Infectious Disease Processes Research Articles

Preliminary Reference Intervals for Capillary Zone Electrophoresis Fractions and an Examination of MRP-126 as a Potential Marker of Inflammation in the Aldabra Giant Tortoise (Aldabrachelys gigantea)

The diagnostic utility and reference intervals for blood studies in Aldabra giant tortoises (Aldabrachelys gigantea) are not well described. Capillary zone electrophoresis (CZE) has been evaluated in non-mammalian vertebrates and shows a higher fraction resolution and less overall variation in results than agarose gel electrophoresis. To date, the investigation of novel biomarkers has been limited in reptiles. MRP-126, a calgranulin homologue in reptiles, has not been evaluated for its diagnostic potential in tortoises. The goals of this study were to establish preliminary reference intervals for CZE protein electrophoresis and to examine MRP-126 as a potential biomarker of inflammation in Aldabra giant tortoises. In 27 clinically healthy tortoises, CZE resolved seven protein fractions. In tortoises with an inflammatory or infectious disease process (n = 4), MRP-126 concentrations and CZE fractions did not consistently increase or were abnormal. To strengthen the understanding of the diagnostic value of CZE and MRP-126 concentration in this species, future studies should evaluate a larger sample set inclusive of repeated measures of clinically abnormal tortoises as well as CZE and MRP-126 variations in regard to additional health conditions, age, sex, season, and geographic location.

Case report: Reversible splenial lesion syndrome preceding the onset of multiple sclerosis

BackgroundThe reversible splenial lesion syndrome is frequently associated with systemic and central nervous system infections. Whether an infection associated with the occurrence of the reversible splenial lesion syndrome could play a role in the later development of multiple sclerosis is unknown.MethodsCase Report.ResultsA 27-year-old woman developed an infection-related reversible splenial lesion syndrome. Diagnostic findings did not establish a specific type of infection, but revealed evidence for a potential disposition towards autoimmunity. 32 months after the initial presentation, new clinical and radiological manifestations developed that led to a diagnosis of multiple sclerosis.ConclusionsIn susceptible individuals, infectious disease processes involving the central nervous system, such as described in this case, might be a factor in the pathogenesis of multiple sclerosis. More research on the prodromal stage of multiple sclerosis is needed to better understand the relationship between infections and autoimmunity.

Dynamic evolution analysis and parameter optimization design of data-driven network infectious disease model

Background and Objective:globalization and population mobility have increased the spread of infectious diseases and challenged public health security. This paper proposes a complex network epidemic model with nonlinear incidence rate and quadratic transmission. The Turing pattern, sensitivity analysis and parameter identification of the epidemic model under different network structures are studied; Methods:this paper discusses the Turing pattern of the model under different network structures, and identifies the key parameters of the model through sensitivity analysis. The influence of network dimension on the spread of infectious diseases on random networks is also explored, and the problems of minimum path and minimum cover set of random networks are further discussed. We also carry out parameter identification experiments, adopt gradient descent algorithm to realize heterogeneous spatial fitting pattern of red blood cell plasma and simulate the transmission path of COVID-19 through Markov chain Monte Carlo fitting experiment, verifying the effectiveness of the model; Results:the necessary conditions for Turing instability on homogeneous and heterogeneous networks are found. On the heterogeneous lattice network, we observe the special patterns of equal density population. Sensitivity analysis shows that the higher the infection rate, the more infected people. On random networks, the higher the dimension, the better the effect of suppressing the spread of infectious diseases. Through comparison experiment, it is found that gradient descent algorithm has the best performance in parameter identification experiments. Red blood cell plasma fitting experiment reveals the spatial density distribution of infection rate; Conclusions:this study provides theoretical support for the prevention and control of infectious diseases, and the complex network model can simulate the transmission process of infectious diseases more accurately. Sensitivity analysis and parameter identification experiments reveal the key influencing factors of propagation and the role of network structure. The effectiveness of the model is supported by actual data, which is helpful for the government health departments to formulate scientific prevention and control strategies.

