Pub Date : 2021-08-18DOI: 10.11648/J.IJIDT.20210603.14
Zhu Wenfang, Zhang Yiwen
Introduction: Pulmonary infection is a common disease in respiratory department. Different pathogens may lead to the same clinical symptoms and imaging changes, and the same pathogen may also lead to different clinical symptoms and imaging changes. It is often difficult to identify specific pathogens in pulmonary infection. Sometimes the patient’s condition is delayed due to the doctor’s inability to judge the specific pathogen well and the failure to carry out targeted treatment. We share this case and hope that doctors can enhance their understanding of this disease, minimize misdiagnosis and enhance the accuracy of disease diagnosis. Case report: This case reported a patient with recurrent fever, which was misdiagnosed as Mycobacterium tuberculosis infection and developed high fever after diagnostic anti-tuberculosis treatment. The posterior pleural effusion next-generation sequencing (NGS) confirmed that the patient was empyema caused by streptococcus pharyngitis combined with anaerobic infection. After anti-infection with teicoplanin and levofloxacin, the patient's body temperature was normal, lung shadow and pleural effusion were completely absorbed. Discussion/Conclusions: In clinical work, we should be vigilant against false positive T cell spot test (T-SPOT.TB), make rational use of NGS and other detection methods, identify specific pathogens as soon as possible, and carry out reasonable targeted treatment.
{"title":"Streptococcus Pharyngitis with Anaerobes Infection Misdiagnosed as Mycobacterium Tuberculosis Infection: A Case Report","authors":"Zhu Wenfang, Zhang Yiwen","doi":"10.11648/J.IJIDT.20210603.14","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210603.14","url":null,"abstract":"Introduction: Pulmonary infection is a common disease in respiratory department. Different pathogens may lead to the same clinical symptoms and imaging changes, and the same pathogen may also lead to different clinical symptoms and imaging changes. It is often difficult to identify specific pathogens in pulmonary infection. Sometimes the patient’s condition is delayed due to the doctor’s inability to judge the specific pathogen well and the failure to carry out targeted treatment. We share this case and hope that doctors can enhance their understanding of this disease, minimize misdiagnosis and enhance the accuracy of disease diagnosis. Case report: This case reported a patient with recurrent fever, which was misdiagnosed as Mycobacterium tuberculosis infection and developed high fever after diagnostic anti-tuberculosis treatment. The posterior pleural effusion next-generation sequencing (NGS) confirmed that the patient was empyema caused by streptococcus pharyngitis combined with anaerobic infection. After anti-infection with teicoplanin and levofloxacin, the patient's body temperature was normal, lung shadow and pleural effusion were completely absorbed. Discussion/Conclusions: In clinical work, we should be vigilant against false positive T cell spot test (T-SPOT.TB), make rational use of NGS and other detection methods, identify specific pathogens as soon as possible, and carry out reasonable targeted treatment.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"6 1","pages":"116"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43976313","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}
Pub Date : 2021-03-04DOI: 10.11648/J.IJIDT.20210601.16
Hui Liu, Suishan Qiu, Qinai Zhu, Lianfang Xue
Objective: To assess the effect of orthopedic perioperative antibiotic prophylaxis intervention by clinical pharmacist. Methods: 1467 hospitalized patients in department of orthopedics with perioperative records in eight months in 2019 were chosen. 597 surgical cases before intervention were sampled as the control group, and 870 surgical records were sampled as intervention group. Investigation and analysis were performed in orthopedic perioperative prophylactic antibiotics. Results: Compared with the control group, the intervention group showed increased rationalities and decreased irrationalities in perioperative antibiotic prophylaxis. The unreasonable external use of teicoplanin was significantly decreased, and the postoperative prophylaxis duration was significantly shortened. There were no significant difference in the timing of perioperative antibiotic prophylaxis between two groups. Conclusions: After interventions for the preventive use of antibacterial drugs in orthopedic perioperative period, the rational use of antibacterial drugs has been significantly improved, the irrational use of drugs has been improved, and the effect of drug treatment has been improved. However, there is still a gap between the rational use of antibacterial drugs. Further strengthen supervision and management.
