Focus Of Infection Research Articles

Computed tomography in patients with sepsis presenting to the emergency department: exploring its role in light of patient outcomes

ObjectivesThis study aimed to explore the role of CT in septic patients presenting to the emergency department (ED).Materials and methodsWe performed a retrospective secondary analysis of 192 septic patients from a prospective observational study, i.e., the “LIFE POC” study. Sepsis was diagnosed in accordance with the Sepsis-3 definition. Clinical and radiological data were collected from the hospital administration and radiological systems. Information on mortality and morbidity was collected. Time-to-CT between CT scan and sepsis diagnosis (ttCTsd) was calculated. Diagnostic accuracy was assessed with the final sepsis source as reference standard. The reference standard was established through the treating team of the patient based on all available clinical, imaging, and microbiological data.ResultsSixty-two of 192 patients underwent a CT examination for sepsis focus detection. The final septic source was identified by CT in 69.4% (n = 43). CT detected septic foci with 81.1% sensitivity (95% CI, 68.0–90.6%) and 55.6% specificity (95% CI, 21.2–86.3%). Patients with short versus long ttCTsd did not differ in terms of mortality (16.1%, n = 5 vs 9.7, n = 3; p = 0.449), length of hospital stay (median 16 d, IQR 9 d 12 h–23 d 18 h vs median 13 d, IQR 10 d 00 h–24 d 00 h; p = 0.863), or duration of intensive care (median 3d 12 h, IQR 2 d 6 h–7 d 18 h vs median 5d, IQR 2 d–11 d; p = 0.800).ConclusionsOur findings show a high sensitivity of CT in ED patients with sepsis, confirming its relevance in guiding treatment decisions. The low specificity suggests that a negative CT requires further ancillary diagnostic tests for focus detection. The timing of CT did not affect morbidity or mortality outcomes.Clinical relevance statementIn patients with sepsis who present to the ED, CT can be used to identify infectious foci on the basis of clinical suspicion, but should not be used as a rule-out test. Scientific evidence for the optimal timing of CT beyond clinical decision-making is currently missing, as potential mortality benefits are clouded by differences in clinical severity at the time of ED presentation.Key Points• In patients with sepsis who present to the ED, CT for focus identification has a high sensitivity and can thereby be valuable for patient management.• As the specificity is considerably lower, a thorough microbiological assessment is important in these cases.• The timing of CT did not affect morbidity and mortality outcomes in this study, which might be due to variability in clinical severity at the time of ED presentation.

The First Record of Omsk Hemorrhagic Fever Virus and Tick-Borne Encephalitis Virus of Baltic Lineage from the Kemerovo Region of Russia.

Objectives: Tick-borne encephalitis virus Siberian subtype (TBEV-Sib) and Omsk hemorrhagic fever virus (OHFV) are causative agents of natural focal infections in Western Siberia, Russia. The distribution of TBEV phylogenetic lineages and OHFV in the Kemerovo Region of Western Siberia remains poorly investigated. Methods: The phylogenetic analyses of fragment genome sequences 26 flaviviruses identified in 2019 were performed, and the amino acid variation was determined to reveal to which clusteron they belong. The age of Baltic and Asian lineages of the TBEV-Sib was calculated for Kemerovo District and Region, respectively. Results: Twenty-five isolates were members of three TBEV-Sib phylogenetic lineages: Baltic (48%), Asian (36%), and East Siberian (16%). The Baltic lineage's eastern boundary is commonly thought to be in the Novosibirsk Region, but our data suggest that it may reach further east. Analysis of the Baltic lineage clusteron structure showed that the isolates found are unique (6) or belong to clusteron-founder 3D (1) and derived clusteron 3O (5). Based on the age of 3O clusteron, Baltic lineage could have appeared in the Kemerovo Region by the late 1970s. One of the isolated viruses turned out to be the OHFV of the first subtype and not to belong to any known clusteron. This finding is the first known detection of the virus outside the endemic area of Russia. Given the recent discovery of OHFV in Kazakhstan, it can be assumed that the area of this virus distribution is much wider than previously thought. Conclusions: This report provides insights into the population structure of TBEV and OHFV, which may be helpful for epidemiological investigation and surveillance of the viruses.

