M. Arbune, Liliana Baroiu, Gabriela Lupășteanu, Lucreţia Anghel, A. Arbune, C. Dumitru, A. Iancu
The current re-emergence of measles is a serious worldwide public health problem, favored by the decrease in vaccine coverage. Romania is noted for the highest number of illnesses and deaths in the European Union. The study analyzes the clinical-epidemiological characteristics of measles cases hospitalized in a county in south-eastern Romania, where the vaccine coverage with 2 doses of anti-measles vaccine is of 79.6%. We analyzed a number of 221 hospitalized cases confirmed with measles, according to the case definition, characterized by the predominance in unvaccinated infants, from the urban area, frequently diagnosed after the 4th day of illness, most of them with complicated forms of measles.
{"title":"Clinical and epidemiological features on re-emergence of measles in Galati County","authors":"M. Arbune, Liliana Baroiu, Gabriela Lupășteanu, Lucreţia Anghel, A. Arbune, C. Dumitru, A. Iancu","doi":"10.37897/rjid.2019.4.2","DOIUrl":"https://doi.org/10.37897/rjid.2019.4.2","url":null,"abstract":"The current re-emergence of measles is a serious worldwide public health problem, favored by the decrease in vaccine coverage. Romania is noted for the highest number of illnesses and deaths in the European Union. The study analyzes the clinical-epidemiological characteristics of measles cases hospitalized in a county in south-eastern Romania, where the vaccine coverage with 2 doses of anti-measles vaccine is of 79.6%. We analyzed a number of 221 hospitalized cases confirmed with measles, according to the case definition, characterized by the predominance in unvaccinated infants, from the urban area, frequently diagnosed after the 4th day of illness, most of them with complicated forms of measles.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49060291","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}
Manuela Arbune, Liliana Baroiu, Gabriela Lupăşteanu, Lucreţia Anghel, Anca A. Arbune, Caterina Dumitru, Alina-Viorica Iancu
Prof. dr. manuela arbune1,2, asist. univ. dr. liliana Baroiu1,2, drd. dr. gabriela lupăşteanu1,3, Şef lucr. dr. lucreţia anghel2,4, drd. dr. anca arbune5, Şef lucr. dr. caterina dumitru1,2, Şef lucr. dr. alina-Viorica iancu1,2 1 Spitalul Clinic de Boli Infecţioase, Galaţi, România 2 Facultatea de Medicină şi Farmacie, Universitatea "Dunărea de Jos", Galaţi, România 3 Universitatea „Ovidius“, Constanţa, România 4 Spitalul Clinic Judeţean de Urgenţă, Galaţi, România 5 Institutul Clinic Fundeni, Bucureşti, România STUDII CLINICE
Manuela arbone教授博士1.2，助理。Liliana Baroiu博士1,2，博士。加布里埃拉博士战列舰，1.3，主要工作。Anghel2,4博士。ancha arbone博士5，工作负责人。Caterina Dumitru 1.2博士，工作负责人。alina Viorica iancu博士1,2 1罗马尼亚加拉蒂传染病临床医院2罗马尼亚加拉蒂Dunărea de Jos大学医学与药学系3罗马尼亚康斯坦察Ovidius大学4罗马尼亚加拉蒂急诊县临床医院5罗马尼亚布加勒斯特Fundeni临床研究所
{"title":"Particularităţile clinico-epidemiologice ale reemergenţei rujeolei în judeţul Galaţi","authors":"Manuela Arbune, Liliana Baroiu, Gabriela Lupăşteanu, Lucreţia Anghel, Anca A. Arbune, Caterina Dumitru, Alina-Viorica Iancu","doi":"10.37897/rjid.2019.4.5","DOIUrl":"https://doi.org/10.37897/rjid.2019.4.5","url":null,"abstract":"Prof. dr. manuela arbune1,2, asist. univ. dr. liliana Baroiu1,2, drd. dr. gabriela lupăşteanu1,3, Şef lucr. dr. lucreţia anghel2,4, drd. dr. anca arbune5, Şef lucr. dr. caterina dumitru1,2, Şef lucr. dr. alina-Viorica iancu1,2 1 Spitalul Clinic de Boli Infecţioase, Galaţi, România 2 Facultatea de Medicină şi Farmacie, Universitatea \"Dunărea de Jos\", Galaţi, România 3 Universitatea „Ovidius“, Constanţa, România 4 Spitalul Clinic Judeţean de Urgenţă, Galaţi, România 5 Institutul Clinic Fundeni, Bucureşti, România STUDII CLINICE","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46609480","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}
Tudorița-Gabriela Părângă, Iași România Spitalul de Boli Infecțioase „Sfânta Parascheva“, Mariana Obreja, Claudia-Elena Pleșca, D. Leca, Larisa Miftode, Oana Stamateanu, Elisabeta Lupu, Egidia Miftode, Iași România Universitatea de Medicină și Farmacie „Gr.T. Popa“, Iaşi România Institutul Regional de Oncologie