{"title":"The Intervening Effect of Preventive Use of Antibacterials During the Perioperative Period in Orthopedic Department","authors":"Hui Liu, Suishan Qiu, Qinai Zhu, Lianfang Xue","doi":"10.11648/J.IJIDT.20210601.16","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210601.16","url":null,"abstract":"Objective: To assess the effect of orthopedic perioperative antibiotic prophylaxis intervention by clinical pharmacist. Methods: 1467 hospitalized patients in department of orthopedics with perioperative records in eight months in 2019 were chosen. 597 surgical cases before intervention were sampled as the control group, and 870 surgical records were sampled as intervention group. Investigation and analysis were performed in orthopedic perioperative prophylactic antibiotics. Results: Compared with the control group, the intervention group showed increased rationalities and decreased irrationalities in perioperative antibiotic prophylaxis. The unreasonable external use of teicoplanin was significantly decreased, and the postoperative prophylaxis duration was significantly shortened. There were no significant difference in the timing of perioperative antibiotic prophylaxis between two groups. Conclusions: After interventions for the preventive use of antibacterial drugs in orthopedic perioperative period, the rational use of antibacterial drugs has been significantly improved, the irrational use of drugs has been improved, and the effect of drug treatment has been improved. However, there is still a gap between the rational use of antibacterial drugs. Further strengthen supervision and management.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"6 1","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42490805","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}
Pub Date : 2021-02-27DOI: 10.11648/J.IJIDT.20210601.15
Syeda Rida-e-Zehra, S. Kausar, A. Latif, Samar Abbas Jaffri, S. Hussain, I. Ahsan, M. Rafay, P. Bhatti
Currently, COVID-19 is one of the most pressing healthcare problems across the world. With no definitive pharmacological guidelines, multiple drugs were used to treat critical patients with little success. of Tocilizumab, a monoclonal antibody has shown some role in the treatment of Covid-19 infection. The study was a cross-sectional prospective observational study. It was conducted in the COVID-19 Intensive Care Unit (ICU) of Liaquat National Hospital and Medical College, and National Medical Centre Karachi. The study was conducted from 15th June 2020 to 31st July 2020. Objective of the study was to compare the outcomes of severe to critical COVID-19 patients with established Cytokine release Syndrome (CRS), who received Tocilizumab with the group received Tocilizumab followed by intravenous immunoglobulins (IVIG). Two groups were made with one receiving Tocilizumab alone while the other received IVIG after Tocilizumab. Comparison was then made based on frequency of mortality as well the need of mechanical ventilation and its range of days. In results 4 (15.4%) patients in Tocilizumab only group died while Tocilizumab followed by IVIG treated group had 10 (38.46%) deaths. 20 (76.9%) patients needed mechanical ventilation in Tocilizumab only group while Tocilizumab followed by IVIG treated group consisted of 23 (88.46%) patients. This concludes that the group with only Tocilizumab therapy has better outcome as compare to the group who received both Tocilizumab and intravenous immunoglobulins.
{"title":"Outcome Comparison Between Tocilizumab Alone Vs Tocilizumab Followed by Intravenous Immunoglobulin (IVIG) Group in Critical COVID-19 Disease","authors":"Syeda Rida-e-Zehra, S. Kausar, A. Latif, Samar Abbas Jaffri, S. Hussain, I. Ahsan, M. Rafay, P. Bhatti","doi":"10.11648/J.IJIDT.20210601.15","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210601.15","url":null,"abstract":"Currently, COVID-19 is one of the most pressing healthcare problems across the world. With no definitive pharmacological guidelines, multiple drugs were used to treat critical patients with little success. of Tocilizumab, a monoclonal antibody has shown some role in the treatment of Covid-19 infection. The study was a cross-sectional prospective observational study. It was conducted in the COVID-19 Intensive Care Unit (ICU) of Liaquat National Hospital and Medical College, and National Medical Centre Karachi. The study was conducted from 15th June 2020 to 31st July 2020. Objective of the study was to compare the outcomes of severe to critical COVID-19 patients with established Cytokine release Syndrome (CRS), who received Tocilizumab with the group received Tocilizumab followed by intravenous immunoglobulins (IVIG). Two groups were made with one receiving Tocilizumab alone while the other received IVIG after Tocilizumab. Comparison was then made based on frequency of mortality as well the need of mechanical ventilation and its range of days. In results 4 (15.4%) patients in Tocilizumab only group died while Tocilizumab followed by IVIG treated group had 10 (38.46%) deaths. 20 (76.9%) patients needed mechanical ventilation in Tocilizumab only group while Tocilizumab followed by IVIG treated group consisted of 23 (88.46%) patients. This concludes that the group with only Tocilizumab therapy has better outcome as compare to the group who received both Tocilizumab and intravenous immunoglobulins.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"6 1","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2021-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43481980","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 A Soltan, L E Crowley, C R Melville, J Varney, S Cassidy, R Mahida, F S Grudzinska, D Parekh, D P Dosanjh, D R Thickett
Background: Internationally, researchers have called for evidence to support tackling health inequalities during the severe acute respiratory syndrome coronavirus 2 (COVID19) pandemic. Despite the 2020 Marmot review highlighting growing health gaps between wealthy and deprived areas, studies have not explored social determinants of health (ethnicity, frailty, comorbidities, household overcrowding, housing quality, air pollution) as modulators of presentation, intensive care unit (ITU) admissions and outcomes among COVID19 patients. There is an urgent need for studies examining social determinants of health including socioenvironmental risk factors in urban areas to inform the national and international landscape.