Gut microbiota – a new link in the pathogenesis of osteoarthritis (literature review)

The intestinal microbiota (IMB) can indirectly affect the course of ostearthritis (OA) at the systemic level by stimulating a chronic nonspecific inflammatory reaction in the synovial membrane and subchondral bone, the cause of which is an increase in the amount of circulating lipopolysaccharides (LPS) of the bacterial wall, as well as provoke the development of metabolic syndrome, which links the two necessary components of the pathogenesis of OA. The result of direct exposure is the formation of leaky gut syndrome with the activation of LPS of the bacterial wall of mild inflammation, provoking the production of proinflammatory cytokines, the effect of which on synoviocytes and chondrocytes leads to their activation with subsequent production of IL-6 and IL-8, which contributes to the persistence of inflammation. By correlation analysis, the relationship of three taxa with OA joint damage was proved, namely, the order Desulfovibrionales and the genus Ruminiclostridium 5 – with knee joint OA, Methanobacteriaceae – with knee joint OA, and OA of any localization, and the appearance and degree of contamination with the genus Streptococcus correlated with the severity of pain syndrome. The metabolic syndrome itself can provoke the development of dysbiosis, so it can also be its consequence. A change in the composition of the microbiota in the form of the predominance of the genus Clostridium and the species Staphylococcus aureus with a decrease in the diversity of microorganisms is associated with an increase in the amount of adipose tissue in the body, dyslipidemia, insulin resistance with impaired carbohydrate metabolism. Low levels of LPS in the blood are found in obese patients even in the absence of an obvious focus of infection due to violations in the CMB, they signal TLR-4, triggering systemic inflammation. Studies have shown a positive effect of prescribing proand prebiotics on the course of OA, which makes IMB a promising target for the treatment and prevention of OA.

Miescher’s cheilitis granulomatosa: a case report

Miescher’s cheilitis granulomatosa (MCG) is a rare idiopathic chronic persistent painless lip swelling with granulomatous infiltrate. It is often associated with orofacial granulomatosis and Melkersson—Rosenthal syndrome. Sometimes cheilitis granulomatosa is attributed to sarcoidosis (Besnier—Boeck—Schaumann disease) without systemic lesions. Although there is a possibility that it is a separate disease. Secondary causes include a reaction in response to infection with Mycobacterium tuberculosis, as well as to the introduction of tissue fillers.The publication presents a clinical case of Miescher’s cheilitis, the probable cause of which were the following infectious agents: long­term untreated caries of many teeth and COVID­19.Patient K., 46 years old, complained of swelling and enlargement of the lower lip, a feeling of numbness and discomfort. She fell ill a week ago. Swelling formed gradually over 6—7 days without disturbing the general condition; the body temperature was within the normal range. The lips were swollen, increased in size, slightly hyperemic, the lower one was turned outwards. The lips had a soft­elastic consistency and were not painful to palpate. Pain, tactile and temperature sensitivity were preserved. Dermoscopy was performed. White­grey, structureless areas forming a reticular pattern were observed on the entire surface of the examined area. The vessels were not clear, full­blooded, visualised in the surrounding skin at a considerable distance from the lip edge. The patient was prescribed systemic and topical corticosteroids, hydroxychloroquine, and hyaluronidase. The oral cavity was sanitised. During the month of treatment, the swelling of the lips gradually decreased. At the control examination in two months, the patient’s lip size decreased by 2—2.5 times. There was no relapse of the disease.Conclusions. In our opinion, Miescher’s cheilitis granulomatosa is a separate type of cheilitis, probably of autoimmune nature, in the implementation of which bacterial and viral infectious agents play an important role (focal infection, caries, maxillary sinusitis, frontitis, etc.). The recovery of our patient after the sanitation of the infection foci and complex anti­inflammatory therapy is a convincing proof.