dr. tudorița-gabriela părângă2, asist. univ. dr. maria obreja1, asist. univ. dr. claudia-Elena pleșca1,2, Şef lucr. dr. daniela leca1,2, asist. univ. dr. larisa miftode1,2, asist. univ. dr. oana stamateanu1,2, dr. Elisabeta lupu3, prof. dr. Egidia-gabriela miftode1,2 1 Universitatea de Medicină și Farmacie „Gr.T. Popa“, Iași, România 2 Spitalul de Boli Infecțioase „Sfânta Parascheva“, Iași, România 3 Institutul Regional de Oncologie, Iaşi, România PREZENTĂRI DE CAZ
{"title":"Importanța tabloului clinic în diagnosticul sindromului Guillain-Barré","authors":"Tudorița-Gabriela Părângă, Iași România Spitalul de Boli Infecțioase „Sfânta Parascheva“, Mariana Obreja, Claudia-Elena Pleșca, D. Leca, Larisa Miftode, Oana Stamateanu, Elisabeta Lupu, Egidia Miftode, Iași România Universitatea de Medicină și Farmacie „Gr.T. Popa“, Iaşi România Institutul Regional de Oncologie","doi":"10.37897/rjid.2019.4.6","DOIUrl":"https://doi.org/10.37897/rjid.2019.4.6","url":null,"abstract":"dr. tudorița-gabriela părângă2, asist. univ. dr. maria obreja1, asist. univ. dr. claudia-Elena pleșca1,2, Şef lucr. dr. daniela leca1,2, asist. univ. dr. larisa miftode1,2, asist. univ. dr. oana stamateanu1,2, dr. Elisabeta lupu3, prof. dr. Egidia-gabriela miftode1,2 1 Universitatea de Medicină și Farmacie „Gr.T. Popa“, Iași, România 2 Spitalul de Boli Infecțioase „Sfânta Parascheva“, Iași, România 3 Institutul Regional de Oncologie, Iaşi, România PREZENTĂRI DE CAZ","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47041862","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}
I. Ianache, Ş. Lazăr, I. Popa, A. Kosa, A. Luca, Ioana Petre, S. Florescu, C. Oprea, B. Pharmacy
background. HepCare Europe was a project co-funded by the European Commission with the scope to create and implement a model of HCV management (screening, linkage to care, treatment) for patients from key populations, through outreaching the community and to offer integrated primary and secondary care services. The aim of this sequential research inside the project was to evaluate the socio-demographic and clinical characteristics of HIV/HCV co-infected patients enrolled in HepCare Europe Project at Bucharest clinical site and to compare them to HCV-mono-infected patients. Methods. Prospective study on patients who tested positive for HCV antibodies (using rapid oral tests), part of them being linked to care at “Dr. Victor Babes” Clinical Hospital Bucharest, Romania (SVB), between April 2016 and April 2019. Socio-demographic and clinical characteristics of patients linked to care were compared according to their HIV status. Statistical analysis was performed using SPSS vs. 20.0. results. A total of 525 patients were screened for HCV antibodies using rapid oral tests, out of which 230 (43.8%) tested positive. Almost all of them were young males (85.2%) and injecting drug users (IDUs) (92.2%). 168 patients (73.0%) were linked to care, with 41.6% being coinfected with HIV. Liver fibrosis assessment was performed in 82.1% patients, almost a third of them having advanced liver fibrosis (27.5%). Plasma HCV-RNA was performed for half of the patients linked to care and 80.9% were detectable. Directing acting antivirals (DAA) treatment was initiated in 24 patients out of which 22 achieved SVR (sustained virological response) and 2 were non-responders (IDUs with genotype 3 treated with non-pan genotypic regimens). HIV-infection was associated with homelessness (p<0.0001), injecting drug use (p=0.001), NPS (new psychoactive substances) use in combination with opioids (p<0.0001), needle sharing (p<0.0001) and alcohol abuse (p<0.0001). The median CD4 cell count (/μl) and median plasma HIV-RNA (log10copies/ml) were 483 (IQR 290, 646) and 2.74 (IQR 1.27, 4.67), respectively. HCV-RNA was significantly higher in HIV/ HCV co-infected patients (p=0.047). conclusions. HIV/HCV co-infection was high among patients from key populations. HIV infection was associated with multiple risk factors and higher HCV-RNA. Socio-economic barriers and the lack of pan genotypic DAAs limited the treatment and outcomes in this group. This is the first pilot study on managing patients with HCV from key population in Romania.