Methods: An in-depth retrospective cohort study of 408 hospitalized COVID19 patients admitted to the Queen Elizabeth Hospital, Birmingham was conducted. Quantitative data analyses including a two-step cluster analysis were applied to explore the role of social determinants of health as modulators of presentation, ITU admission and outcomes.
Results: Patients admitted from highest Living Environment deprivation indices were at increased risk of presenting with multi-lobar pneumonia and, in turn, ITU admission whilst patients admitted from highest Barriers to Housing and Services (BHS) deprivation Indies were at increased risk of ITU admission. Black, Asian and Minority Ethnic (BAME) patients were more likely, than Caucasians, to be admitted from regions of highest Living Environment and BHS deprivation, present with multi-lobar pneumonia and require ITU admission.
Conclusion: Household overcrowding deprivation and presentation with multi-lobar pneumonia are potential modulators of ITU admission. Air pollution and housing quality deprivation are potential modulators of presentation with multi-lobar pneumonia. BAME patients are demographically at increased risk of exposure to household overcrowding, air pollution and housing quality deprivation, are more likely to present with multi-lobar pneumonia and require ITU admission. Irrespective of deprivation, consideration of the Charlson Comorbidity Score and the Clinical Frailty Score supports clinicians in stratifying high risk patients.
{"title":"To What Extent do Social Determinants of Health Modulate Presentation, ITU Admission and Outcomes among Patients with SARS-COV-2 Infection? An Exploration of Household Overcrowding, Air Pollution, Housing Quality, Ethnicity, Comorbidities and Frailty.","authors":"M A Soltan, L E Crowley, C R Melville, J Varney, S Cassidy, R Mahida, F S Grudzinska, D Parekh, D P Dosanjh, D R Thickett","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Internationally, researchers have called for evidence to support tackling health inequalities during the severe acute respiratory syndrome coronavirus 2 (COVID19) pandemic. Despite the 2020 Marmot review highlighting growing health gaps between wealthy and deprived areas, studies have not explored social determinants of health (ethnicity, frailty, comorbidities, household overcrowding, housing quality, air pollution) as modulators of presentation, intensive care unit (ITU) admissions and outcomes among COVID19 patients. There is an urgent need for studies examining social determinants of health including socioenvironmental risk factors in urban areas to inform the national and international landscape.</p><p><strong>Methods: </strong>An in-depth retrospective cohort study of 408 hospitalized COVID19 patients admitted to the Queen Elizabeth Hospital, Birmingham was conducted. Quantitative data analyses including a two-step cluster analysis were applied to explore the role of social determinants of health as modulators of presentation, ITU admission and outcomes.</p><p><strong>Results: </strong>Patients admitted from highest Living Environment deprivation indices were at increased risk of presenting with multi-lobar pneumonia and, in turn, ITU admission whilst patients admitted from highest Barriers to Housing and Services (BHS) deprivation Indies were at increased risk of ITU admission. Black, Asian and Minority Ethnic (BAME) patients were more likely, than Caucasians, to be admitted from regions of highest Living Environment and BHS deprivation, present with multi-lobar pneumonia and require ITU admission.</p><p><strong>Conclusion: </strong>Household overcrowding deprivation and presentation with multi-lobar pneumonia are potential modulators of ITU admission. Air pollution and housing quality deprivation are potential modulators of presentation with multi-lobar pneumonia. BAME patients are demographically at increased risk of exposure to household overcrowding, air pollution and housing quality deprivation, are more likely to present with multi-lobar pneumonia and require ITU admission. Irrespective of deprivation, consideration of the Charlson Comorbidity Score and the Clinical Frailty Score supports clinicians in stratifying high risk patients.</p>","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"9 Suppl 2","pages":"1000002"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9353607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-09DOI: 10.11648/J.IJIDT.20210601.13
R. Moreira, Mariana Alencar Miranda, Jessica Muller, S. W. Cardoso, R. Moreira, E. Nunes, R. Griep, M. Fonseca, V. Veloso, B. Grinsztejn, D. Chor, A. Pacheco
Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.