Evaluation of Certification Board of Infection Control and Epidemiology, Inc. Certification in Infection Control (CIC) Examination Rates

BackgroundInfection Prevention professionals develop through training and certification practices, with the Certified in Infection Control and Epidemiology (CIC®) exam being the industry standard for infection prevention and control expertise. MethodsThis study conducted a secondary analysis of Certification Board of Infection Control and Epidemiology, Inc. (CBIC) exam scores from 2013-2022. Reliability coefficients, Spearman-Brown coefficients, and Standard Error Measurement (SEM) averages were calculated for the CIC® exam’s eight objective areas from 2016-2022. ResultsOver the past decade, pass rates varied from 57.30% to 85.40%, with a mean of 69.7%. The number of exam participants ranged from 574 to 1,392. Despite the variability, the highest reliability, Spearman-Brown, and SEM averages were consistently observed in areas such as identifying infectious disease processes, surveillance, epidemiological investigation, and controlling transmission of infectious agents. ConclusionAs more facilities push for certification, the number of CIC® exam takers has increased. However, the evolving nature of infection prevention and the lack of a standardized training track contribute to variations in reliability coefficients across the exam's objective areas.

Virus Infection Induces Immune Gene Activation with CTCF-anchored Enhancers and Chromatin Interactions in Pig Genome.

Chromatin organization is important for gene transcription in pig genome. However, its three-dimensional (3D) structure and dynamics are much less investigated than those in human. Here, we applied the long-read chromatin interaction analysis by paired-end tag sequencing (ChIA-PET) method to map the whole-genome chromatin interactions mediated by CCCTC-binding factor (CTCF) and RNA polymerase II (RNAPII) in porcine macrophage cells before and after polyinosinic-polycytidylic acid [Poly(I:C)] induction. Our results reveal that Poly(I:C) induction impacts the 3D genome organization in the 3D4/21 cells at the fine-scale chromatin loop level rather than at the large-scale domain level. Furthermore, our findings underscore the pivotal role of CTCF-anchored chromatin interactions in reshaping chromatin architecture during immune responses. Knockout of the CTCF-binding locus further confirms that the CTCF-anchored enhancers are associated with the activation of immune genes via long-range interactions. Notably, the ChIA-PET data also support the spatial relationship between single nucleotide polymorphisms (SNPs) and related gene transcription in 3D genome aspect. Our findings in this study provide new clues and potential targets to explore key elements related to diseases in pigs and are also likely to shed light on elucidating chromatin organization and dynamics underlying the process of mammalian infectious diseases.

Clinicopathologic findings and causes of mortality in 100 pet rabbits from the Canary Islands, Spain, 2011-2022.

The European domestic rabbit (Oryctolagus cuniculus domesticus) is commonly kept as a pet, with increasing popularity among pet owners. Despite the increasing body of information on lagomorph medicine and pathology, comprehensive published compilations of causes of mortality in pet rabbits are limited. We analyzed health disorders, pathology findings, and most probable causes of death in 100 pet rabbits submitted to the Anatomopathological Diagnostic Service of the Veterinary School of the University of Las Palmas de Gran Canaria, Canary Islands, Spain, from 2011 to 2022. We reviewed clinical data and gross and histopathologic findings to classify the various disorders into infectious (n = 39), noninfectious (n = 45), and idiopathic conditions (n = 16). Within infectious disease processes, Encephalitozoon cuniculi infection (n = 14) and rabbit hemorrhagic viral disease (n = 14) had the highest prevalence. Regarding the noninfectious conditions, perioperative mortality (n = 10), gastrointestinal syndrome (n = 7), and trauma (n = 6) were the most common clinicopathologic entities observed.

Evaluation of Infection Preventionists' Competencies Using the Association for Professionals in Infection Control and Epidemiology Competency Model in Tertiary Care Government Hospitals, Bahrain.

