Infectious Disease Reports

8 pages, 254 KiB

Open AccessOpinion

How to Treat COVID-19 Patients at Home in the Italian Context: An Expert Opinion

by Davide Roberto Donno, Ignazio Grattagliano, Alessandro Rossi, Pierangelo Lora Aprile, Gerardo Medea, Erik Lagolio, Guido Granata, Nicola Petrosillo and Claudio Cricelli

Infect. Dis. Rep. 2021, 13(1), 251-258; https://doi.org/10.3390/idr13010028 - 20 Mar 2021

Cited by 11 | Viewed by 5984

Abstract

The impact of the coronavirus disease (COVID-19), caused by the novel coronavirus SARS-CoV-2, continues to be widespread, with more than 100 million cases diagnosed in more than 220 countries since the virus was first identified in January 2020. Although patients with mild to [...] Read more.

The impact of the coronavirus disease (COVID-19), caused by the novel coronavirus SARS-CoV-2, continues to be widespread, with more than 100 million cases diagnosed in more than 220 countries since the virus was first identified in January 2020. Although patients with mild to moderate forms of COVID-19 could be efficiently managed at home, thus reducing the pressure on the healthcare system and minimizing socio-psychological impact on patients, no trial has been proposed, conducted, or even published on COVID-19 home therapy to date. These expert opinions provide indications on the therapeutical at home management of COVID-19 patients, based on the evidence from the literature and on current guidelines. Full article

(This article belongs to the Section Viral Infections)

12 pages, 8222 KiB

Open AccessArticle

A Dynamic Bayesian Model for Identifying High-Mortality Risk in Hospitalized COVID-19 Patients

by Amir Momeni-Boroujeni, Rachelle Mendoza, Isaac J. Stopard, Ben Lambert and Alejandro Zuretti

Infect. Dis. Rep. 2021, 13(1), 239-250; https://doi.org/10.3390/idr13010027 - 18 Mar 2021

Cited by 8 | Viewed by 5859

Abstract

As Coronavirus Disease 2019 (COVID-19) hospitalization rates remain high, there is an urgent need to identify prognostic factors to improve patient outcomes. Existing prognostic models mostly consider the impact of biomarkers at presentation on the risk of a single patient outcome at a [...] Read more.

As Coronavirus Disease 2019 (COVID-19) hospitalization rates remain high, there is an urgent need to identify prognostic factors to improve patient outcomes. Existing prognostic models mostly consider the impact of biomarkers at presentation on the risk of a single patient outcome at a single follow up time. We collected data for 553 Polymerase Chain Reaction (PCR)-positive COVID-19 patients admitted to hospital whose eventual outcomes were known. The data collected for the patients included demographics, comorbidities and laboratory values taken at admission and throughout the course of hospitalization. We trained multivariate Markov prognostic models to identify high-risk patients at admission along with a dynamic measure of risk incorporating time-dependent changes in patients’ laboratory values. From the set of factors available upon admission, the Markov model determined that age >80 years, history of coronary artery disease and chronic obstructive pulmonary disease increased mortality risk. The lab values upon admission most associated with mortality included neutrophil percentage, red blood cells (RBC), red cell distribution width (RDW), protein levels, platelets count, albumin levels and mean corpuscular hemoglobin concentration (MCHC). Incorporating dynamic changes in lab values throughout hospitalization lead to dramatic gains in the predictive accuracy of the model and indicated a catalogue of variables for determining high-risk patients including eosinophil percentage, white blood cells (WBC), platelets, pCO2, RDW, large unstained cells (LUC) count, alkaline phosphatase and albumin. Our prognostic model highlights the nuance of determining risk for COVID-19 patients and indicates that, rather than a single variable, a range of factors (at different points in hospitalization) are needed for effective risk stratification. Full article

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9 pages, 265 KiB

Open AccessArticle

Insight into Kytococcus schroeteri Infection Management: A Case Report and Review

by Shelly Bagelman and Gunda Zvigule-Neidere

Infect. Dis. Rep. 2021, 13(1), 230-238; https://doi.org/10.3390/idr13010026 - 14 Mar 2021

Cited by 7 | Viewed by 2632

Abstract

Background: Kytococcus schroeteri is a member of normal skin microflora, which can cause lethal infections in immunosuppressed hosts. In this review we attempted to draw patterns of its pathogenicity, which seem to vary regarding host immune status and the presence of implantable devices. [...] Read more.

Background: Kytococcus schroeteri is a member of normal skin microflora, which can cause lethal infections in immunosuppressed hosts. In this review we attempted to draw patterns of its pathogenicity, which seem to vary regarding host immune status and the presence of implantable devices. Evidence suggests this pathogen houses many resistance-forming proteins, which serve to exacerbate the challenge in curing it. Available information on K. schroeteri antibacterial susceptibility is scarce. In this situation, a novel, genome-based antibiotic resistance analysis model, previously suggested by Su et al., could aid clinicians dealing with unknown infections. In this study we merged data from observed antibiotic resistance patterns with resistance data demonstrated by DNA sequences. Methods: We reviewed all available articles and reports on K. schroeteri, from peer-reviewed online databases (ClinicalKey, PMC, Scopus and WebOfScience). Information on patients was then subdivided into patient profiles and tabulated independently. We later performed K. schroeteri genome sequence analysis for resistance proteins to understand the trends K. schroeteri exhibits. Results: K. schroeteri is resistant to beta-lactams, macrolides and clindamycin. It is susceptible to aminoglycosides, tetracyclines and rifampicin. We combined data from the literature review and sequence analysis and found evidence for the existence of PBP, PBP-2A and efflux pumps as likely determinants of K. schroeteri. Conclusions: Reviewing the data permits the speculation that baseline immune status plays a role in the outcome of a Kytococcal infection. Nonetheless, our case report demonstrates that the outcome of a lower baseline immunity could still be favorable, possibly using rifampicin in first-line treatment of infection caused by K. schroeteri. Full article

11 pages, 1433 KiB

Open AccessArticle

Characterization of Neonatal Infections by Gram-Negative Bacilli and Associated Risk Factors, Havana, Cuba

by Arlenis Oliva, Yenisel Carmona, Elizabeth de La C. López, Roberto Álvarez, Meiji Soe Aung, Nobumichi Kobayashi and Dianelys Quiñones

Infect. Dis. Rep. 2021, 13(1), 219-229; https://doi.org/10.3390/idr13010025 - 09 Mar 2021

Cited by 2 | Viewed by 2170

Abstract

Infections represent an important problem in neonates because of the high mortality. An increase in neonatal infections has been found in Cuban hospitals in recent years. The aim of this study was to provide evidence on the clinical and microbiological behavior of Gram-negative [...] Read more.

