Florescu, B. Pharmacy

Currently, SARS-CoV-2 infection has affected the entire population of the globe, registering an alarming increase in the number of cases, but also in deaths. The main clinical expression of COVID-19 is pneumonia, for its evaluation being necessary an imaging characterization of lung lesions both by chest radiography and by computed tomography (CT) of the chest. Vari-ous studies performed on groups of patients revealed that CT examination is more accurately in diagnosing lung lesions at the onset of symptoms, but also before it. The most common lesions were multiple, bilateral, peripheral, in the lower lung fields. The appearance often varies between alveolar consolidation and ground-glass. Also, the data from the relevant studies emphasize the possibility of the existence of early pathological aspects on CT acquisitions, which do not involve clinical expression. Thus, it can be stated that both investi-gations are crucial in assessing the impact of the new coronavirus infection on the lung parenchyma, but also in guiding therapeutic management. © 2020, Amaltea Medical Publishing House. All rights reserved.

目前，严重急性呼吸系统综合征冠状病毒2型感染已经影响到全球所有人口，病例数量和死亡人数都出现了惊人的增长。新冠肺炎的主要临床表现是肺炎，通过胸部放射线摄影和胸部计算机断层扫描（CT）对肺部病变进行成像表征是必要的。对一组患者进行的各种研究表明，CT检查在症状出现时更准确地诊断肺部病变，但在症状出现之前也更准确。最常见的病变是下肺野的多发性、双侧、外周性病变。肺泡实变和毛玻璃的外观通常各不相同。此外，来自相关研究的数据强调了CT采集中存在早期病理方面的可能性，这些方面不涉及临床表达。因此，可以说，这两项研究对于评估新型冠状病毒感染对肺实质的影响以及指导治疗管理都至关重要。©2020，Amaltea医学出版社。保留所有权利。

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引用次数: 0

Particular evolutive modalities in SARS-CoV-2 infection SARS-CoV-2感染的特殊进化模式

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.2.17

Ş. Lazăr, Adela Neculai, L. Musetescu, C. Marcu, S. Dinu, M. Nica, E. Ceaușu, S. Florescu, Carol Davila, B. Pharmacy

The COVID-19 pandemic has challenged the medical world in many ways regarding diagnosis troubles and therapeutic options. In this paper, we will present three cases of patients from different age groups, in which we identified specific ways of evolution, from both clinically and laboratory data point of view. We used a critical evolution risk estimation calculator at admission and compared the results with the subsequent evolution of patients. From the analysis of the presented cases, we found persistent organic damage that will require their long-term follow-up. © 2020, Amaltea Medical Publishing House. All rights reserved.

引用次数: 0

Acute ischemic stroke in a patient with gastrointestinal complaints of COVID-19 infection 新冠肺炎感染胃肠道主诉患者急性缺血性脑卒中1例

Q4 Immunology and Microbiology

Revista Romana de Boli Infectioase

Pub Date : 2020-06-30 DOI: 10.37897/rjid.2020.2.19

Oana Obrișcă, A. Arbune, M. Draghici, E. Davidescu, Ayghiul Mujdaba-Elmi, A. Dulamea, B. Pharmacy

The most important pandemic in the last century triggered by SARS-CoV-2 infection is ongoing, and long-term implications are still unknown. We report the case of a 65-year old man, who presented with sudden onset of right-sided limb weakness, facial asymmetry, and dysarthria, accompanied by vomiting and headache. The initial neurological exam suggested acute stroke, although the cerebral CT-scan was not relevant neither recent ischemic, nor haemorrhage findings. According to the therapeutic protocol, intravenous thrombolytic therapy was timely administered, with a neurofluctuating course. The infusion was premature interrupted due to the sudden hematemesis, following by concurrent diarrhoea, abdominal cramps and recurrent vomiting. The new cerebral imaging confirmed the acute ischemic stroke in the vertebrobasilar territory and the abdominal CT-exam displayed an inflammatory aspect inflammation surrounding the right kidney and the proxi-mal colon, minimal right pleural effusion and hypo-ventilated areas in the pulmonary bases. The laboratory work-up revealed mild leukocytosis with neutrophilia, increased levels of D-dimers, altered renal function. Considering the epidemic COVID-19, a RT-PCR test for SARS-CoV-2 have been request and, surprisingly, it was positive. Previous unknown paroxysmal atrial fibrillation was found at admission by electrocardiography, suggesting the cardioembolic nature of the ischemic stroke, while a favouring role of infection is possible. The subsequent evolution was positive, following by the secondary prevention with oral anticoagulation, along with hypotensive and statin medication. Apart from the respiratory affection, COVID-19 infection can be present in patients with other major medical emergencies, including acute stroke, with no apparent sign of infection. Additional signs of gastrointestinal affection, along with attentive evaluation of abdominal CT-scan represent important hints for concomitant SARS-CoV-2 infection. © 2020, Amaltea Medical Publishing House. All rights reserved.

由严重急性呼吸系统综合征冠状病毒2型感染引发的上个世纪最重要的流行病正在进行，其长期影响仍然未知。我们报告了一例65岁的男性，他突然出现右侧肢体无力、面部不对称和构音障碍，并伴有呕吐和头痛。最初的神经系统检查提示急性中风，尽管大脑CT扫描与近期缺血性和出血表现无关。根据治疗方案，及时进行静脉溶栓治疗，疗程有神经波动。由于突然吐血，输液过早中断，随后并发腹泻、腹部痉挛和反复呕吐。新的大脑成像证实了椎基底动脉区域的急性缺血性中风，腹部CT检查显示右肾和结肠下段周围有炎症，右侧胸腔积液很少，肺底通气不足。实验室检查显示轻度白细胞增多伴中性粒细胞增多，D-二聚体水平升高，肾功能改变。考虑到新冠肺炎的流行，已要求对SARS-CoV-2进行RT-PCR检测，令人惊讶的是，检测结果呈阳性。入院时心电图检查发现先前未知的阵发性心房颤动，这表明缺血性中风具有心脏栓塞性质，而感染可能起到有利作用。随后的进展是积极的，随后通过口服抗凝药物以及降压和他汀类药物进行二级预防。除了呼吸道感染外，新冠肺炎感染也可能出现在其他重大医疗紧急情况的患者中，包括急性中风，但没有明显的感染迹象。胃肠道疾病的其他迹象，以及对腹部CT扫描的仔细评估，是伴随严重急性呼吸系统综合征冠状病毒2型感染的重要提示。©2020，Amaltea医学出版社。保留所有权利。

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