Introduction Infection preventionists (IPs) are healthcare workers (HCWs) who received specialized training in infection prevention and control (IPC) to be able to deliver specific tasks to prevent and control infection transmission to patients, HCWs, and visitors in all healthcare settings. Most IPs started their professional life as nurses, physicians, microbiology, public health, or allied health specialties before moving to the IPC field, not necessarily with specialized training or diploma, which may need more focus on unified competency tool to evaluate their skills and strengths and improve IPC program outcome. Aim This study aimed to examine IPs' self-rated competency level using the Association for Professionals in Infection Control and Epidemiology(APIC) core competencies and to determine what factors influence the level of competency among IPs in Government Hospitals (GHs) in Manama, Bahrain. Subject and methods This cross-sectional study was conducted among non-certified IPs in Bahrain's GHs. A self-administered questionnaire was distributed among the targeted IPs using the Microsoft 365 form (Microsoft® Corp., Redmond, WA). The questionnaire includes socio-demographic characteristics (e.g., age, gender, years of experience, etc.), the APIC competency tool to assess IP competency, and the perceived effectiveness of the IPC program. Results Of the 17 IPs, 88.2% were females, and 47.1% were between 31 and 35 years old. Among the eight APIC core competencies, management and communication had the highest mean percentage score (84.2%), followed by preventing/controlling the transmission of infectious diseases (84.1%) and the identification of infectious disease processes (81.5%). The total mean competency score was 142.8 (SD: 20.3), with 70.6% classified as having a good level of competency. Increasing years of IP experience was the only factor associated with increased competency scores. Conclusion The level of IPC competency among "novice" or "becoming" proficient IPs was sufficient. Using the APIC competency tool, IPs showed competence in managing and communicating, preventing or controlling transmission of infectious agents, identifying infectious disease processes, and surveillance and epidemiologic investigations. Further research is needed to give more insights into the level of IPC competency of IPs in our region.

Infection Prevention and Control in the Emergency Department Unit in King Khalid Hospital, Hail City, Saudi Arabia

Context: The emergency department presents unique challenges to infection control and prevention. Infection control (IC) activities include the identification of infectious disease processes, surveillance, and epidemiologic investigation, preventing/controlling the transmission of infectious agents/healthcare-associated infections, employee/occupational health, management and communication, education and research, managing the environment of care, and cleaning, sterilization, disinfection, and asepsis. Aim: Assess infection prevention and control practices in the emergency department in King Khalid Hospital, Hail City, Saudi Arabia. Methods: A quantitative, descriptive correlational study design was used to conduct the study in the emergency department (ED) unit at King Khalid Hospital (KKH), Hail City, Saudi Arabia. All available nurses working in the emergency department KKH at the time of data collection. A self-administered structured questionnaire was utilized to collect data in the current study. Results: 71.7% (n=76) of the participants were between 25 and 35 years old, 24.5% (n=26) were between 36-45 years old, and only 3.8% (n=4) were over 45 years old. 79.2% of the nurses reported that there is a curriculum or program for IC training for doctors and nurses, 71.7% mentioned that they have recommendations for IC training link doctors and nurses, 84.8% reported that IC issues are parts of the examination and evaluation in basic training for nurses, and there are policies and procedures elaborating infection control interventions. Besides, 82.1% of the nurses reported infection control policies and guidelines in their units, and 83% and 82.7% stated that there is a list of reportable infectious agents available in their unit and accessible to all staff, and there is an active infection control team, respectively. Conclusion: Overall, this study indicated that nurses reported a high level of infection prevention and control practices in the ED of King Khalid Hospital. There was no statistically significant association between nurses' knowledge of infection prevention and control practices and their demographic characteristics. Implementing regular training and educational programs for nurses, focusing on updating knowledge and skills in IPC practices, was recommended.

Development and evaluation of an intensive short course: the Quantitative Microbial Risk Assessment Interdisciplinary Instructional Institute (QMRA III).