Infections represent an important problem in neonates because of the high mortality. An increase in neonatal infections has been found in Cuban hospitals in recent years. The aim of this study was to provide evidence on the clinical and microbiological behavior of Gram-negative bacilli that cause neonatal infections in hospitals of Havana, Cuba. It was carried out as a descriptive cross-sectional investigation from September 2017 to July 2018 in The Tropical Medicine Institute “Pedro Kouri” (IPK). Sixty-one Gram-negative bacilli isolated from neonates with infections in six Gyneco-Obstetric and Pediatric Hospitals of Havana were analyzed for their species and antimicrobial susceptibility. Late-onset infections were more common than early-onset ones and included urinary tract infection in the community (87%) and sepsis in hospitals (63.3%). Catheter use (47%) and prolonged stay (38%) were the most frequent risk factors. Species of major pathogens were Escherichia coli (47%) and Klebsiella spp. (26%). The isolated Gram-negative bacilli showed high resistance rates to third-generation cephalosporins, ciprofloxacin and gentamicin, while being more susceptible to carbapenems, fosfomycin, colistin and amikacin. The present study revealed the clinical impact of Gram-negative bacilli in neonatology units in hospitals of Havana. Evaluation of antimicrobial susceptibilities to the isolates from neonates is necessary for selection of appropriate empirical therapy and promotion of the rational antibiotic use. Full article

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4 pages, 660 KiB

Open AccessCase Report

North Italy: Welcome to the Tropics!

by Federica Veronese, Francesca Graziola, Pamela Farinelli, Elisa Zavattaro, Vanessa Tarantino, Elia Esposto and Paola Savoia

Infect. Dis. Rep. 2021, 13(1), 215-218; https://doi.org/10.3390/idr13010024 - 05 Mar 2021

Cited by 1 | Viewed by 3386

Abstract

We describe a case of cutaneous Larva Migrans in an 8-year-old Caucasian girl. The lesion appeared ten days after a bath in the river in a valley in the north-east of Piedmont. The patient was successfully treated with Albendazole 400 mg daily for [...] Read more.

We describe a case of cutaneous Larva Migrans in an 8-year-old Caucasian girl. The lesion appeared ten days after a bath in the river in a valley in the north-east of Piedmont. The patient was successfully treated with Albendazole 400 mg daily for 5 days. Autochthonous cases are rare, particularly in northern Italy. Probably the high temperatures and the high degree of humidity favored by the climate changes to which Europe is subjected are favorable to the development of larvae. The diagnosis of cutaneous Larva Migrans should, therefore, be considered also in individuals who have not traveled in geographic areas at risk for the climate. Full article

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10 pages, 237 KiB

Open AccessArticle

A Case-Control Study on the Association between Salmonella Bacteriuria and Cystoscopy

by Eugene Y. H. Yeung

Infect. Dis. Rep. 2021, 13(1), 205-214; https://doi.org/10.3390/idr13010023 - 01 Mar 2021

Cited by 2 | Viewed by 2672

Abstract

To date, there is only one published report of an outbreak of urinary tract infections by Salmonella species after cystoscopy. Disinfection procedures for cystoscope have come into question. The current study aimed to determine the odds of developing Salmonella bacteriuria after cystoscopy. A [...] Read more.

To date, there is only one published report of an outbreak of urinary tract infections by Salmonella species after cystoscopy. Disinfection procedures for cystoscope have come into question. The current study aimed to determine the odds of developing Salmonella bacteriuria after cystoscopy. A retrospective case-control study was conducted on all patients with Salmonella species in urine (case) and blood (control) from 2017 to 2019 in 16 hospitals in Eastern Ontario, Canada. Eight of the 11 patients had cystoscopy prior to Salmonella bacteriuria; three of the 74 patients had urological procedures prior to Salmonella bacteremia, but none of their procedures were cystoscopy. The odds ratio of urological procedures with Salmonella bacteriuria was 63.1 (95% CI 10.9 to 366.6; p < 0.0001). In the bacteriuria group, the most frequently identified isolates were Salmonella enteritidis (n = 8), followed by Salmonella oranienburg, and Salmonella heidelberg. Seven of the S. enteritidis isolates had identical susceptibilities (ampicillin-sensitive; sulfamethoxazole/trimethoprim-sensitive; ciprofloxacin intermediate). In the bacteremia group, the most frequently identified isolates were S. enteritidis (n = 22), followed by Salmonella typhi, S. heidelberg, S. oranienburg, and Salmonella typhimurium. The result suggested cystoscopy is a risk factor for Salmonella bacteriuria. Identification of Salmonella bacteriuria should prompt public health investigations of linkage between cystoscopy and Salmonella bacteriuria. Full article

14 pages, 904 KiB

Open AccessArticle

Nasopharyngeal Carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) among Sickle Cell Disease (SCD) Children in the Pneumococcal Conjugate Vaccine Era

by Nicholas T. K. D. Dayie, Deborah N. K. Sekoh, Fleischer C. N. Kotey, Beverly Egyir, Patience B. Tetteh-Quarcoo, Kevin Kofi Adutwum-Ofosu, John Ahenkorah, Mary-Magdalene Osei and Eric S. Donkor

Infect. Dis. Rep. 2021, 13(1), 191-204; https://doi.org/10.3390/idr13010022 - 01 Mar 2021

Cited by 6 | Viewed by 2656

Abstract

The aim of this cross-sectional study was to investigate Staphylococcus aureus nasopharyngeal carriage epidemiology in relation to other nasopharyngeal bacterial colonizers among sickle cell disease (SCD) children about five years into pneumococcal conjugate vaccine 13 (PCV-13) introduction in Ghana. The study involved bacteriological [...] Read more.