{"title":"Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro","authors":"R. Moreira, Mariana Alencar Miranda, Jessica Muller, S. W. Cardoso, R. Moreira, E. Nunes, R. Griep, M. Fonseca, V. Veloso, B. Grinsztejn, D. Chor, A. Pacheco","doi":"10.11648/J.IJIDT.20210601.13","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210601.13","url":null,"abstract":"Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"6 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47770280","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}
Pub Date : 2021-02-09DOI: 10.11648/J.IJIDT.20210601.12
Emmanuel Peace Chukwuzurum, Ebenezer Daniel, O. Popoola, P. Abiodun, A. Bello, Kabir Yunusa Amari, CHRISTIE OMOLOLA ADAMS, O. Ojo, O. Olagbegi, Gabriel Omoniyi Ayeni, I. Popoola
Malaria is a life threatening infectious disease that constitutes a major global public health and economic concern. Consequently, the WHO has recommended a T3 initiative (Test, Treat & Track) to help curb the scourge globally. This study aimed to ascertain the efficacy of malaria diagnosis in malaria case management and perception of community pharmacists on the WHO recommended standard of parasitological diagnosis before commencement of treatment within Abuja metropolis. A descriptive cross sectional study was performed amongst 207 community pharmacists within Abuja Metropolis. Data was obtained through structured, self-administered questionnaire. The association of respondent characteristics with the awareness, practice, and perception of malaria testing, and treatment was evaluated by Chi-square analysis for proportion. Where the number of categories was less than five, Fisher exact test was used. Seventy-two percent (72.9%) were aware of the WHO recommended T3 initiative on malaria case management. However, less than 10% of respondents had training in all the three components. On practice, 28.5% of community pharmacists carry out malaria diagnosis with a confirmatory test before instituting treatment. Ninety-two percent (92.3%) treat malaria based on clinical signs and symptoms only. Despite the high rate of clinical diagnosis, a majority (84.1%) agreed that the confirmatory test is more effective and efficient in malaria case management than clinical diagnosis. Most respondents (60.4%) reported that the confirmatory test most readily available was mRDT. Eighty-seven percent (87%) have good perception on parasitological confirmatory testing for malaria diagnosis and most respondents have confidence in results from the malaria confirmatory test while 68.6% trust their malaria confirmatory test skill. A little above half (52.7%) of the respondents treat for malaria regardless of negative confirmatory test results when the patient insists on treatment. A higher proportion (39%) of male community Pharmacists compared to females carry out malaria diagnosis with a confirmatory test before treatment. There was significant association of perception on the efficacy of a parasitological confirmatory test for malaria with age and work experience and there was significant association of work experience with the practice of confirmatory testing before treatment (P<0.05). Inferentially, this is call to action for government, professional bodies in the health sector and all committed to fight the scourge of malaria for more awareness to the general public on importance of the WHO T3 and capacity strengthening for the frontline health workers – community pharmacy attending to community needs on malaria case management.
{"title":"Malaria Diagnosis and Treatment: Perception of Community Pharmacists in Abuja Metropolis, Nigeria","authors":"Emmanuel Peace Chukwuzurum, Ebenezer Daniel, O. Popoola, P. Abiodun, A. Bello, Kabir Yunusa Amari, CHRISTIE OMOLOLA ADAMS, O. Ojo, O. Olagbegi, Gabriel Omoniyi Ayeni, I. Popoola","doi":"10.11648/J.IJIDT.20210601.12","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210601.12","url":null,"abstract":"Malaria is a life threatening infectious disease that constitutes a major global public health and economic concern. Consequently, the WHO has recommended a T3 initiative (Test, Treat & Track) to help curb the scourge globally. This study aimed to ascertain the efficacy of malaria diagnosis in malaria case management and perception of community pharmacists on the WHO recommended standard of parasitological diagnosis before commencement of treatment within Abuja metropolis. A descriptive cross sectional study was performed amongst 207 community pharmacists within Abuja Metropolis. Data was obtained through