Quantitative microbial risk assessment (QMRA) is a growing interdisciplinary field addressing exposures to microbial pathogens and infectious disease processes. Risk science is inherently interdisciplinary, but few of the contributing disciplinary programs offer courses and training specifically in QMRA. To develop multidisciplinary training in QMRA, an annual 10-day long intensive workshop was conducted from 2015 to 2019-the Quantitative Microbial Risk Assessment Interdisciplinary Instructional Institute (QMRA III). National leaders in the fields of public health, engineering, microbiology, epidemiology, communications, public policy, and QMRA served as instructors and mentors over the course of the program. To provide cross-training, multidisciplinary teams of 5-6 trainees were created from the approximately 30 trainees each year. A formal assessment of the program was performed based on observations and surveys containing Likert-type scales and open-ended prompts. In addition, a longitudinal alumni survey was also disseminated to facilitate the future redevelopment of QMRA institutes and determine the impact of the program. Across all years, trainees experienced statistically significant increases (P < 0.05) in their perceptions of their QMRA abilities (e.g., use of specific computer programs) and knowledge of QMRA constructs (e.g., risk management). In addition, 12 publications, three conference presentations, and two research grants were derived from the QMRA III institute projects or tangential research. The success of QMRA III indicates that a short course format can effectively address many multidisciplinary training needs. Key features of QMRA III, including the inter-disciplinary training approach, hands-on exercises, real-world institute projects, and interaction through a mentoring process, were vital for training multidisciplinary teams housing multiple forms of expertise. Future QMRA institutes are being redeveloped to leverage hybrid learning formats that can further the multidisciplinary training and mentoring objectives.

An inflammatory paradox: strategies inflammophilic oral pathobionts employ to exploit innate immunity via neutrophil manipulation.

Inflammatory dysbiotic diseases present an intriguing biological paradox. Like most other infectious disease processes, the alarm bells of the host are potently activated by tissue-destructive pathobionts, triggering a cascade of physiological responses that ultimately mobilize immune cells like neutrophils to sites of active infection. Typically, these inflammatory host responses are critical to inhibit and/or eradicate infecting microbes. However, for many inflammatory dysbiotic diseases, inflammophilic pathobiont-enriched communities not only survive the inflammatory response, but they actually obtain a growth advantage when challenged with an inflammatory environment. This is especially true for those organisms that have evolved various strategies to resist and/or manipulate components of innate immunity. In contrast, members of the commensal microbiome typically experience a competitive growth disadvantage under inflammatory selective pressure, hindering their critical ability to restrict pathobiont proliferation. Here, we examine examples of bacteria-neutrophil interactions from both conventional pathogens and inflammophiles. We discuss some of the strategies utilized by them to illustrate how inflammophilic microbes can play a central role in the positive feedback cycle that exemplifies dysbiotic chronic inflammatory diseases.

Experimental Infection Models and Their Usefulness for White Spot Syndrome Virus (WSSV) Research in Shrimp

White spot syndrome virus (WSSV) is marked as one of the most economically devastating pathogens in shrimp aquaculture worldwide. Infection of cultured shrimp can lead to mass mortality (up to 100%). Although progress has been made, our understanding of WSSV’s infection process and the virus–host–environment interaction is far from complete. This in turn hinders the development of effective mitigation strategies against WSSV. Infection models occupy a crucial first step in the research flow that tries to elucidate the infectious disease process to develop new antiviral treatments. Moreover, since the establishment of continuous shrimp cell lines is a work in progress, the development and use of standardized in vivo infection models that reflect the host–pathogen interaction in shrimp is a necessity. This review critically examines key aspects of in vivo WSSV infection model development that are often overlooked, such as standardization, (post)larval quality, inoculum type and choice of inoculation procedure, housing conditions, and shrimp welfare considerations. Furthermore, the usefulness of experimental infection models for different lines of WSSV research will be discussed with the aim to aid researchers when choosing a suitable model for their research needs.