ПРОТИВОМИКРОБНАЯ ТЕРАПИЯ ПРИ РИНОСИНУСОГЕННЫХ ОСЛОЖНЕНИЯХ: ВЗГЛЯД КЛИНИЧЕСКОГО ФАРМАКОЛОГА

Rhinosinusogenic orbital (RSOC) and intracranial complications (RSIC) remain relevant for physicians of various specialties due to high risks of unfavorable outcomes. The key to successful medical care of patients with complicated forms of nasal and paranasal sinus pathology is not only untimely diagnosis and surgical sanation of the primary focus of infection, but also properly selected systemic antimicrobial therapy (SPMT), the choice of which is based on local data on the structure of pathogens and their sensitivity to antibacterial drugs. As a result of retrospective analysis of medical records of 266 completed cases of complicated forms of rhinosinusitis in adult patients for the period from 2010 to 2023, the peculiarities of the course of RSOC and RSIC, the microbial landscape in this pathology, the nature and extent of SPMT were studied. It was revealed that in the structure of the complicated course of RSOC occupy the leading positions. Secondary meningitis prevailed among RSIC, accounting for (92.6%). Clearly expressed changes of inflammatory character on the part of the general blood analysis and integral hematologic indices were characteristic for RSIC and purulent-inflammatory complications of the eyes. Staphylococcus spp. prevailed in the structure of etiologic factors in RSOC, while polymorphism of the isolated microflora was observed in RSIC (Staphylococcus spp., Streptococcus spp., Enterobacterales, Acinetobacter spp., Enterococcus spp., anaerobes, Candida spp., Mucor spp). Analysis of antibiograms revealed that the most problematic in terms of the choice of SPMT were representatives of the order Enterobacterales, Acinetobacter spp., in some established ones - Enterococcus spp., among the pathogens of mycosis - Mucor spp. 3-generation cephalosporins prevailed in the structure of empirical SPMT, and to a lesser extent inhibitor-protected aminopenicillins. However, the severity of the patients' condition, especially in case of RSIC, the results of microbiologic examination dictated the need to switch to "observation" antibiotics (meropenem, cefepime). Timely diagnosis, clear tactics of medical care, including the choice of effective SPMT led to favorable outcomes in 98.8% of patients.

Determinants of Surgical Outcomes in Tricuspid Valve Endocarditis

BackgroundCurrent treatment guidelines for infective endocarditis focus on left-sided infective endocarditis. Because right-sided infective endocarditis has different presentations and outcomes, it is crucial to further delineate surgical outcomes for isolated tricuspid valve endocarditis (TVE). MethodsThis retrospective study reviewed 374 surgically treated patients with isolated TVE from January 2012 through April 2022 who underwent isolated tricuspid valve surgical procedures. Primary outcomes were in-hospital mortality, permanent pacemaker need, and postsurgical inotropic support. ResultsThe in-hospital mortality was 4% (n = 15). Patients with liver disease had 3.81-times higher odds of death vs no liver disease (odds ratio [OR], 3.81; 95% CI, 1.22-12.17). A pacemaker was required in 17% of patients without a prior pacemaker, which was 4.07 times the odds with tricuspid valve replacement (OR, 4.07; 95% CI, 1.72-11.60) vs tricuspid valve repair. Each yearly increase in patient age demonstrated lower odds of permanent pacemaker requirement by 7% (OR, 0.93; 95% CI, 0.89-0.97). The odds for postoperative inotropic support increased 2.55-times higher in patients receiving preoperative inotropic agents (OR, 2.55; 95% CI, 1.29-5.05), 2.27-times higher with renal failure (OR, 2.27; 95% CI, 1.38-3.74), and 86% higher in patients administered preoperative heparin (OR, 1.86; 95% CI, 1.14-3.02). ConclusionsMortality of surgical treatment for TVE was 4%, with higher risks with liver disease. Tricuspid valve replacement was associated with higher odds for permanent pacemaker vs repair. Renal failure, preoperative inotropic support, and preoperative heparin were associated with higher odds for postoperative inotropic support. These findings further illustrate surgical outcomes with TVE.