structured, self-administered questionnaire. The association of respondent characteristics with the awareness, practice, and perception of malaria testing, and treatment was evaluated by Chi-square analysis for proportion. Where the number of categories was less than five, Fisher exact test was used. Seventy-two percent (72.9%) were aware of the WHO recommended T3 initiative on malaria case management. However, less than 10% of respondents had training in all the three components. On practice, 28.5% of community pharmacists carry out malaria diagnosis with a confirmatory test before instituting treatment. Ninety-two percent (92.3%) treat malaria based on clinical signs and symptoms only. Despite the high rate of clinical diagnosis, a majority (84.1%) agreed that the confirmatory test is more effective and efficient in malaria case management than clinical diagnosis. Most respondents (60.4%) reported that the confirmatory test most readily available was mRDT. Eighty-seven percent (87%) have good perception on parasitological confirmatory testing for malaria diagnosis and most respondents have confidence in results from the malaria confirmatory test while 68.6% trust their malaria confirmatory test skill. A little above half (52.7%) of the respondents treat for malaria regardless of negative confirmatory test results when the patient insists on treatment. A higher proportion (39%) of male community Pharmacists compared to females carry out malaria diagnosis with a confirmatory test before treatment. There was significant association of perception on the efficacy of a parasitological confirmatory test for malaria with age and work experience and there was significant association of work experience with the practice of confirmatory testing before treatment (P<0.05). Inferentially, this is call to action for government, professional bodies in the health sector and all committed to fight the scourge of malaria for more awareness to the general public on importance of the WHO T3 and capacity strengthening for the frontline health workers – community pharmacy attending to community needs on malaria case management.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64794918","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}
Pub Date : 2021-01-05DOI: 10.11648/J.IJIDT.20210601.11
I. Basse, N. Seck, Lamine Thiam, D. Boiro, A. A. Ndongo, A. Sow, A. Fall, M. Cissé, N. Ndiaye, Dina Obambi, N. Guèye, O. Ndiaye
Introduction: Purulent pleurisy refers to the presence in the large pleural cavity of a purulent, cloudy or lemon-yellow liquid, but containing altered polynuclear cells. It is a frequent pathology, the epidemiology of which is constantly changing in Africa and throughout the world. This is why we conducted this study with the aim of updating epidemiological, clinical, bacteriological and therapeutic data. Methods: This is a retrospective, mono-centric, descriptive study including the records of children aged 0 to 15 years old hospitalized during the period from 20 May 2014 to 26 March 2019 at the Children's Hospital of Diamniadio for purulent pleurisy. The data were entered and analyzed using sphinx, Excel under Windows 8 and SPSS software. Results: We counted 42 cases of purulent pleurisy, i.e. a hospital frequency of 0.7%. Most of the patients were aged between 2 and 12 years (48%). The average age at diagnosis was 46 months. The sex ratio was 2.5. Most of the children came from parents with a low socio-economic status (64%); fever was the most frequent reason for consultation (50%), followed by cough (33%) and respiratory difficulty (29%). In all cases, a liquid effusion syndrome was objectively diagnosed (100%), tachycardia in 36% of cases and a pulmonary condensation syndrome in 33% of patients. X-rays showed a predominantly right-sided effusion (62%) which was very abundant in 71% of cases. In bacteriology, staphylococcus aureus was the most frequently isolated germ (75%), followed by streptococcus pneumoniae (20%) and group D streptococcus (5%). Biology showed an average hemoglobin level of 9.2 and there was a predominantly neutrophilic hyperleukocytosis in 98% of cases. All patients had received antibiotic therapy and pleural drainage in 76% of cases. Mortality was 10%. Conclusion: In the light of this work, we insist on the importance of early diagnosis and adequate management of purulent pleurisy in order to avoid complications and after-effects. Thus, antibiotic therapy should be more closely monitored, and its administration better codified to reduce bacterial resistance and germ selection.