ЭПИДЕМИОЛОГИЧЕСКАЯ ЭФФЕКТИВНОСТЬ ИММУНОПРОФИЛАКТИКИ ИНФЕКЦИОННЫХ БОЛЕЗНЕЙ В РЕСПУБЛИКЕ БЕЛАРУСЬ: ОТ ТЕОРИИ К ПРАКТИКЕ

Introduction. Under modern conditions, immunoprophylaxis should be considered a highly effective intervention in the epidemic process of infectious diseases. However, in scientific and methodological literature, there are a large number of different terms and approaches to determine the epidemiological effectiveness of vaccine prophylaxis. Several of them will not allow giving an adequate assessment of effectiveness in the conditions of mass vaccination of the population, which makes it expedient to unify the concepts and methods to interpret both direct and indirect effects of immunoprophylaxis, to identify and assess the parameters of the "impact" of vaccines and their influence on public health. Objective. Analyze the direct and indirect effects of vaccine prophylaxis under the conditions of routine vaccination of the population. Materials and methods. The material of the epidemiological study was clinical and epidemiological data on the morbidity of the population of the Republic of Belarus with vaccine-preventable infectious diseases, data on the monitoring of immunoprophylaxis at national and regional levels, and demographic indicators. Epidemiologic, descriptive evaluation, analytical, prognostic and statistical methods of research were used. Results. The direct epidemiological effects of vaccines against pertussis, measles, rubella, epidemic parotitis, viral hepatitis B at the population level (in Belarus), viral hepatitis A, and Hib infection at the regional level (were analyzed under Minsk) in the conditions of routine vaccination of the population. The indirect effects of influenza vaccination on the epidemic process of bacterial aerosol infections (meningococcal infection and scarlatina) at national and regional levels were determined. Conclusion. Currently, a methodology and terminology for a comprehensive evaluation of direct and indirect effects of vaccine prophylaxis under real conditions of mass vaccination, including those available in the practical work of a physician-epidemiologist.

Age-related resistance of cattle to leukemia virus

The emergence and spread of the epizootic process of infectious diseases is characterized by a variety of biological, natural-geographical, socio-economic, and other factors. The question of the age dynamics of animals infected with HCV remains important. The article describes the results of studying the age dynamics of HCV infection and changes in the biochemical status of cattle blood. These data indicate that the features and patterns in the development and manifestation of bovine leukemia do not depend to a small extent on the age of the animal. In general, with increasing age of cows, the intensity of the infectious process increases. According to our data, a gradual increase in the infection rate of livestock over the 3 years of the study was observed up to the age of 7 years. From 30.9 and 32.8% in cows aged 2 to 3 years, to 61.0 and 65.7% of infection in cows under 7 years old. Cows older than 7 years had a significant decrease in the level of infection with HCV. However, as studies have shown, the state of metabolism of cows also plays an important role in the development of the infectious process. Disorders of protein metabolism, a decrease in the level of globulins in the blood can contribute to the acceleration of the development of the infectious process caused by VLCRS.

Stability and Hopf Bifurcation Analysis of a Multi-Delay Vector-Borne Disease Model with Presence Awareness and Media Effect

Vector-borne diseases, being one of the most difficult infectious diseases to understand, model, and control, account for a large proportion of human infectious diseases. In the current transmission process of infectious diseases, the latent period of pathogens in vivo, the influence of media coverage, and the presence of awareness on the spread and control of diseases are important factors that cannot be ignored. Based on this, a novel vector-borne disease model with latent delay and media coverage delay is proposed to discuss the impact of these factors. First, the global existence and ultimate boundedness of solutions for this model are obtained. Further, the exact expressions for the basic reproduction number are given, from which the existence and local stability of the disease-free and endemic equilibria are analyzed. Moreover, using the delay as a bifurcation parameter, we also discuss the existence, direction, and stability of the Hopf bifurcation. Finally, some numerical examples are carried out to explain the main theoretical results and discuss the impacts of the main parameters of this model on the transmission of vector-borne disease.