背景。HepCare Europe是由欧盟委员会共同资助的一个项目，其范围是通过外展社区并提供综合初级和二级保健服务，为关键人群患者创建和实施一种HCV管理模式(筛查、与护理和治疗联系)。该项目的顺序研究的目的是评估在布加勒斯特临床点参加HepCare欧洲项目的HIV/HCV合并感染患者的社会人口统计学和临床特征，并将其与HCV单一感染患者进行比较。方法。对HCV抗体检测呈阳性的患者(使用快速口服检测)进行前瞻性研究，其中部分患者与2016年4月至2019年4月期间在罗马尼亚布加勒斯特“Dr. Victor Babes”临床医院(SVB)的护理有关。根据患者的艾滋病毒状况比较与护理相关的患者的社会人口统计学和临床特征。采用SPSS vs. 20.0进行统计学分析。结果。使用快速口服试验对525例患者进行了HCV抗体筛查，其中230例(43.8%)检测呈阳性。其中绝大多数为年轻男性(85.2%)和注射吸毒者(92.2%)。168名患者(73.0%)与护理相关，其中41.6%合并感染艾滋病毒。82.1%的患者进行了肝纤维化评估，其中近三分之一(27.5%)为晚期肝纤维化。半数接受治疗的患者进行了血浆HCV-RNA检测，80.9%的患者可检测到HCV-RNA。24名患者开始了指导作用抗病毒药物(DAA)治疗，其中22名患者实现了SVR(持续病毒学应答)，2名无应答(基因型为3的idu接受非泛基因型方案治疗)。艾滋病毒感染与无家可归(p<0.0001)、注射吸毒(p=0.001)、新型精神活性物质与阿片类药物联合使用(p<0.0001)、共用针头(p<0.0001)和酗酒(p<0.0001)有关。CD4细胞计数中位数(/μl)和血浆HIV-RNA中位数(log10copies/ml)分别为483 (IQR 290、646)和2.74 (IQR 1.27、4.67)。HCV- rna在HIV/ HCV合并感染患者中显著升高(p=0.047)。结论。重点人群中HIV/HCV合并感染率较高。HIV感染与多种危险因素和较高的HCV-RNA相关。社会经济障碍和缺乏泛基因型daa限制了该组的治疗和结果。这是罗马尼亚首个关于管理关键人群HCV患者的试点研究。
{"title":"Integrated care services for Romanian HIV/HCV co-infected patients from key populations – lessons learned from HepCare Europe Project experience in Bucharest clinical site","authors":"I. Ianache, Ş. Lazăr, I. Popa, A. Kosa, A. Luca, Ioana Petre, S. Florescu, C. Oprea, B. Pharmacy","doi":"10.37897/rjid.2019.4.1","DOIUrl":"https://doi.org/10.37897/rjid.2019.4.1","url":null,"abstract":"background. HepCare Europe was a project co-funded by the European Commission with the scope to create and implement a model of HCV management (screening, linkage to care, treatment) for patients from key populations, through outreaching the community and to offer integrated primary and secondary care services. The aim of this sequential research inside the project was to evaluate the socio-demographic and clinical characteristics of HIV/HCV co-infected patients enrolled in HepCare Europe Project at Bucharest clinical site and to compare them to HCV-mono-infected patients. Methods. Prospective study on patients who tested positive for HCV antibodies (using rapid oral tests), part of them being linked to care at “Dr. Victor Babes” Clinical Hospital Bucharest, Romania (SVB), between April 2016 and April 2019. Socio-demographic and clinical characteristics of patients linked to care were compared according to their HIV status. Statistical analysis was performed using SPSS vs. 20.0. results. A total of 525 patients were screened for HCV antibodies using rapid oral tests, out of which 230 (43.8%) tested positive. Almost all of them were young males (85.2%) and injecting drug users (IDUs) (92.2%). 168 patients (73.0%) were linked to care, with 41.6% being coinfected with HIV. Liver fibrosis assessment was performed in 82.1% patients, almost a third of them having advanced liver fibrosis (27.5%). Plasma HCV-RNA was performed for half of the patients linked to care and 80.9% were detectable. Directing acting antivirals (DAA) treatment was initiated in 24 patients out of which 22 achieved SVR (sustained virological response) and 2 were non-responders (IDUs with genotype 3 treated with non-pan genotypic regimens). HIV-infection was associated with homelessness (p<0.0001), injecting drug use (p=0.001), NPS (new psychoactive substances) use in combination with opioids (p<0.0001), needle sharing (p<0.0001) and alcohol abuse (p<0.0001). The median CD4 cell count (/μl) and median plasma HIV-RNA (log10copies/ml) were 483 (IQR 290, 646) and 2.74 (IQR 1.27, 4.67), respectively. HCV-RNA was significantly higher in HIV/ HCV co-infected patients (p=0.047). conclusions. HIV/HCV co-infection was high among patients from key populations. HIV infection was associated with multiple risk factors and higher HCV-RNA. Socio-economic barriers and the lack of pan genotypic DAAs limited the treatment and outcomes in this group. This is the first pilot study on managing patients with HCV from key population in Romania.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45001765","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}
Liliana Baroiu, M. Arbune, A. Iancu, C. Dumitru, Gabriela Lupășteanu, M. Draganescu, M. Debita, S. Rugina, Dunărea de Jos