{"title":"Purulent Pleurisy of Children: About 42 Cases in Senegal","authors":"I. Basse, N. Seck, Lamine Thiam, D. Boiro, A. A. Ndongo, A. Sow, A. Fall, M. Cissé, N. Ndiaye, Dina Obambi, N. Guèye, O. Ndiaye","doi":"10.11648/J.IJIDT.20210601.11","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20210601.11","url":null,"abstract":"Introduction: Purulent pleurisy refers to the presence in the large pleural cavity of a purulent, cloudy or lemon-yellow liquid, but containing altered polynuclear cells. It is a frequent pathology, the epidemiology of which is constantly changing in Africa and throughout the world. This is why we conducted this study with the aim of updating epidemiological, clinical, bacteriological and therapeutic data. Methods: This is a retrospective, mono-centric, descriptive study including the records of children aged 0 to 15 years old hospitalized during the period from 20 May 2014 to 26 March 2019 at the Children's Hospital of Diamniadio for purulent pleurisy. The data were entered and analyzed using sphinx, Excel under Windows 8 and SPSS software. Results: We counted 42 cases of purulent pleurisy, i.e. a hospital frequency of 0.7%. Most of the patients were aged between 2 and 12 years (48%). The average age at diagnosis was 46 months. The sex ratio was 2.5. Most of the children came from parents with a low socio-economic status (64%); fever was the most frequent reason for consultation (50%), followed by cough (33%) and respiratory difficulty (29%). In all cases, a liquid effusion syndrome was objectively diagnosed (100%), tachycardia in 36% of cases and a pulmonary condensation syndrome in 33% of patients. X-rays showed a predominantly right-sided effusion (62%) which was very abundant in 71% of cases. In bacteriology, staphylococcus aureus was the most frequently isolated germ (75%), followed by streptococcus pneumoniae (20%) and group D streptococcus (5%). Biology showed an average hemoglobin level of 9.2 and there was a predominantly neutrophilic hyperleukocytosis in 98% of cases. All patients had received antibiotic therapy and pleural drainage in 76% of cases. Mortality was 10%. Conclusion: In the light of this work, we insist on the importance of early diagnosis and adequate management of purulent pleurisy in order to avoid complications and after-effects. Thus, antibiotic therapy should be more closely monitored, and its administration better codified to reduce bacterial resistance and germ selection.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49290370","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}
Pub Date : 2020-11-04DOI: 10.11648/J.IJIDT.20200504.14
I. Basse, P. Faye, A. Sow, Marie Acakpo, N. Seck, Lamine Thiam, N. Ndiaye, Dina Obambi, D. Boiro, A. A. Ndongo, N. Guèye, O. Ndiaye
Introduction: Despite much progress, purulent childhood meningitis (PCM) remains a public health problem. The objective of this work was to determine the epidemiological, clinical, therapeutic and evolutionary profile of purulent meningitis in children. Methods: Based on retrospective work carried out over a 4-year period (01 January 2014 to 31 December 2017), we studied the epidemiological, clinical, therapeutic and evolutionary aspects of cases of purulent meningitis hospitalized in the pediatric ward of the Children's Hospital of Diamniadio. Included were all children from 29 days to 15 years of age in whom the diagnosis of purulent meningitis was confirmed by the laboratory. Results: The hospital frequency was 1.9%. The mean age of the patients was 41.0 months. Among the affected children, 68.6% were fully vaccinated. The main germ was Neisseria meningitidis W135 (58.8%). Third generation cephalosporins were the antibiotics of choice (97.1%). No resistance was found to them. The cure rate with sequelae was 5.7%. Streptococcus pneumoniae was the germ responsible for 50% of the objective sequelae. The mortality rate was 7.1%. Conclusion: Neisseria meningitidis W135 is the main germ of purulent meningitis in our study. It is not included in the national routine immunization. It is imperative to adapt vaccination to the epidemiological fluctuation of pathogens in our regions.
{"title":"Purulent Meningitis in Children: A Retrospective Study of 70 Cases in Senegal","authors":"I. Basse, P. Faye, A. Sow, Marie Acakpo, N. Seck, Lamine Thiam, N. Ndiaye, Dina Obambi, D. Boiro, A. A. Ndongo, N. Guèye, O. Ndiaye","doi":"10.11648/J.IJIDT.20200504.14","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20200504.14","url":null,"abstract":"Introduction: Despite much progress, purulent childhood meningitis (PCM) remains a public health problem. The objective of this work was to determine the epidemiological, clinical, therapeutic and evolutionary profile of purulent meningitis in children. Methods: Based on retrospective work carried out over a 4-year period (01 January 2014 to 31 December 2017), we studied the epidemiological, clinical, therapeutic and evolutionary aspects of cases of purulent meningitis hospitalized in the pediatric ward of the Children's Hospital of Diamniadio. Included were all children from 29 days to 15 years of age in whom the diagnosis of purulent meningitis was confirmed by the laboratory. Results: The hospital frequency was 1.9%. The mean age of the patients was 41.0 months. Among the affected children, 68.6% were fully vaccinated. The main germ was Neisseria meningitidis W135 (58.8%). Third generation cephalosporins were the antibiotics of choice (97.1%). No resistance was found to them. The cure rate with sequelae was 5.7%. Streptococcus pneumoniae was the germ responsible for 50% of the objective sequelae. The mortality rate was 7.1%. Conclusion: Neisseria meningitidis W135 is the main germ of purulent meningitis in our study. It is not included in the national routine immunization. It is imperative to adapt vaccination to the epidemiological fluctuation of pathogens in our regions.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"5 1","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44498868","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}