EPIZOOTOLOGICAL MONITORING OF EQUINE HERPESVIRUS IN KAZAKHSTAN

Equine herpesvirus is one of the most common infectious diseases of horses, causing huge economic losses associated with fetal abortion and subsequent chronic course. At the same time, a difficult epizootological situation regarding herpesvirus infections remains in the republic. Therefore, epizootological surveillance and planned monitoring studies of the epidemiological process in a certain territory are one of the effective tools for preventing the spread of еquine herpesvirus in horse breeding farms. This article presents the results of an analysis of epizootological monitoring and ongoing diagnostic measures regarding еquine herpesvirus on the territory of the Republic of Kazakhstan. According to epizootological data, over the past 10 years, 35 outbreaks of еquine herpesvirus have been registered in Kazakhstan. Serological monitoring confirmed the circulation of the causative agent of equine herpesvirus in the country's horse breeding farms. In a study of 1391 blood serum samples, antibodies to equine herpesvirus were detected in 93 cases (6.7%). The data obtained give reason to believe that in disadvantaged areas it is necessary to take a full range of measures for timely diagnosis, prevention and elimination of foci of infection.

Pseudomonas stutzeri bloodstream infection is a prevailing community-onset disease with important mortality rates: results from a retrospective observational study in Australia

Background The recognition of Pseudomonas stutzeri as a cause of infections in humans has been increasing. However, only case reports and small series of P. stutzeri bloodstream infections have been published. Epidemiological data on these infections are extremely scarce. Our objective was to describe the incidence, epidemiology, antimicrobial resistance rates, and outcomes of P. stutzeri bloodstream infections in a large population-based cohort in Australia. Methods Retrospective, laboratory-based surveillance study conducted in Queensland, Australia (population ≈ 5 million) during 2000–2019. Clinical information was obtained from public hospital admissions and vital statistics databases. Results In total, 228 episodes of P. stutzeri bloodstream infections were identified. Increased incidence was observed in the later years, especially in older men, and was higher during the rainy months of the year and in the warmest and more humid regions of the state. The majority of bloodstream infections were community-onset with 120 (52.6%) community-associated and 59 (25.9%) ambulatory healthcare-associated episodes. Only 49 cases (21.5%) were nosocomial. The most common foci of infection were skin and soft tissue, lower respiratory tract, and intra-abdominal. No isolate showed antimicrobial resistance. Thirty-one patients (13.6%) died. The mortality rate in patients with a respiratory infectious source was higher (21%). Conclusions P. stutzeri bloodstream infection was predominantly a community-onset condition including ambulatory healthcare related cases, with increasing incidence, especially in older males. No antimicrobial resistance was observed. Mortality was high in patients with respiratory infectious source. This new observational data have implications when considering the epidemiology of these infections and for patient management.

Analysis Of Risk Factors For Hypoxic Damages Of Newborn`S Central Nervous System

Currently, perinatal damage to the central nervous system of newborns occupies an important place in the structure of pathology of young children, which is associated with high prevalence, severity of clinical manifestations and the risk of disability formation. The purpose of our study was to determine the significance of risk factors for the development and to develop criteria for the severity of hypoxic-ischemic CNS damage in newborns. We examined 120 newborns with moderate to severe perinatal CNS damage. The examination consisted of the collection of maternal history, which included information on somatic and gynecological diseases, the course of this pregnancy, childbirth, general clinical examination methods, examination of a newborn with an assessment of somatic and neurological status. The results of the study showed that modifying risk factors for the development of moderate perinatal encephalopathy are the threat of miscarriage, toxicosis, the age of the mother over 35 years old, moderate anemia, acute upper respiratory tract infections, gynecological pathology, taking antifungal drugs, rapid and protracted childbirth, weak birth activity. We also found that the modifying risk factors for the development of severe perinatal encephalopathy are stillbirth, bad habits in the father, closely related marriage, obesity, chronic foci of infection, acute bacterial infectious diseases, urogenital infection, NSAIDs, rapid and protracted childbirth, chronic fetal hypoxia.