Threshold dynamics of an uncertain SIRS epidemic model with a bilinear incidence

This paper mainly discusses the extinction and persistent dynamic behavior of infectious diseases with temporary immunity. Considering that the transmission process of infectious diseases is affected by environmental fluctuations, stochastic SIRS models have been proposed, while the outbreak of diseases is sudden and the interference terms that affect disease transmission cannot be qualified as random variables. Liu process is introduced based on uncertainty theory, which is a new branch of mathematics for describing uncertainty phenomena, to describe uncertain disturbances in epidemic transmission. This paper first extends the classic SIRS model from a deterministic framework to an uncertain framework and constructs an uncertain SIRS infectious disease model with constant input and bilinear incidence. Then, by means of Yao-Chen formula, α-path of uncertain SIRS model and the corresponding ordinary differential equations are obtained to introduce the uncertainty threshold function R 0 * as the basic reproduction number. Moreover, two equilibrium states are derived. A series of numerical examples show that the larger the value of R 0 * , the more difficult it is to control the disease. If R 0 * ≤ 1 , the infectious disease will gradually disappear, while if R 0 * &gt; 1 , the infectious disease will develop into a local epidemic.

Immunoregulatory functions of natural killer cells in avian influenza virus infection

The avian influenza virus (AIV) has a great pandemic potential both in animals, and in human population. For effective struggle against this virus, it is important to study the immune response against AIV, and, in particular, the features of T cell immunity. At the period of early immune response, when the activation of adaptive immunity factors has not yet occurred, the natural killers, which have both cytotoxic and immunoregulatory functions, are known to play a key role in the fight against the influenza virus. In this study, we investigated the interaction between natural killers and T helpers in the process of antiviral response. The aim of this study was to study immunoregulatory functions of NK cells in BALB/c mice vaccinated with different doses of avian influenza virus.We used a strain of mouse-adapted avian influenza virus (AIV) of the H5N2 serotype (A/duck/ Pennsylvania/10218/1984). The determination of the virus titer in the mice lung tissue was performed by infecting 10-day-old chicken embryos (SPF) with lung extracts at various decimal dilutions, followed by the immune agglutination test. Quantitative determination of natural killers and T helpers (Th) in the mice spleen tissue was carried out by flow cytometry. The amount of Th cells in mice spleens increased at low infectious dose (2.5 EID50) which is explained by active clonal expansion of this cell subpopulation. The infectious disease process ended upon complete virus elimination from the lungs. The amounts of Th cells were also increased in a group of mice infected with intermediate infectious dose (25 EID50), however, being accompanied by virus replication in lungs. When the mice were infected with a high dose of the virus (250 EID50), there was a decrease in the Th cells number versus control group of animals, whereas replication of AIV was noted throughout the entire observation period in the lung tissue.The amounts of helper T cells at high doses of viral infection could be decreased due to activation of NK cells. The activated NK cells may then eliminate exhausted helper T cells. Thus, NK cells immunoregulatory function represents an important immunological factor which keeps balance between the pathogen destruction and excessive inflammation of the lung tissue affected by the avian influenza virus.

The spatiotemporal analysis of the population migration network in China, 2021

Population migration is a critical component of large-scale spatiotemporal models of infectious disease transmission. Identifying the most influential spreaders in networks is vital to controlling and understanding the spreading process of infectious diseases. We used Baidu Migration data for the whole year of 2021 to build mobility networks. The nodes of the network represent cities, and the edges represent the population flow between cities. By applying the k-shell decomposition and the Louvain algorithm, we could get the k-shell values for each city and community partition. Then, we identified the most efficient nodes or pathways in a complex network by generating random networks. Furthermore, we analyzed the eigenvalue of the migration matrix to find the nodes that have the most impact on the network. We also found the consistency between k-shell value and eigenvalue through Kendall's τ test. The main result is that in Spring Festival and National Day, the network is at higher risk of an infectious disease outbreak and the Yangtze River Delta is at the highest risk of an epidemic all year around. Shanghai is the most significant node in both k-shell value and eigenvalue analysis. The spatiotemporal property of the network should be taken into account to model the transmission of infectious diseases more accurately.

Morphological Spectrum of Bone Marrow Aspirates in Infections: A Clinico-Hematological Analysis.