The aim of this cross-sectional study was to investigate Staphylococcus aureus nasopharyngeal carriage epidemiology in relation to other nasopharyngeal bacterial colonizers among sickle cell disease (SCD) children about five years into pneumococcal conjugate vaccine 13 (PCV-13) introduction in Ghana. The study involved bacteriological culture of nasopharyngeal swabs obtained from 202 SCD children recruited from the Princess Marie Louise Children’s Hospital. S. aureus isolates were identified using standard methods and subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method. Cefoxitin-resistant S. aureus isolates were screened for carriage of the mecA, pvl, and tsst-1 genes using multiplex polymerase chain reaction. The carriage prevalence of S. aureus was 57.9% (n = 117), and that of methicillin-resistant S. aureus (MRSA) was 3.5% (n = 7). Carriage of the mecA, pvl, and tsst-1 genes were respectively demonstrated in 20.0% (n = 7), 85.7% (n = 30), and 11.4% (n = 4) of the cefoxitin-resistant S. aureus isolates. PCV-13 vaccination (OR = 0.356, p = 0.004) and colonization with coagulase-negative staphylococci (CoNS) (OR = 0.044, p < 0.0001) each protected against S. aureus carriage. However, none of these and other features of the participants emerged as a determinant of MRSA carriage. The following antimicrobial resistance rates were observed in MRSA compared to methicillin-sensitive S. aureus: clindamycin (28.6% vs. 4.3%), erythromycin (42.9% vs. 19.1%), tetracycline (100% vs. 42.6%), teicoplanin (14.3% vs. 2.6%), penicillin (100% vs. 99.1%), amoxiclav (28.6% vs. 3.5%), linezolid (14.3% vs. 0.0%), ciprofloxacin (42.9% vs. 13.9%), and gentamicin (42.9% vs. 13.0%). The proportion of S. aureus isolates that were multidrug resistant was 37.7% (n = 46). We conclude that S. aureus was the predominant colonizer of the nasopharynx of the SCD children, warranting the continuous monitoring of this risk group for invasive S. aureus infections. Full article

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4 pages, 447 KiB

Open AccessCase Report

Deranged Coagulation Profile Secondary to Cefazolin Use: Case Report

by Jinghao Nicholas Ngiam, Tze Sian Liong, Sai Meng Tham, Thanawin Pramotedham, Rawan AlAgha, Joy Yong, Paul Anantharajah Tambyah and Lionel Hon Wai Lum

Infect. Dis. Rep. 2021, 13(1), 187-190; https://doi.org/10.3390/idr13010021 - 01 Mar 2021

Cited by 4 | Viewed by 2382

Abstract

Cefazolin is a widely used first-generation cephalosporin. While generally well tolerated, several case reports have described severe coagulopathy induced by intravenous (IV) cefazolin. This was seen particularly in patients with impaired renal function, where antibiotic choice is limited and may require specific dose [...] Read more.

Cefazolin is a widely used first-generation cephalosporin. While generally well tolerated, several case reports have described severe coagulopathy induced by intravenous (IV) cefazolin. This was seen particularly in patients with impaired renal function, where antibiotic choice is limited and may require specific dose adjustments. Altered renal handling of antibiotics and their metabolites may potentiate toxicity and side effects. We report a case of a 72-year-old Chinese man who had been treated for methicillin-sensitive staphylococcus aureus (MSSA, coagulase-positive) infective endocarditis with cefazolin and, consequently, developed significantly elevated international normalised ratio (INR) while on therapy. This resolved within 48 h after cessation of cefazolin and administration of oral vitamin K. Malnourished patients with pre-existing or acute kidney injury may be at an increased risk of cefazolin-related coagulopathy. Full article

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6 pages, 17184 KiB

Open AccessCase Report

Intracranial Tuberculoma Mimicking Neurosarcoidosis: A Clinical Challenge

by Fatemah Abbasi, Muhammet Ozer, Kirti Juneja, Suleyman Yasin Goksu, Babak Jamasian Mobarekah and Marc S. Whitman

Infect. Dis. Rep. 2021, 13(1), 181-186; https://doi.org/10.3390/idr13010020 - 01 Mar 2021

Cited by 5 | Viewed by 4695

Abstract

Central nervous system (CNS) tuberculosis is a rare manifestation of all tuberculosis presentations. The incidence of brain tuberculoma is increasing in developed countries due to HIV infection and immigration from tuberculosis-endemic countries. Symptoms and radiologic findings of CNS tuberculosis can be non-specific and [...] Read more.

Central nervous system (CNS) tuberculosis is a rare manifestation of all tuberculosis presentations. The incidence of brain tuberculoma is increasing in developed countries due to HIV infection and immigration from tuberculosis-endemic countries. Symptoms and radiologic findings of CNS tuberculosis can be non-specific and lead to misdiagnosis or mistreatment. Intracranial tuberculoma can present with a seizure, intracranial hypertension, or focal neurologic symptoms. In our case, the diagnosis was challenging between neurosarcoidosis and intracranial tuberculoma due to inconclusive results of stereotactic brain biopsy and clinical presentation. The pathology result of the open brain biopsy revealed non-caseating granuloma. Finally, we were able to diagnose intracranial tuberculoma following acid-fast bacilli culture results of open brain biopsy. This report highlights the importance of including intracranial tuberculoma in the differential diagnosis of cerebral space-occupying lesions, even in patients with negative laboratory findings of tuberculosis. Full article

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8 pages, 730 KiB

Open AccessArticle

Detection of Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae in Culture Negative Cerebrospinal Fluid Samples from Meningitis Patients Using a Multiplex Polymerase Chain Reaction in Nepal

by Supriya Sharma, Jyoti Acharya, Dominique A. Caugant, Megha Raj Banjara, Prakash Ghimire and Anjana Singh

Infect. Dis. Rep. 2021, 13(1), 173-180; https://doi.org/10.3390/idr13010019 - 01 Mar 2021

Cited by 2 | Viewed by 2853

Abstract

The rapid identification of bacteria causing meningitis is crucial as delays in the treatment increase mortality rate. Though considered as the gold standard for the laboratory diagnosis of bacterial meningitis, culture might give false negative results in a case of patients under antibiotics [...] Read more.