Expanding a peptide-covalent probe hybrid for PET imaging of S. aureus driven focal infections

BackgroundThe urgent demand for innovative theranostic strategies to combat bacterial resistance to antibiotics is evident, with substantial implications for global health. Rapid diagnosis of life-threatening infections can expedite treatment, improving patient outcomes. Leveraging diagnostic modalities i.e., positron emission tomography (PET) and single photon emission computed tomography (SPECT) for detecting focal infections has yielded promising results. Augmenting the sensitivity of current PET and SPECT tracers could enable effective imaging of pathogenic bacteria, including drug-resistant strains.UBI (29–41), an antimicrobial peptide (AMP) fragment recognizes the S. aureus membrane through electrostatic binding. Radiolabeled UBI (29–41) is a promising SPECT and PET-based tracer for detecting focal infections. 2-APBA (2-acetyl-phenyl-boronic acid), a non-natural amino acid, specifically targets lysyl-phosphatidyl-glycerol (lysyl-PG) on the S. aureus membranes, particularly in AMP-resistant strains. We propose that combining UBI with 2-APBA could enhance the diagnostic potential of radiolabeled UBI.ResultsPresent work aimed to compare the diagnostic potential of two radiolabeled peptides, namely UBI (29–41) and 2-APBA modified UBI (29–41), referred to as UBI and UBI-APBA. APBA modification imparted antibacterial activity to the initially non-bactericidal UBI against S. aureus by inducing a loss of membrane potential. The antibacterial activity demonstrated by UBI-APBA can be ascribed to the synergistic interaction of both UBI and UBI-APBA on the bacterial membrane. To enable PET imaging, we attached the chelator 1,4,7-triazacyclononane 1-glutaric acid 4,7-acetic acid (NODAGA) to the peptides for complexation with the positron emitter Gallium-68 (68Ga). Both NODAGA conjugates were radiolabeled with 68Ga with high radiochemical purity. The resultant 68Ga complexes were stable in phosphate-buffered saline and human serum. Uptake of these complexes was observed in S. aureus but not in mice splenocytes, indicating the selective nature of their interaction. Additionally, the APBA conjugate exhibited superior uptake in S. aureus while preserving the selectivity of the parent peptide. Furthermore, [68Ga]Ga-UBI-APBA demonstrated accumulation at the site of infection in rats, with an improved target-to-non-target ratio, as evidenced by ex-vivo biodistribution and PET imaging.ConclusionsOur findings suggest that linking UBI, as well as AMPs in general, with APBA shows promise as a strategy to augment the theranostic potential of these molecules.

Wunderlich syndrome as a rare complication of polyarteritis nodosa: a case report.

Spontaneous subcapsular and perirenal hemorrhage, known as Wunderlich syndrome (WS), is a rare clinical manifestation of polyarteritis nodosa (PAN). We report a case of a 48-year-old male with a history of recurrent episodes of leg muscle tenderness and dysesthesia, bilateral flank pain, painful nodular skin lesions in the lower limbs, weight loss, and difficult-to-control arterial hypertension. The abdominopelvic computed tomography angiography showed a large left perirenal hematoma, leading to the patient's admission to the intensive care unit. After the exclusion of infectious or neoplastic foci, the patient was diagnosed with PAN and started intravenous methylprednisolone pulses with a good response. Since WS is a rare initial clinical manifestation of PAN, an early diagnosis and aggressive treatment will significantly improve clinical outcomes.

Bacterial osteomyelitis in pediatric patients: a comprehensive review.

Bacterial osteomyelitis, an inflammatory response in the bone caused by microorganisms, typically affects the metaphysis in the skeletally immature. Bacterial osteomyelitis possesses a significant diagnostic challenge in pediatric patients due to its nonspecific clinical presentation. Because the metaphysis is the primary focus of infection in skeletally immature patients, understanding the normal physiologic, maturation process of bones throughout childhood allows to understand the pathophysiology of osteomyelitis.Timely and accurate diagnosis is crucial to initiate appropriate treatment, and prevent long-term sequelae and efforts must be made to isolate the causative organism. The potential causative organism changes according to the age of the patient and underlying medical conditions. Staphylococcus Aureus is the most common isolated bacteria in pediatric pyogenic osteomyelitis whereas Kingella Kingae is the most common causative agent in children aged 6months to 4years. Imaging plays a pivotal role in the diagnosis, characterization, evaluation of complications, and follow up of bacterial osteomyelitis. Imaging also plays a pivotal role in the evaluation of potential neoplastic and non-neoplastic mimickers of osteomyelitis. In children, MRI is currently the gold standard imaging modality when suspecting bacterial osteomyelitis, whereas surgical intervention may be required in order to isolate the microorganism, treat complications, and exclude mimickers.