Clostridium difficile infection (CDI) associates in the spectrum of comorbidities, more and more often, chronic toxic metabolic or viral hepatic diseases. Patients with chronic hepatic diseases have more severe episodes of CDI with poorer prognosis than episodes of CDI that have occurred in patients with other comorbidities. The measures of prophylaxis and treatment of CDI in these patients require particularizations according to the risk factors and the clinical-evolutionary specificity of these patients. The present study aims to identify the main risk factors of these patients for CDI, as well as to evaluate the severity of the episodes of CDI, the rate of recurrence and death in these patients, compared to those without liver disease.
{"title":"Clostridium difficile infection in patients with chronic hepatic disease","authors":"Liliana Baroiu, M. Arbune, A. Iancu, C. Dumitru, Gabriela Lupășteanu, M. Draganescu, M. Debita, S. Rugina, Dunărea de Jos","doi":"10.37897/rjid.2019.3.1","DOIUrl":"https://doi.org/10.37897/rjid.2019.3.1","url":null,"abstract":"Clostridium difficile infection (CDI) associates in the spectrum of comorbidities, more and more often, chronic toxic metabolic or viral hepatic diseases. Patients with chronic hepatic diseases have more severe episodes of CDI with poorer prognosis than episodes of CDI that have occurred in patients with other comorbidities. The measures of prophylaxis and treatment of CDI in these patients require particularizations according to the risk factors and the clinical-evolutionary specificity of these patients. The present study aims to identify the main risk factors of these patients for CDI, as well as to evaluate the severity of the episodes of CDI, the rate of recurrence and death in these patients, compared to those without liver disease.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48044878","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}
Revista Română de Boli infecţioase – Volumul XXII, Nr. 3, An 2019 Autor de corespondenţă: Dr. Cătălin Bejinariu, Secţia de Chirurgie Plastică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Şoseaua Berceni nr. 12, cod 041915, Bucureşti, România E-mail: drbejinariu@gmail.com Consideraţii CliniCe şi opţiuni de tratament în infeCţiile piCiorului Cu StaphylococcuS aureuS
{"title":"Consideraţii clinice şi opţiuni de tratament în infecţiile piciorului cu Staphylococcus aureus","authors":"Cătălin Bejinariu, C. Giuglea, Silviu Marinescu","doi":"10.37897/rjid.2019.3.5","DOIUrl":"https://doi.org/10.37897/rjid.2019.3.5","url":null,"abstract":"Revista Română de Boli infecţioase – Volumul XXII, Nr. 3, An 2019 Autor de corespondenţă: Dr. Cătălin Bejinariu, Secţia de Chirurgie Plastică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Şoseaua Berceni nr. 12, cod 041915, Bucureşti, România E-mail: drbejinariu@gmail.com Consideraţii CliniCe şi opţiuni de tratament în infeCţiile piCiorului Cu StaphylococcuS aureuS","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46938825","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}
Liliana Baroiu, Manuela Arbune, Alina-Viorica Iancu, Caterina Dumitru, Gabriela Lupăşteanu, Miruna Drăgănescu, Mihaela Debita, Sorin Rugină, România Spitalul Clinic de Boli Infecţioase Galaţi, Constanţa România Universitatea „Ovidius“, Academia de Ştiinţe Medicale din România, România Academia de Ştiinţe Medicale
{"title":"Infecţia cu Clostridium difficile la pacienţii cu afectare cronică hepatică","authors":"Liliana Baroiu, Manuela Arbune, Alina-Viorica Iancu, Caterina Dumitru, Gabriela Lupăşteanu, Miruna Drăgănescu, Mihaela Debita, Sorin Rugină, România Spitalul Clinic de Boli Infecţioase Galaţi, Constanţa România Universitatea „Ovidius“, Academia de Ştiinţe Medicale din România, România Academia de Ştiinţe Medicale","doi":"10.37897/rjid.2019.3.4","DOIUrl":"https://doi.org/10.37897/rjid.2019.3.4","url":null,"abstract":"","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48060472","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}