The rapid identification of bacteria causing meningitis is crucial as delays in the treatment increase mortality rate. Though considered as the gold standard for the laboratory diagnosis of bacterial meningitis, culture might give false negative results in a case of patients under antibiotics prior to lumbar puncture. This study aimed to detect Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae by a multiplex polymerase chain reaction (PCR) in culture-negative cerebrospinal fluid samples collected from clinically suspected meningitis cases attending different hospitals in Kathmandu, Nepal from January 2017 to December 2019. S. pneumoniae, N. meningitidis and H. influenzae were detected in 8.59% (33/384) of the specimens by PCR and 7.55% (29/384) of the specimens by culture. Correlation between culture and PCR of the same sample was good (Spearman’s rho correlation coefficient = 0.932). However, the difference in positivity between culture and PCR was statistically not significant (p value > 0.05). In four specimens, culture could not detect any of the targeted bacteria whereas PCR could detect presence of H. influenzae. PCR increases the diagnostic yield for bacterial meningitis. PCR may be considered as an adjunctive test for establishing the cause of infection in culture negative clinically suspected meningitis cases. Full article

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7 pages, 229 KiB

Open AccessCommunication

Seroprevalence and Molecular Detection of Brucellosis in Hospitalized Patients in Lahore Hospitals, Pakistan

by Riffat Yousaf, Iahtasham Khan, Wasim Shehzad, Riaz Hussain, Shahzad Ali, Heinrich Neubauer and Gamal Wareth

Infect. Dis. Rep. 2021, 13(1), 166-172; https://doi.org/10.3390/idr13010018 - 08 Feb 2021

Cited by 8 | Viewed by 2520

Abstract

Brucellosis is one of the most notorious zoonoses worldwide. The disease is common and endemic in humans and animals of Pakistan, but lack of awareness and lack of research have resulted in an increased incidence in the human population. The present study aimed [...] Read more.

Brucellosis is one of the most notorious zoonoses worldwide. The disease is common and endemic in humans and animals of Pakistan, but lack of awareness and lack of research have resulted in an increased incidence in the human population. The present study aimed to determine the seroprevalence and at molecular detection of brucellosis in patients with clinical symptoms in six different hospitals from Lahore, which is the capital city of Punjab province. A total of 218 blood samples were collected from hospitalized patients. The samples were initially screened by the Rose Bengal Plate Test (RBPT), and then quantitative real-time PCR (qRT-PCR) was applied. An overall seroprevalence of 17% (37/218) was found. The highest prevalence was found at the Lady Health center (36.53%), which was followed by the Lady Willingdon Hospital (28.6%). Female patients showed a higher seroprevalence than males and peaked at 34% (n = 32) for women who suffered from abortion. In total, 16.8% of patients younger than 30 years showed seropositive reactions, while the prevalence was 19% in patients between 31 and 50. Thirty-three DNA samples from 24 seropositive and nine seronegative patients tested positive, 32 samples were found positive for B. abortus DNA, and one sample failed to be identified at the species level. Almost all positive cases had direct contact with animals and consumed unpasteurized dairy products. Research on human brucellosis is still scarce in Pakistan. For the diagnosis of brucellosis, serology and molecular tools should be combined if isolation by culture is not possible. Nationwide control activities and increasing awareness for zoonotic brucellosis are needed. Full article

5 pages, 766 KiB

Open AccessCase Report

Consequences of a Delayed Diagnosis of Kaposi’s Sarcoma: A Case Report of Disseminated Infection

by Leonardo Henrique Bertolucci, Carolina Rossatto Ribas, Ellen Mullich Flesch, Lisiane Aurélio Knebel Balbinot and Fabiano Ramos

Infect. Dis. Rep. 2021, 13(1), 161-165; https://doi.org/10.3390/idr13010017 - 06 Feb 2021

Viewed by 2310

Abstract

Kaposi’s Sarcoma (KS), first reported by Dr [...] Full article

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13 pages, 2589 KiB

Open AccessArticle

Implications of the COVID-19 Lockdown on Dengue Transmission in Malaysia

by Song-Quan Ong, Hamdan Ahmad and Ahmad Mohiddin Mohd Ngesom

Infect. Dis. Rep. 2021, 13(1), 148-160; https://doi.org/10.3390/idr13010016 - 05 Feb 2021

Cited by 23 | Viewed by 4722

Abstract

We aim to investigate the effect of large-scale human movement restrictions during the COVID-19 lockdown on both the dengue transmission and vector occurrences. This study compared the weekly dengue incidences during the period of lockdown to the previous years (2015 to 2019) and [...] Read more.

We aim to investigate the effect of large-scale human movement restrictions during the COVID-19 lockdown on both the dengue transmission and vector occurrences. This study compared the weekly dengue incidences during the period of lockdown to the previous years (2015 to 2019) and a Seasonal Autoregressive Integrated Moving Average (SARIMA) model that expected no movement restrictions. We found that the trend of dengue incidence during the first two weeks (stage 1) of lockdown decreased significantly with the incidences lower than the lower confidence level (LCL) of SARIMA. By comparing the magnitude of the gradient of decrease, the trend is 319% steeper than the trend observed in previous years and 650% steeper than the simulated model, indicating that the control of population movement did reduce dengue transmission. However, starting from stage 2 of lockdown, the dengue incidences demonstrated an elevation and earlier rebound by four weeks and grew with an exponential pattern. We revealed that Aedes albopictus is the predominant species and demonstrated a strong correlation with the locally reported dengue incidences, and therefore we proposed the possible diffusive effect of the vector that led to a higher acceleration of incidence rate. Full article

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12 pages, 546 KiB

Open AccessArticle

Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia

by Anak Agung Sagung Sawitri, I Nyoman Sutarsa, Ketut Tuti Parwati Merati, I Made Bakta and Dewa Nyoman Wirawan

Infect. Dis. Rep. 2021, 13(1), 136-147; https://doi.org/10.3390/idr13010015 - 05 Feb 2021

Cited by 1 | Viewed by 3060

Abstract

This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and [...] Read more.