COMPARATIVE STUDY OF VARIOUS TECHNIQUES TONSILLECTOMY

Objective: The purpose of the study was to compare intraoperative factors and postoperative outcomes between the image-guided acute dissection technique and the endoscopic image-guided acute dissection technique. Material and methods: The study was conducted in 153 patients (81 men and 72 women, average age 26.4 years) who underwent tonsillectomy (2018-2023). Patients were randomly assigned 2 group 52% percent of patients(group1) underwent tonsillectomy with acute dissection technique under visual control, and 48% of patients (group 2) underwent tonsillectomy with acute dissection technique under endoscopic visualization using a 4.0 mm 0° endoscope (Karl Storz, Tuttlingen, Germany). Indications for tonsillectomy were hypertrophy of the tonsils in 82 patients, recurrent tonsillitis in 23 patients and focal infection of the tonsils in 48 patients. Tonsillectomy was performed under general anesthesia using an oral speculum specifically designed for tonsillectomy. All patients were assessed and compared for postoperative pain, bleeding, recurrence, or tonsil tissue growth in the immediate and late postoperative period. The removed adenoid is sent for histology. Clinical diagnosis: Chronic decompensated tonsillitis. Pathohistological diagnosis: Within the limits of the examined material, the histological picture corresponds to chronic tonsillitis, hypertrophy of nasopharyngeal adenoid tissue. Results: There were no serious intra- or postoperative complications. Bleeding points were identified in 47 patients (31 patients group1 and 16 patients group 2). The source of bleeding was observed in the central deep part of the adenoids - in 18 patients, in the lateral parts of the adenoids - in 16 patients, adenoids on both sides in 13. Remnants of adenoid tissue were found in 23 patients, (17 patients group 1 and 6 patients group 2). Remnants of adenoid tissue were removed using bipolar diathermy under image guidance. The operation time for endoscopic tonsillectomy is shorter than for traditional procedures. Conclusions: The visibility provided Tonsillectomy by endoscopic techniques improves the ease and precision of surgery. Clinical significance determines the need for further testing of already proposed means and methods.

A Proposal for a Multidisciplinary Integrated Oral Health Network for Patients Undergoing Major Orthopaedic Surgery (IOHN-OS).

The passing of the years of life physiologically leads to the accumulation of changes in tissues in the oral cavity, influencing dentition, chewing and swallowing mechanisms, and the oral microbiota. Some diseases and medications can aggravate oral symptoms and negatively influence eating behaviours, increasing the likelihood of becoming malnourished. This could make older individuals more vulnerable to complications when undergoing major orthopaedic surgery. Hidden infection foci in the oral cavity are a recognised cause of post-operative periprosthetic joint infections. Dysfunctional oral problems might also compromise feeding after surgery when good nutrition represents a fundamental aspect of a proper recovery. To manage these shortcomings, in this article, the authors hypothesise a multidisciplinary path of care named the Integrated Oral Health Network applied to major Orthopaedic Surgery (IOHN-OS). This peri-operative initiative would include pre-operative oral health screening and risk management by a dental team, patient education programmes before and after surgery, and bedside gerodontology actions like oral care and meal and eating support for fragile individuals. The IOHN-OS has the potential to reshape the concept of suitability for major orthopaedic surgery and generate momentum for designing community-based surveillance programmes that can keep the mouths of older subjects healthy for a long time.