Objectives. Foot cellulitis caused by Staphylococcus aureus raises multiple problems regarding early diagnosis and choice of the optimal treatment, especially in diabetic patients. The research aims to research clinical and prognostic features related to patients diagnosed with foot cellulitis. Material and methods. The study presents the clinical and prognostic features of 41 patients who received treatment at the "Bagdasar-Arseni" Emergency Clinical Hospital. Outcomes. The results of the analysis show that cellulitis caused by Staphylococcus aureus is associated with a favorable prognosis in the case of the rapid establishment of specific antibiotic treatment in combination with serial excisional debridement. conclusions. It is well known that the late establishment of therapeutic measures can have devastating consequences, culminating in the death of the patient. However, it should not be neglected that the combination of the surgical treatment with the specific antibiotic therapy can most often be the salvage solution for these difficult cases.
{"title":"Clinical considerations and treatment options in Staphylococcus aureus foot infections","authors":"Catalin Bejinariu, C. Giuglea, S. Marinescu","doi":"10.37897/rjid.2019.3.2","DOIUrl":"https://doi.org/10.37897/rjid.2019.3.2","url":null,"abstract":"Objectives. Foot cellulitis caused by Staphylococcus aureus raises multiple problems regarding early diagnosis and choice of the optimal treatment, especially in diabetic patients. The research aims to research clinical and prognostic features related to patients diagnosed with foot cellulitis. Material and methods. The study presents the clinical and prognostic features of 41 patients who received treatment at the \"Bagdasar-Arseni\" Emergency Clinical Hospital. Outcomes. The results of the analysis show that cellulitis caused by Staphylococcus aureus is associated with a favorable prognosis in the case of the rapid establishment of specific antibiotic treatment in combination with serial excisional debridement. conclusions. It is well known that the late establishment of therapeutic measures can have devastating consequences, culminating in the death of the patient. However, it should not be neglected that the combination of the surgical treatment with the specific antibiotic therapy can most often be the salvage solution for these difficult cases.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43727211","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. Hoara, S. Florescu, S. Pișcu, G. Țârdei, P. Calistru, “Dr. Victor Babes” Infectious, B. Pharmacy
Introduction. Coxiella burnetii is the etiological agent of Q fever, a zoonosis that is still subject of „Query”. Formerly classified as a Rickettsia, C. burnetii is a highly infectious obligate intracellular bacteria, whose main animal reservoirs are cattle, sheep and goats. Commonly following transmission through inhalation of aerosols containing the pathogen spread during animal parturition, Q fever may present as a self-limited febrile illness, pneumonia or acute hepatitis. Nevertheless, the possibility of evolving towards a chronic form exists under certain circumstances, mainly involving previously affected heart valves or blood vessels. Diagnosis is usually serologically based and Doxycycline represents the most frequent choice of antibiotherapy. Objectives. The aim of this study is to analyse the clinical and laboratory settings that led to diagnosis of acute or chronic Q fever, the treatment regimens applied and consecutive outcome within the group of patients defined below. Materials and methods. The present paper represents an observational descriptive study performed on a group composed of 24 patients admitted in our hospital along 2018 and diagnosed with confirmed or probable acute or chronic Q fever. Both male and female subjects regardless of their age were included, under the condition of meeting the CDC case definition, by integrating the serological results into the clinical context. results and conclusions. A suggestive epidemiological frame was rarely proven. Out of the 24 subjects with ages between 34 and 80 years old, of which only 2 were women, 22 had acute Q fever, manifested mostly as a combination of atypical pneumonia and hepatitis (9 cases, representing 41. Only 2 of the acute Q fever cases had a confirmed diagnosis. Frequent complaints were fever (all cases), chills, headaches and vomiting. Only 28% of the radiologically confirmed pneumonias were accompanied by dry cough, whilst only 21% of the hepatitis cases associated jaundice. Biologically, although leukocytosis was more weakly cor-related with acute disease activity, all patients exhibited a moderate to high inflammatory response (through C