This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination). Full article

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10 pages, 446 KiB

Open AccessArticle

Prevalence and Determinants of Medication Adherence among Patients with HIV/AIDS in Southern Vietnam

by Phuong M. Nguyen, Anh N. Thach, Xuan D. Pham, Anh N. Lam, Thao N. P. Nguyen, Chu X. Duong, Lam V. Nguyen, Thao H. Nguyen, Suol T. Pham, Katja Taxis and Thang Nguyen

Infect. Dis. Rep. 2021, 13(1), 126-135; https://doi.org/10.3390/idr13010014 - 05 Feb 2021

Cited by 4 | Viewed by 2851

Abstract

This study was conducted to determine the prevalence and determinants of medication adherence among patients with HIV/AIDS in southern Vietnam. Methods: A cross-sectional study was conducted in a hospital in southern Vietnam from June to December 2019 on patients who began antiretroviral therapy [...] Read more.

This study was conducted to determine the prevalence and determinants of medication adherence among patients with HIV/AIDS in southern Vietnam. Methods: A cross-sectional study was conducted in a hospital in southern Vietnam from June to December 2019 on patients who began antiretroviral therapy (ART) for at least 6 months. Using a designed questionnaire, patients were considered adherent if they took correct medicines with right doses, on time and properly with food and beverage and had follow-up visits as scheduled. Multivariable logistic regression was used to identify determinants of adherence. Key findings: A total of 350 patients (from 861 medical records) were eligible for the study. The majority of patients were male (62.9%), and the dominant age group (≥35 years old) accounted for 53.7% of patients. Sexual intercourse was the primary route of transmission of HIV (95.1%). The proportions of participants who took the correct medicine and at a proper dose were 98.3% and 86.3%, respectively. In total, 94.9% of participants took medicine appropriately in combination with food and beverage, and 75.7% of participants were strictly adherent to ART. The factors marital status (odds ratio (OR) = 2.54; 95%CI = 1.51–4.28), being away from home (OR = 1.7; 95%CI = 1.03–2.78), substance abuse (OR = 2.7; 95%CI = 1.44–5.05), general knowledge about ART (OR = 2.75; 95%CI = 1.67–4.53), stopping medication after improvement (OR = 4.16; 95%CI = 2.29–7.56) and self-assessment of therapy adherence (OR = 9.83; 95%CI = 5.44–17.77) were significantly associated with patients’ adherence. Conclusions: Three-quarters of patients were adherent to ART. Researchers should consider these determinants of adherence in developing interventions in further studies. Full article

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24 pages, 796 KiB

Open AccessReview

SARS–CoV-2 Immuno-Pathogenesis and Potential for Diverse Vaccines and Therapies: Opportunities and Challenges

by Andrew R. McGill, Roukiah Khalil, Rinku Dutta, Ryan Green, Mark Howell, Subhra Mohapatra and Shyam S. Mohapatra

Infect. Dis. Rep. 2021, 13(1), 102-125; https://doi.org/10.3390/idr13010013 - 04 Feb 2021

Cited by 22 | Viewed by 8301

Abstract

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that emerged from Wuhan, China in late 2019 causing coronavirus disease-19 (COVID-19). SARS-CoV-2 infection begins by attaching to angiotensin-converting enzyme 2 receptor (ACE2) via the spike glycoprotein, followed by cleavage by TMPRSS2, revealing [...] Read more.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that emerged from Wuhan, China in late 2019 causing coronavirus disease-19 (COVID-19). SARS-CoV-2 infection begins by attaching to angiotensin-converting enzyme 2 receptor (ACE2) via the spike glycoprotein, followed by cleavage by TMPRSS2, revealing the viral fusion domain. Other presumptive receptors for SARS-CoV-2 attachment include CD147, neuropilin-1 (NRP1), and Myeloid C-lectin like receptor (CLR), each of which might play a role in the systemic viral spread. The pathology of SARS-CoV-2 infection ranges from asymptomatic to severe acute respiratory distress syndrome, often displaying a cytokine storm syndrome, which can be life-threatening. Despite progress made, the detailed mechanisms underlying SARS-CoV-2 interaction with the host immune system remain unclear and are an area of very active research. The process’s key players include viral non-structural proteins and open reading frame products, which have been implicated in immune antagonism. The dysregulation of the innate immune system results in reduced adaptive immune responses characterized by rapidly diminishing antibody titers. Several treatment options for COVID-19 are emerging, with immunotherapies, peptide therapies, and nucleic acid vaccines showing promise. This review discusses the advances in the immunopathology of SARS-CoV-2, vaccines and therapies under investigation to counter the effects of this virus, as well as viral variants. Full article

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6 pages, 249 KiB

Open AccessBrief Report

Presence of SARS-CoV-2 RNA in Semen—Cohort Study in the United States COVID-19 Positive Patients

by Bruno Machado, Gustavo Barcelos Barra, Nickolas Scherzer, Jack Massey, Hemerson dos Santos Luz, Rafael Henrique Jacomo, Ticiane Herinques Santa Rita and Rodney Davis

Infect. Dis. Rep. 2021, 13(1), 96-101; https://doi.org/10.3390/idr13010012 - 04 Feb 2021

Cited by 41 | Viewed by 2941

Abstract

On 31 December 2019, China informed the World Health Organization they were facing a viral pneumonia epidemic of a new type of Coronavirus. Currently, 10 months later, more than 43,000,000 people have been infected, and about 1,150,000 deceased worldwide from the disease. Knowledge [...] Read more.

On 31 December 2019, China informed the World Health Organization they were facing a viral pneumonia epidemic of a new type of Coronavirus. Currently, 10 months later, more than 43,000,000 people have been infected, and about 1,150,000 deceased worldwide from the disease. Knowledge about the virus is updated daily, and its RNA was isolated from several human secretions, e.g., throat, saliva, pulmonary alveolar washing, and feces. So far, only one publication found the presence of SARS-CoV-2 in semen. In this 5-month cross-sectional study, we recruited 15 patients diagnosed with a positive nasal swab for SARS-CoV-2 with no or mild symptoms in our institution. A semen sample after a shower was retrieved and tested for viral RNA in the semen. The samples were tested for the viral RNA with RT-PCR with two different genetic probes. The samples were re-tested 24 h after the first test to confirm the results. The SARS-Cov-2 viral RNA was present in 1/15 patients [6.66%] in our sample. Even in a small sample, the RNA from SARS-CoV-2 can be isolated from human semen. This information should alert the scientific community and public health officials about a possible new form of transmission of the disease and long-term clinical effects on the population. Full article