Bone marrow examination (BME) is an invaluable tool for cases with pyrexia of unknown origin and pancytopenia. However, it is under-utilized for diagnosing infectious etiology and there is a paucity of literature regarding its role in infective pathology. This study aims to bring to light the role of BME in diagnosing infectious pathology. A retrospective study was carried out on bone marrow aspirates (BMAs) sent to the hematology department over the past 4 years. Clinical details, peripheral smears and BMA were retrieved from the records and analyzed. Leishman-stained peripheral smears and BMA were studied along with bone marrow biopsy wherever feasible. A total of 52 cases were studied. The most common clinical presentation was fever, clinical finding was splenomegaly and hematological finding was anemia. Based on the morphological findings in combination with clinical history, cases were categorized into-parasitic (26.9%), viral (23.1%), tubercular (11.5%), and nonspecific infections (38.5%). Parasites such as Leishmania donovani, microfilaria, plasmodium falciparum, and vivax were reported in 14/52 (27%) cases. Associated BMA findings were plasmacytosis, eosinophilia, reactive lymphocytosis, or dyserythopoiesis. In 38% (20/52) cases, no specific cause of infection was found in the bone marrow. These patients showed histiocytosis, hemophagocytosis, maturation arrest in myeloid lineage, relative myeloid hyperplasia, dysmyelopoiesis, toxic granulation/vacuolation in myeloid cells, lymphocytosis, increased plasma cells or monocytosis in marrow. Increased histiocytes, hemophagocytosis, dysplastic changes, maturation arrest, relative myeloid hyperplasia or reactive plasmacytosis, lymphocytosis, and monocytosis are BMA features which must alert the pathologist towards an infectious disease process, a knowledge of these changes can help extend the scope of BME beyond hemato-lymphoid malignancies.

Unilateral Ptosis Secondary to Pansinusitis in a Pediatric Patient: A Case Report

Introduction: Ptosis or the dropping of an eyelid can affect both the adult and pediatric populations and can be caused by various factors. Ptosis is not very common and in children, the common causes include orbital cellulitis, congenital ptosis, Cranial Nerve III palsy, and Horner’s syndrome. However, unilateral acute ptosis from an infectious disease process is rare and there are only a few documented cases of such occurrences. Acute ptosis is a medical emergency and prompt diagnosis, and management is critical for the resolution of symptoms and prevention of serious complications. Case: We present an interesting case of a 14-year-old female with pansinusitis who experienced unilateral left-sided ptosis. Initially prescribed oral antibiotics for sinusitis, the patient developed ptosis, requiring inpatient hospital admission and intravenous antibiotics. On admission, the patient had leukocytosis, elevated CRP, and ESR levels. CT facial bones showed pansinusitis and ruled out orbital cellulitis, acute intracranial abnormalities, and venous sinus thrombosis. After aggressive treatment with intravenous antibiotics and systemic steroids, the sinusitis resolved, as did her unilateral ptosis and facial swelling. Discussion: This is a unique presentation of ptosis that was treated successfully allowing for prompt and complete resolution. We want to highlight the establishment of a varying diagnosis and treatment courses which led to the final resolution of the acute ptosis. The patient was treated with meropenem and dexamethasone. The adjunctive use of corticosteroids, in this case, was beneficial.

A data-driven Markov process for infectious disease transmission.

The 2019 coronavirus pandemic exudes public health and socio-economic burden globally, raising an unprecedented concern for infectious diseases. Thus, describing the infectious disease transmission process to design effective intervention measures and restrict its spread is a critical scientific issue. We propose a level-dependent Markov model with infinite state space to characterize viral disorders like COVID-19. The levels and states in this model represent the stages of outbreak development and the possible number of infectious disease patients. The transfer of states between levels reflects the explosive transmission process of infectious disease. A simulation method with heterogeneous infection is proposed to solve the model rapidly. After that, simulation experiments were conducted using MATLAB according to the reported data on COVID-19 published by Johns Hopkins. Comparing the simulation results with the actual situation shows that our proposed model can well capture the transmission dynamics of infectious diseases with and without imposed interventions and evaluate the effectiveness of intervention strategies. Further, the influence of model parameters on transmission dynamics is analyzed, which helps to develop reasonable intervention strategies. The proposed approach extends the theoretical study of mathematical modeling of infectious diseases and contributes to developing models that can describe an infinite number of infected persons.