Pub Date : 2020-10-17DOI: 10.11648/J.IJIDT.20200504.13
S. Badreddine, M. Zammo, A. Elhosiny, Mohanna Walid Alhomsy, Y. Aldabbagh, Abdullah Sameer Mansouri, Sara Hesham Taha, Reem Yahya ALQuraa, A. A. A. Nahdi, A. Eissa, H. Faruqui, N. Ahmed, Ahmad Alzahrani, N. Bahabri
Background: Since the first case of SARS-CoV 2 has been reported from Wuhan China back in December 2019, the virus has spread all over the world and has so far infected more than 35 million humans and led to more than one million deaths woldwide. We describe in this paper the clinical characteristics and outcome of PCR confirmed Covid 19 patients that were admitted to a tertiary care hospital in Saudi Arabia. Methods: Retrospective review of patients that had positive PCR on nasopharyngeal swab for SARS Cov2 and that were admitted and discharged from a tertiary care hospital in the city of Jeddah, Saudi Arabia between March and July 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of patients was reviewed. Risk factors for involvement of lower respiratory tract (Pneumonia), for need for ICU and for death were analyzed. Results: The records of total of 395 patients were reviewed. 15% of Covid 19 patients in our population were completely asymptomatic, one quarter of which had abnormalities on chest imaging. Among the patients with one or more Covid 19 symptoms, 75% had lower respiratory tract involvement and one quarter had normal chest imaging. One third of all patients developed leukopenia and around 2 thirds had lymphocytopenia. Thrombocytopenia was not common (occurred in 15%), 29% of our patients had CRP>10 and 25.1% had elevated ALT (not exceeding 5 times upper normal). Nine percent of our patients needed ICU admission, 3.8% needed mechanical ventilation. 9 patients (2.3%) in our population died. Advancing age, increasing BMI, and smoking history were significantly associated with increased mortality. Developing abnormalities on chest imaging (Pneumonia) was significantly associated with increasing BMI, advancing age, not receiving BCG vaccination at birth, history of smoking and presence of co-morbidities (p value less 0.05 with all these variables). Blood group and presence of co-morbidities was significantly associated with need for ICU care but not with mortality. In our population neither ethnicity, nor gender, had significant association with hospital course or outcome, and no one younger than 45 years and no one with BMI less than 24 died. Conclusion: Advancing age, increasing BMI and history of smoking were found to be significant risk factors for mortality in our population. History of Bacille calmette Guerin (BCG) vaccination was significantly associated with less involvement of lower respiratory tract but had no significant association with final outcome. Asymptomatic Covid 19 is more of a silent active infection rather than a silent inactive carrier state.
{"title":"Clinical Course and Outcome of 395 Covid 19 Patients Admitted to One Hospital in Jeddah- Saudi Arabia","authors":"S. Badreddine, M. Zammo, A. Elhosiny, Mohanna Walid Alhomsy, Y. Aldabbagh, Abdullah Sameer Mansouri, Sara Hesham Taha, Reem Yahya ALQuraa, A. A. A. Nahdi, A. Eissa, H. Faruqui, N. Ahmed, Ahmad Alzahrani, N. Bahabri","doi":"10.11648/J.IJIDT.20200504.13","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20200504.13","url":null,"abstract":"Background: Since the first case of SARS-CoV 2 has been reported from Wuhan China back in December 2019, the virus has spread all over the world and has so far infected more than 35 million humans and led to more than one million deaths woldwide. We describe in this paper the clinical characteristics and outcome of PCR confirmed Covid 19 patients that were admitted to a tertiary care hospital in Saudi Arabia. Methods: Retrospective review of patients that had positive PCR on nasopharyngeal swab for SARS Cov2 and that were admitted and discharged from a tertiary care hospital in the city of Jeddah, Saudi Arabia between March and July 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of patients was reviewed. Risk factors for involvement of lower respiratory tract (Pneumonia), for need for ICU and for death were analyzed. Results: The records of total of 395 patients were reviewed. 15% of Covid 19 patients in our population were completely asymptomatic, one quarter of which had abnormalities on chest imaging. Among the patients with one or more Covid 19 symptoms, 75% had lower respiratory tract involvement and one quarter had normal chest imaging. One third of all patients developed leukopenia and around 2 thirds had lymphocytopenia. Thrombocytopenia was not common (occurred in 15%), 29% of our patients had CRP>10 and 25.1% had elevated ALT (not exceeding 5 times upper normal). Nine percent of our patients needed ICU admission, 3.8% needed mechanical ventilation. 