7 pages, 388 KiB

Open AccessArticle

Frequency of Hepatitis B, C and HIV Infections among Transfusion-Dependent Beta Thalassemia Patients in Dhaka

by Golam Sarower Bhuyan, Aftab Uz Zaman Noor, Rosy Sultana, Farjana Akther Noor, Nusrat Sultana, Suprovath Kumar Sarker, Muhammad Tarikul Islam, Md. Abu Sayeed, Md. Imam Ul Khabir, A. K. M. Ekramul Hossain, Zebunnesa Zeba, Syeda Kashfi Qadri, Md. Ruhul Furkan Siddique, Syed Saleheen Qadri, Firdausi Qadri and Kaiissar Mannoor

Infect. Dis. Rep. 2021, 13(1), 89-95; https://doi.org/10.3390/idr13010011 - 15 Jan 2021

Cited by 4 | Viewed by 2874

Abstract

Transfusion transmitted infections have remained a major deterrent to public health, particularly among the patients with transfusion-dependent Beta thalassemia in developing countries. Although proper donor selection through adoption of WHO-advised infection panel has lowered the rate of infections, the multi-transfused patients are not [...] Read more.

Transfusion transmitted infections have remained a major deterrent to public health, particularly among the patients with transfusion-dependent Beta thalassemia in developing countries. Although proper donor selection through adoption of WHO-advised infection panel has lowered the rate of infections, the multi-transfused patients are not free of risk. In this study, we screened 148 transfusion-dependent Beta thalassemia patients to determine the frequency of Hepatitis C Virus (HCV), Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) using the ELISA method. Among them, infected cases with HCV, HBV and HIV were 13.51%, 3.37% and 0%, respectively. Moreover, 2% of the patients were found to be co-infected with both HBV and HCV. The percentage of infections in the patients with frequent transfusion interval (≤30 days) was significantly higher (p < 0.0005) than that in the patients with less frequent transfusion intervals (>30 days). Immunochromatography (ICT)-based rapid test kits are usually used to screen and confirm these infections in the blood of the patients. However, ICT-based tests are not sensitive enough to detect the infections. So, a combination of both Nucleic Acid testing (NAT) and serological testing are suggested to significantly reduce the risk of viral infections during blood transfusion. Full article

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7 pages, 2764 KiB

Open AccessCase Report

Intramedullary Conus Medullaris Tuberculoma: A Case Report and Review of the Literature

by Verajit Chotmongkol, Chinadol Wanitpongpun, Warinthorn Phuttharak and Sittichai Khamsai

Infect. Dis. Rep. 2021, 13(1), 82-88; https://doi.org/10.3390/idr13010010 - 15 Jan 2021

Cited by 3 | Viewed by 4173

Abstract

Intramedullary tuberculoma (IMT) of the conus medullaris is extremely rare. We present a case of intramedullary conus medullaris tuberculoma in which the diagnosis was based on there being very high levels of adenosine deaminase (ADA) in the patient’s cerebrospinal fluid (CSF) and improvement [...] Read more.

Intramedullary tuberculoma (IMT) of the conus medullaris is extremely rare. We present a case of intramedullary conus medullaris tuberculoma in which the diagnosis was based on there being very high levels of adenosine deaminase (ADA) in the patient’s cerebrospinal fluid (CSF) and improvement with antituberculous therapy. A 78-year-old man presented after having had a dull ache in both thighs and progressive paraparesis. The patient’s medical history included diffuse large B-cell lymphoma, which had undergone remission due to chemotherapy two years earlier, and long-term, well-controlled diabetes. A chest X-ray showed no evidence of tuberculosis. The results of CSF analysis were compatible with Froin’s syndrome. An initial diagnosis was made of an intramedullary tumor of the conus medullaris, based on magnetic resonance imaging (MRI). A myelotomy and multiple punch out biopsy were performed, and histopathology of the tissues revealed mild reactive gliosis. Due to the patient having high levels of CSF-ADA, IMT of the conus medullaris was suspected. The patient was treated with an 18-month course of antituberculous therapy. The dull ache gradually disappeared, and motor power improved slightly. A follow-up MRI of the lumbosacral (LS) spine revealed that the lesion had completely disappeared. Intramedullary tuberculoma of the conus medullaris should be considered in patients with underlying malignancy and no symptoms of systemic tuberculosis. CSF adenosine deaminase levels can be helpful in determining the presence of central nervous system tuberculosis when other systemic signs of disease are lacking. Full article

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10 pages, 1529 KiB

Open AccessCase Report

Idiopathic CD4 T Cell Lymphocytopenia: A Case of Overexpression of PD-1/PDL-1 and CTLA-4

by Gaurav Kumar, Heidy Schmid-Antomarchi, Annie Schmid-Alliana, Michel Ticchioni and Pierre-Marie Roger

Infect. Dis. Rep. 2021, 13(1), 72-81; https://doi.org/10.3390/idr13010009 - 13 Jan 2021

Viewed by 2135

Abstract

Idiopathic CD4 T cell lymphocytopenia (ICL) is a rare entity characterized by CD4 T cell count of <300 cells/mm³ along with opportunistic infection for which T cell marker expression remains to be fully explored. We report an ICL case for which T [...] Read more.

Idiopathic CD4 T cell lymphocytopenia (ICL) is a rare entity characterized by CD4 T cell count of <300 cells/mm³ along with opportunistic infection for which T cell marker expression remains to be fully explored. We report an ICL case for which T lymphocyte phenotype and its costimulatory molecules expression was analyzed both ex vivo and after overnight stimulation through CD3/CD28. The ICL patient was compared to five healthy controls. We observed higher expression of inhibitory molecules PD-1/PDL-1 and CTLA-4 on CD4 T cells and increased regulatory T cells in ICL, along with high activation and low proliferation of CD4 T cells. The alteration in the expression of both the costimulatory pathway and the apoptotic pathway might participate to down-regulate both CD4 T cell functions and numbers observed in ICL. Full article

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14 pages, 1637 KiB

Open AccessArticle

Reducing Spread of Infections with a Photocatalytic Reactor—Potential Applications in Control of Hospital Staphylococcus aureus and Clostridioides difficile Infections and Inactivation of RNA Viruses

by Abeer Gharaibeh, Richard H. Smith and Michael J. Conway

Infect. Dis. Rep. 2021, 13(1), 58-71; https://doi.org/10.3390/idr13010008 - 11 Jan 2021

Cited by 4 | Viewed by 5388

Abstract

Contaminated surfaces and indoor environments are important sources of infectious spread within hospital and non-hospital facilities. Bacterial infections such as infections with Clostridioides (formerly Clostridium) difficile (C. difficile) and Staphylococcus aureus (S. aureus) and its antibiotic resistant strains [...] Read more.