Nursing care in pediatric patients with sepsis in a national hospital in Lima

Sepsis is a complication resulting from an unbalanced immune response to an infectious focus. Abdominal sepsis is an inflammatory process of the peritoneum caused by pathogenic germs, localized or diffuse. Objective: Describe nursing care in the care of pediatric patients diagnosed with sepsis. Methodology: Qualitative research, single case type of study, executed with the nursing care process method (PAE), applying Marjory Gordon's assessment instrument to a 12-year-old male patient; Diagnoses and care planning were formulated according to the NANDA-I, NOC and NIC taxonomy; The evaluation was carried out taking into account the results of the difference in baseline and final scores, obtaining scores of +1 and +1. Results: Nine altered nursing diagnoses were identified, the main nursing diagnosis (00007) Hyperthermia r/c high metabolic rate m/p temperature of 39°, hot skin and tachycardia and the main CR of septic shock were prioritized. The nursing interventions were effective, the patient improved his thermoregulation problem and, given the CR risk of septic shock, the results are in the process of improvement.Conclusions: the clinical characteristics of the pediatric patient with a diagnosis of sepsis were identified, as well as the risk factors that could complicate health, nursing interventions and preventive care were classified and prioritized to reduce the risk of complications, based on the PAE. An individual care plan was developed that allowed him to progressively improve his health condition

Role of ixodid ticks in tick-borne pathogen spread and circulation in the Belarusian Lakeland

Results of ixodid tick analysis for their ecological, epizootological and epidemiological significance for tick-borne pathogen spread across the Belarusian Lakeland are presented. The ticks were collected in publicly accessible areas of the Vitebsk Raion in April – November 2022: 8 routes were tracked, 18 flag-km were passed, 529 tick specimens were collected, including 350 imago ticks and 179 nymph ticks. The ixodid tick genus and species were determined using N. A. Filippova’s ixodid tick determinator. All caught ticks were tested for Borrelia spp., Anaplasma spp. (Ehrlichia spp.), Babesia spp. and Tick-borne encephalitis virus genetic materials with real-time polymerase chain reaction using the reagent kit for nucleic acid extraction from environmental samples in accordance with the manufacturer’s instruc­tions. The specimens were grouped in accordance with the MG 3.1.1027-01 “Collection, recording and preparation for laboratory tests of blood-sucking arthropods being vectors of natural focal infections”; therewith, one specimen includes only one tick. Differences in the numbers of ixodid ticks and the occurrence of genetic markers of tick-borne pathogens in them were found to be associated with ecological characteristics of the examined territories. The following epidemically and epizootically significant ticks contributing to transmissible infection and invasion spread were found in the Belarusian Lakeland: ticks of Ixodes and Dermacentor genera; their frequency index was 70.1 and 29.9%, respectively. Tick-transmitted pathogen prevalence rate in the examined territories of the Vitebsk Raion was as follows: 61.7% for Borrelia spp., 25.8% for Anaplasma spp. (Ehrlichia spp.) and 25% for Babesia spp., mixed infections were found in 10.8% of the ticks. No tick-borne encephalitis virus genetic materials were found in the specimens. Total infection rate for ixodid ticks was 22.7%.

308-nm excimer light is effective for palmoplantar pustulosis regardless of the presence or absence of focal infection: Single-center real-world experience of treatment for palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is relatively rare and recognition of PPP is different in different countries. Therefore, real-world data are limited. Local phototherapy for the palms and the soles is commonly used to treat PPP due to tolerable safety. However, data on the effectiveness of 308-nm excimer light are limited. In our study, we retrospectively investigated the effectiveness of treatments for PPP, especially phototherapy (308-nm excimer light), in our department. In addition, we examined whether smoking status and focal infection affected responsiveness to treatment of PPP. Patients who were diagnosed with PPP by board-certified dermatologists and visited our hospital from April 2015 to August 2018 were analyzed in this study. We collected data on PPP area severity index (PPPASI) before treatment. We also collected data on PPPASI in May to August 2018 as "after treatment" from all patients. Patients who received any treatment for less than 3 months were excluded. Nineteen patients (16 women and three men) were analyzed in this study. In patients treated with phototherapy (n = 12), PPPASI significantly decreased from a mean ± SD of 16.5 ± 10.3 to 4.5 ± 3.6 (p = 0.004), whereas it did not in patients treated without phototherapy (n = 7). Patients who quit smoking showed a significant decrease in PPPASI after treatment (16.8 ± 12.7 to 2.4 ± 2.9, p = 0.008). Regarding focal infection, in patients treated without phototherapy, the reduction rate of PPPASI was significantly lower in patients with focal infection than in those without focal infection (17.7 ± 21.5%, 71.1 ± 19.3%, p = 0.035), indicating that focal infection is associated with intractability. Meanwhile, in patients treated with phototherapy, PPPASI decreased regardless of the presence or absence of focal infection. In conclusion, our study demonstrated the effectiveness of local phototherapy consisting of 308-nm excimer light, regardless of focal infection. Patients who quit smoking were responsive to any treatment, indicating the importance of smoking cessation.

Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures.

The aim of the present study is to evaluate the necessity of performing lumbar puncture in patients experiencing febrile seizures, considering the epidemiology specific to Brazil. A retrospective cross-sectional study was performed from January 2017 to December 2021. A total of 469 children with seizure and fever were analyzed. The identified event was the first in 65.9% (n = 309). A total of 54.2% (n = 254) of patients had a simple febrile seizure. Infectious focus, excluding previous central nervous system (CNS) infection, was identified in 35.6% (n = 167) patients. Meningitis was identified in 7.7% (n = 36) patients, all of them were viral. Patients with CNS infection had a higher frequency of symptoms such as nausea and vomiting, drowsiness, headache, and higher level of leukocytosis. A longer duration of fever was found to be more strongly associated with CNS infection. When considering the use of lumbar puncture in febrile seizure, it is important to conduct a comprehensive evaluation that considers multiple factors, including clinical signs, symptoms, and the overall clinical context. Meningeal signs may be less prominent, and other symptoms such as lethargy, irritability, and vomiting may serve as more reliable indicators. Although clinical examination suggestive of meningitis remains an important factor, the recurrence of febrile seizures and a longer length of fever can provide additional insights and aid in decision-making regarding lumbar puncture.

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation

PurposeOrgan transplantation is an effective treatment for children with severe heart, liver, and kidney diseases. These patient groups may have more oral and dental diseases than healthy controls. It is important to eliminate oral infection foci before transplantation and to maintain good oral health to avoid potential post-transplant complications. The aim of this study was to describe and compare oral health in Finnish paediatric heart, liver, and kidney transplant recipients prior to organ transplantation.MethodsEighty-six children who received a heart (n = 21), liver (n = 19), or kidney (n = 46) transplant in Finland during the years 2014–2018 were included in this study. The inclusion criterion was a pre-transplantation oral examination. Oral hygiene, enamel anomalies, and the number of decayed, missing, and filled teeth (dmft/DMFT) were analyzed retrospectively from medical and dental records and compared between the three patient groups.ResultsChildren with liver (p = 0.043) or heart (p = 0.047) disease had higher combined primary and permanent dentition dmft/DMFT scores compared to children with kidney disease. A higher combined dmft/DMFT score was associated with poor oral hygiene (p = 0.005). No significant differences in oral hygiene between the patient groups were found. Furthermore, all patient groups had a high prevalence of developmental dental defects.ConclusionChildren with liver or heart disease seem to have a higher combined dmft/DMFT score, indicating a higher prevalence of caries compared to children with kidney disease. Prevention of dental caries, along with promoting a good oral hygiene routine and regular check-ups, is suggested in these patient groups.

Bones on fire: illuminating osteomyelitis through the radiant lens of 18F-FDG PET/CT.

Osteomyelitis is an inflammatory process that is caused by an infecting microorganism and leads to progressive bone destruction and loss. Osteomyelitis can occur at any age and can involve any bone. The infection can be limited to a single portion of the bone or can involve several regions, such as marrow, cortex, periosteum, and the surrounding soft tissue. Early and accurate diagnosis plays a crucial role in reducing unnecessary treatment measures, improving the patient's prognosis, and minimizing time and financial costs. In recent years, the use of functional metabolic imaging has become increasingly widespread. Among them, 18F-FDG PET/CT has emerged as a cutting-edge imaging modality that combines anatomical and functional metabolic information. It has seen rapid development in the field of infectious diseases. 18F-FDG PET/CT has been demonstrated to yield acceptable diagnostic accuracy in a number of infectious and inflammatory diseases. This review aims to provide information about the 18F-FDGPET/CT in the use of chronic osteomyelitis,osteomyelitis secondary to a contiguous focus of infection and osteomyelitis associated with peripheral vascular disease.