9 patients (2.3%) in our population died. Advancing age, increasing BMI, and smoking history were significantly associated with increased mortality. Developing abnormalities on chest imaging (Pneumonia) was significantly associated with increasing BMI, advancing age, not receiving BCG vaccination at birth, history of smoking and presence of co-morbidities (p value less 0.05 with all these variables). Blood group and presence of co-morbidities was significantly associated with need for ICU care but not with mortality. In our population neither ethnicity, nor gender, had significant association with hospital course or outcome, and no one younger than 45 years and no one with BMI less than 24 died. Conclusion: Advancing age, increasing BMI and history of smoking were found to be significant risk factors for mortality in our population. History of Bacille calmette Guerin (BCG) vaccination was significantly associated with less involvement of lower respiratory tract but had no significant association with final outcome. Asymptomatic Covid 19 is more of a silent active infection rather than a silent inactive carrier state.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"5 1","pages":"118"},"PeriodicalIF":0.0,"publicationDate":"2020-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48588616","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}
Pub Date : 2020-10-13DOI: 10.11648/J.IJIDT.20200504.12
J. Coursen, P. Roth, C. Schrank, J. Schrank
Several studies have established outpatient parenteral antibiotic therapy (OPAT) as an alternative to prolonged inpatient stays to reduce healthcare expenditure, decrease hospital admission times, and increase patient satisfaction. However, studies have also shown significant adverse events occurring while receiving treatment outpatient. We collected retrospective data through electronic medical record review on all patients discharged on IV antibiotics whose OPAT was managed by the infectious disease specialists at Greenville Health System between 1/1/17 and 6/30/17. There were a total of 336 individual patients discharged on OPAT during the 6 month period. Bacteremia (25.4%), osteomyelitis (14.9%), and diabetic foot infections (12.8%) were the most common indications for OPAT with methicillin-sensitive staphylococcus aureus (MSSA) being the most common organism targeted (22.5%). 11% of patients had a medication change during their treatment course. The most common reasons were nausea/malaise (26%) and acute kidney injury (26%). Our hospital re-admission rate was 8.7%. Statistical analysis of the data indicated that home infusion was significantly more likely to result in re-admission compared to the infusion center (p=0.02). Also receiving antibiotics for osteomyelitis was more likely to result in re-admission compared to other diagnoses (p=0.048). Our data indicates that self-administration of antibiotics at home results in higher re-admission rates compared to administration at infusion centers. Factors that may contribute to this difference such as compliance, co-morbidities, or frequency of nurse assessments warrant further exploration to optimize the safety of OPAT, especially in rural South Carolina.
{"title":"The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina","authors":"J. Coursen, P. Roth, C. Schrank, J. Schrank","doi":"10.11648/J.IJIDT.20200504.12","DOIUrl":"https://doi.org/10.11648/J.IJIDT.20200504.12","url":null,"abstract":"Several studies have established outpatient parenteral antibiotic therapy (OPAT) as an alternative to prolonged inpatient stays to reduce healthcare expenditure, decrease hospital admission times, and increase patient satisfaction. However, studies have also shown significant adverse events occurring while receiving treatment outpatient. We collected retrospective data through electronic medical record review on all patients discharged on IV antibiotics whose OPAT was managed by the infectious disease specialists at Greenville Health System between 1/1/17 and 6/30/17. There were a total of 336 individual patients discharged on OPAT during the 6 month period. Bacteremia (25.4%), osteomyelitis (14.9%), and diabetic foot infections (12.8%) were the most common indications for OPAT with methicillin-sensitive staphylococcus aureus (MSSA) being the most common organism targeted (22.5%). 11% of patients had a medication change during their treatment course. The most common reasons were nausea/malaise (26%) and acute kidney injury (26%). Our hospital re-admission rate was 8.7%. Statistical analysis of the data indicated that home infusion was significantly more likely to result in re-admission compared to the infusion center (p=0.02). Also receiving antibiotics for osteomyelitis was more likely to result in re-admission compared to other diagnoses (p=0.048). Our data indicates that self-administration of antibiotics at home results in higher re-admission rates compared to administration at infusion centers. Factors that may contribute to this difference such as compliance, co-morbidities, or frequency of nurse assessments warrant further exploration to optimize the safety of OPAT, especially in rural South Carolina.","PeriodicalId":73792,"journal":{"name":"Journal of infectious disease and therapy","volume":"5 1","pages":"112"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49481483","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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