Contaminated surfaces and indoor environments are important sources of infectious spread within hospital and non-hospital facilities. Bacterial infections such as infections with Clostridioides (formerly Clostridium) difficile (C. difficile) and Staphylococcus aureus (S. aureus) and its antibiotic resistant strains continue to pose a significant risk to healthcare workers and patients. Additionally, the recent emergence of the coronavirus disease 2019 (COVID-19) pandemic, which is caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), highlights the need for safe and effective methods to decontaminate surfaces to control infection spread in hospitals and the community. To address these critical needs, we tested a photocatalytic reactor decontamination method to disinfect contaminated surfaces in a hospital and a laboratory setting. By placing the reactor in a test hospital room, growth of S. aureus and C. difficile were significantly reduced compared with a control room. Additionally, using a model enveloped positive-sense single-stranded RNA virus, dengue virus type 2 (DENV2), we showed that the use of the photocatalytic reactor reduces viral infectivity. Collectively, the results demonstrate the potential utility of photocatalytic reactors in reducing the spread of highly contagious bacterial and viral infections through contaminated surfaces and environments. Full article

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13 pages, 2291 KiB

Open AccessArticle

On Pilot Massive COVID-19 Testing by Antigen Tests in Europe. Case Study: Slovakia

by Jaroslav Frnda and Marek Durica

Infect. Dis. Rep. 2021, 13(1), 45-57; https://doi.org/10.3390/idr13010007 - 07 Jan 2021

Cited by 23 | Viewed by 5434

Abstract

This paper provides a summary of mass COVID-19 testing of almost the entire population in Slovakia by antigen tests. We focused on the results delivered by two testing rounds and analyzed the benefits and weaknesses of such type of testing. We prepared mathematical [...] Read more.

This paper provides a summary of mass COVID-19 testing of almost the entire population in Slovakia by antigen tests. We focused on the results delivered by two testing rounds and analyzed the benefits and weaknesses of such type of testing. We prepared mathematical models to critically examine the effectiveness of the testing, and we also estimated the number of potentially sick people that would become infected by those marked as positives by antigen tests. Our calculations have proven that antigen testing in hotspots can flatten the curve of daily newly reported cases significantly, but in regions with low-risk of COVID-19, the benefit of such testing is questionable. As for the regions with low infection rates, we could only estimate the proportion of true and false-positive cases because the national health authority had not validated the results by RT–PCR tests. Therefore, this work can serve as an introductory study on the first nationwide testing by antigen tests in Europe. Full article

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12 pages, 305 KiB

Open AccessArticle

Incidence of Antibiotic Treatment Failure in Patients with Nursing Home-Acquired Pneumonia and Community Acquired Pneumonia

by Mariana Lopes, Gonçalo Alves Silva, Rui Filipe Nogueira, Daniela Marado, João Gonçalves, Carlos Athayde, Dilva Silva, Ana Figueiredo, Jorge Fortuna and Armando Carvalho

Infect. Dis. Rep. 2021, 13(1), 33-44; https://doi.org/10.3390/idr13010006 - 05 Jan 2021

Cited by 6 | Viewed by 3396

Abstract

Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this [...] Read more.

Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this study was to compare the rate antibiotic failure between NHAP and CAP patients. Methods: Demographic characteristics, co-morbidities, clinical and laboratory variables, antibiotic therapy, and mortality data were collected retrospectively for all patients with pneumonia admitted to an Internal Medicine Service between April 2017 and April 2018. Results: In total, 313 of 556 patients had CAP and 243 had NHAP. NHAP patients were older, and were more likely to be dependent, to have recent antibiotic use, and to experience treatment failure (odds ratio (OR) 1.583; 95% CI 1.102–2.276; p = 0.013). In multivariate analysis, patient’s origin did not predict treatment failure (OR 1.083; 95% CI 0.726–1.616; p = 0.696). Discussion: Higher rates of antibiotic failure and mortality in NHAP patients were explained by the presence of other risk factors such as comorbidities, more severe presentation, and age. Admission from a nursing home is not a sufficient condition to start broader-spectrum antibiotics. Full article

7 pages, 711 KiB

Open AccessCase Report

Primary Peritonitis Secondary to Streptococcus pyogenes in a Young Female Adult—A Case Report and Literature Review

by Avelyn E. Y. Aw, James W. K. Lee and Kon Voi Tay

Infect. Dis. Rep. 2021, 13(1), 26-32; https://doi.org/10.3390/idr13010005 - 01 Jan 2021

Cited by 3 | Viewed by 4474

Abstract

Primary spontaneous bacterial peritonitis (SBP) is a rare cause of acute abdomen in previously healthy patients, even more unusually caused by a group A Streptococcus (GAS) (also known as Streptococcus pyogenes) infection. We report a young, otherwise healthy female who presented with [...] Read more.

Primary spontaneous bacterial peritonitis (SBP) is a rare cause of acute abdomen in previously healthy patients, even more unusually caused by a group A Streptococcus (GAS) (also known as Streptococcus pyogenes) infection. We report a young, otherwise healthy female who presented with generalized abdominal pain that was initially managed conservatively as gastroenteritis, with a computed tomography (CT) scan showing a ruptured corpus luteal cyst. Upon subsequent readmission with worsened pain and symptoms, a repeat CT scan showed worsened free fluid with signs of peritonitis. A diagnostic laparoscopy confirmed primary peritonitis with an unknown infection source and causative pathology, as the appendix, ovaries and bowels were healthy-looking. Fluid cultures returned positive for GAS Pyogenes, while blood and urine cultures were negative. The discussion reviews the challenges in diagnosis and treatment of GAS primary peritonitis, highlighting the need for clinical suspicion, early diagnosis via laparoscopy or laparotomy and prompt antibiotic therapy as the current standard for treatment. Full article