reactive protein). Considering the latency of specific antibodies’ dosage results, the decision of initiating treatment was based on a clinical support. Antibiotherapy consisted of Doxycyclin, alone or in combinations meant to cover a larger spectrum, given the usually nonspecific symptoms and the initially low clinical suspicion for Q fever. Clinical evolution was favorable in all cases. Regarding the two patients with chronic Q fever, manifested as blood culture-negative endocarditis, of which only one was confirmed according to the CDC definition, both had presented valvular lesions before developing IE and had no history of acute infection with C. burnetii. In the first case, under empirical infective endocarditis agents (Ceftriaxone and Vancomycin), acute heart failure and necessity of surgical replacement of the affected
{"title":"Clinical and evolutive aspects of Coxiella burnetii infection","authors":"M. Hoara, S. Florescu, S. Pișcu, G. Țârdei, P. Calistru, “Dr. Victor Babes” Infectious, B. Pharmacy","doi":"10.37897/rjid.2019.2.2","DOIUrl":"https://doi.org/10.37897/rjid.2019.2.2","url":null,"abstract":"Introduction. Coxiella burnetii is the etiological agent of Q fever, a zoonosis that is still subject of „Query”. Formerly classified as a Rickettsia, C. burnetii is a highly infectious obligate intracellular bacteria, whose main animal reservoirs are cattle, sheep and goats. Commonly following transmission through inhalation of aerosols containing the pathogen spread during animal parturition, Q fever may present as a self-limited febrile illness, pneumonia or acute hepatitis. Nevertheless, the possibility of evolving towards a chronic form exists under certain circumstances, mainly involving previously affected heart valves or blood vessels. Diagnosis is usually serologically based and Doxycycline represents the most frequent choice of antibiotherapy. Objectives. The aim of this study is to analyse the clinical and laboratory settings that led to diagnosis of acute or chronic Q fever, the treatment regimens applied and consecutive outcome within the group of patients defined below. Materials and methods. The present paper represents an observational descriptive study performed on a group composed of 24 patients admitted in our hospital along 2018 and diagnosed with confirmed or probable acute or chronic Q fever. Both male and female subjects regardless of their age were included, under the condition of meeting the CDC case definition, by integrating the serological results into the clinical context. results and conclusions. A suggestive epidemiological frame was rarely proven. Out of the 24 subjects with ages between 34 and 80 years old, of which only 2 were women, 22 had acute Q fever, manifested mostly as a combination of atypical pneumonia and hepatitis (9 cases, representing 41. Only 2 of the acute Q fever cases had a confirmed diagnosis. Frequent complaints were fever (all cases), chills, headaches and vomiting. Only 28% of the radiologically confirmed pneumonias were accompanied by dry cough, whilst only 21% of the hepatitis cases associated jaundice. Biologically, although leukocytosis was more weakly cor-related with acute disease activity, all patients exhibited a moderate to high inflammatory response (through C reactive protein). Considering the latency of specific antibodies’ dosage results, the decision of initiating treatment was based on a clinical support. Antibiotherapy consisted of Doxycyclin, alone or in combinations meant to cover a larger spectrum, given the usually nonspecific symptoms and the initially low clinical suspicion for Q fever. Clinical evolution was favorable in all cases. Regarding the two patients with chronic Q fever, manifested as blood culture-negative endocarditis, of which only one was confirmed according to the CDC definition, both had presented valvular lesions before developing IE and had no history of acute infection with C. burnetii. In the first case, under empirical infective endocarditis agents (Ceftriaxone and Vancomycin), acute heart failure and necessity of surgical replacement of the affected","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42817190","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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