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3 pages, 582 KiB

Open AccessCase Report

Angioedema and COVID-19: A New Dermatological Manifestation?

by Pierre-Yves Royer, Souheil Zayet, Claire Jacquin-Porretaz, N’dri Juliette Kadiane-Oussou, Lynda Toko, Vincent Gendrin and Timothée Klopfenstein

Infect. Dis. Rep. 2021, 13(1), 23-25; https://doi.org/10.3390/idr13010004 - 01 Jan 2021

Cited by 3 | Viewed by 4634

Abstract

The main localization of SARS-CoV-2 infection is the respiratory tract. Digestive and otorhinolaryngological localizations are also reported. More recently, dermatological manifestations have been reported during Coronavirus disease-19 (COVID-19). We report a case of a labial angioedema in a patient with confirmed COVID-19. Full article

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5 pages, 552 KiB

Open AccessArticle

Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea

by Bijan Teja, Nafeesa Alibhai, Gordon D. Rubenfeld, Linda R. Taggart, Naheed Jivraj, Sameer A. Hirji, Brian P. O’Gara and Shahzad Shaefi

Infect. Dis. Rep. 2021, 13(1), 18-22; https://doi.org/10.3390/idr13010003 - 01 Jan 2021

Cited by 3 | Viewed by 2171

Abstract

While early empiric antibiotic therapy is beneficial for patients presenting with sepsis, the presentation of sepsis from Clostridioides difficile (formerly Clostridium difficile) infection (CDI) has not been well studied in large cohorts. We sought to determine whether the combination of extreme leukocytosis [...] Read more.

While early empiric antibiotic therapy is beneficial for patients presenting with sepsis, the presentation of sepsis from Clostridioides difficile (formerly Clostridium difficile) infection (CDI) has not been well studied in large cohorts. We sought to determine whether the combination of extreme leukocytosis and diarrhea was strongly predictive of CDI in a cohort of 8659 patients admitted to the intensive care unit. We found that CDI was present in 15.0% (95% CI, 12.1–18.3%) of patients with extreme leukocytosis and diarrhea and that mortality for those with CDI, diarrhea, and extreme leukocytosis was 33.8% (95% CI, 23.2–44.3%). These data support consideration of empiric treatment for CDI in unstable critically ill patients with extreme leukocytosis and diarrhea, along with treatment of other possible sources of sepsis as appropriate. Empiric treatment for CDI can usually be discontinued promptly, along with narrowing of other broad-spectrum antimicrobial coverage, if a sensitive C. difficile test is negative. Full article

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7 pages, 1217 KiB

Open AccessCase Report

Portal Dissemination of Fusarium graminearum in a Patient with Acute Lymphoblastic Leukemia and Febrile Neutropenia

by Mary Gabriela Uscamayta, Alexandra Martin-Onraet, Karla Espinosa-Bautista, Roberto Herrera-Goepfert, Rigoberto Hernández-Castro and Carolina Perez-Jimenez

Infect. Dis. Rep. 2021, 13(1), 11-17; https://doi.org/10.3390/idr13010002 - 01 Jan 2021

Cited by 1 | Viewed by 2485

Abstract

We present the case of a man with acute lymphoblastic leukemia and prolonged profound neutropenia, who developed an invasive infection by Fusarium graminearum, acquired via non-cutaneous entry, with gastrointestinal symptoms, sigmoid perforation and liver abscesses due to portal dissemination. The etiologic agent [...] Read more.

We present the case of a man with acute lymphoblastic leukemia and prolonged profound neutropenia, who developed an invasive infection by Fusarium graminearum, acquired via non-cutaneous entry, with gastrointestinal symptoms, sigmoid perforation and liver abscesses due to portal dissemination. The etiologic agent was identified using the 18S-ITS1-5.8S-ITS2-28S rRNA sequence gene, from a liver biopsy. The infection was resolved with surgical drainage and antifungal treatment based on voriconazole. As far as we know, there are no previous reports in the literature of cases of human infection due to Fusarium graminearum. Full article

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10 pages, 821 KiB

Open AccessCase Report

Acute Brucellosis with a Guillain-Barre Syndrome-Like Presentation: A Case Report and Literature Review

by Ali Alanazi, Sara Al Najjar, Jnadi Madkhali, Yaser Al Malik, Athal Al-Khalaf and Ahmad Alharbi

Infect. Dis. Rep. 2021, 13(1), 1-10; https://doi.org/10.3390/idr13010001 - 01 Jan 2021

Cited by 7 | Viewed by 3961

Abstract

Introduction: Brucellosis is a zoonotic disease that can affect the central and peripheral nervous system and it has variable neurological manifestation. However, brucellosis infection that presents with acute peripheral neuropathy mimicking Guillain-Barre syndrome (GBS) is rarely reported in the literature. Objective and method: [...] Read more.

Introduction: Brucellosis is a zoonotic disease that can affect the central and peripheral nervous system and it has variable neurological manifestation. However, brucellosis infection that presents with acute peripheral neuropathy mimicking Guillain-Barre syndrome (GBS) is rarely reported in the literature. Objective and method: We report a 56-year-old man who was initially diagnosed with GBS, and then he was confirmed to have acute Brucella infection. We also did a systematic literature review to study the natural history and management of previously reported cases of brucellosis that presented with manifestations consistent with GBS. Results: We found 19 (including our patient) cases of brucellosis that presented with GBS-like manifestations. The age range was 9–62 years. Eight (42.1%) patients had a history of fever. Seven (36.8%) patients had no constitutional symptoms. Five (26.3%) patients had splenomegaly. Brucella serological tests were positive in all patients, while blood Brucella culture was positive in three (37.5%) out of eight patients. Albuminocytological dissociation was present in nine (64.3%) out of 14 patients. Nerve conduction studies and electromyography were consistent with demyelination polyneuropathy in eight (42.1%) patients, with axonal polyneuropathy in six (31.6) patients, and with mixed axonal and demyelinating polyneuropathy in one (5.3%) patient. Spine MRI showed root enhancement in three (42.9%) patients. Conclusion: In regions endemic with brucellosis, acute peripheral neuropathy presentation may warrant investigations for Brucella infection. Full article

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Infect. Dis. Rep., Volume 13, Issue 1 (March 2021) – 28 articles

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