Manifestations Of Infection Research Articles

Skin manifestations and human immunodeficiency virus infection in the Tigray region, Ethiopia: Implications for clinical management and epidemiologic surveillance

AbstractBackgroundPatients with human immunodeficiency virus (HIV) infection may present a large variety of skin manifestations, often associated with significant morbidity. In turn, dermatological diseases may represent an early sign of HIV infection, particularly in resource‐limited settings.ObjectivesThis study aimed to assess the spectrum of dermatological diseases and their potential value as clinical proxies for the early detection and management of HIV in a rural region of Ethiopia.MethodsThe study was performed on a population of 67,161 patients with skin diseases attending the Italian Dermatological Center in Mekele, Tigray region, Ethiopia. HIV infection was diagnosed in 1892 individuals (1065 female), all naïve to antiretroviral therapy.ResultsInfectious skin diseases were present in 57.2% of the total HIV population. Among the infectious skin manifestations, dermatophytosis (20.5%), impetigo (5.9%), candidiasis (4.7%) and molluscum contagiosum (4.7%) were significantly more represented in patients with HIV infection (p < 0.001). Regarding the noninfectious manifestations, pruritus and atrophy of the papillae on the tongue were significantly associated with HIV (p < 0.001). Notably, females had a significantly higher incidence of dermatophytosis and seborrheic dermatitis as compared to their male counterparts (p < 0.001), whereas scabies, psoriasis and leishmaniasis were significantly more frequent in males (p < 0.001).ConclusionsSkin manifestations are common in HIV patients, often reflecting compromised immune status. In addition, Dermatophytosis and pruritus were the most frequently reported manifestations of HIV, thus representing useful clinical proxies to raise the suspicion of an underlying HIV infection. Besides, gender differences in skin manifestations should also be considered in the clinical evaluation.

Mortality in Community-Acquired Sepsis and Infections in the Faroe Islands-A Prospective Observational Study.

The aim of this study was to collect data and analyze mortality among patients hospitalized with community-acquired infections in the Faroe Islands. A prospective observational study was conducted in the Medical Department of the National Hospital of the Faroe Islands from October 2013 to April 2015. Cumulative all-cause, in-hospital, short-term, intermediate-term and long-term mortality rates were calculated. Kaplan-Meier survival curves comparing infection-free patients with infected patients of all severities and different age groups are presented. A log-rank test was used to compare groups. Mortality hazard ratios were calculated for subgroups using Cox regression multivariable models. There were 1309 patients without infection and 755 patients with infection. There were 51% female and 49% male patients. Mean age was 62.73 ± 19.71. Cumulative all-cause mortality and in-hospital mortality were highest in more severe forms of infection. This pattern remained the same for short-term mortality in the model adjusted for sex and age, while there were no significant differences among the various infection groups in regard to intermediate- or long-term survival after adjustment. Overall and short-term mortality rates were highest among those with severe manifestations of infection and those with infection compared to infection-free patients.

Predictors of early-onset neonatal infections (review)

Predictors of early-onset neonatal infections (review)

Maxillofacial Abscess et Causa Odontogenic Infection: A Case Report

Background: Odontogenic infection is an infection that occurs in the oral cavity caused by carious teeth and periodontal disease where the disease can spread to surrounding tissues to the face, jaw and neck. Maxillofacial abscess is a manifestation of periapical or periodontal infection. incicus, canicus or molar teeth, where periapical infection is the most frequent source of odontogenic infection compared to periodontal. Inflammation or damage to chronic dental problems can cause complications of abscesses in the surrounding area. The main complaint that causes sufferers to come to the hospital is pain in the abscess area. These complaints can also be accompanied by trismus, dysphagia, stridor caused by compression of the trachea, and even respiratory tract obstruction. Objective: To determine the progression of maxillofacial abscess so that medical management can be provided up to surgical incision and drainage. Case report: We report 2 cases of maxillofacial abscess due to odontogenic infection with management according to the progression of each case. Conclusion: The most common cause or etiology that can cause maxillofacial abscess is toothache. Management of maxillofacial abscesses begins with empirical antibiotics, which is the first step to reduce bacterial infections that produce beta lactamase. In maxillofacial abscesses, medical therapy can be given in the form of antibiotics combined with ceftriaxone with metronidazole, or meropenem with metronidazole and termination measures in the form of incision and drainage. Treatment can be chosen based on the presence or absence of warning signs and signs of complications. Incision and drainage is performed when complaints do not improve after administration of antibiotics, multiple abscesses and airway obstruction threaten the patient's life.

Uropathogens and clinical manifestations of pyuria-negative urinary tract infections in young infants: A single center cross-sectional study

BackgroundUrine leukocyte count under microscopy is one of the most frequently used routine screening tests for urinary tract infection (UTI). Nevertheless, it is observed that pyuria is lacking in 10-25% of children with UTI. This study aims to determine the factors related to pyuria-negative UTI in young infants aged under four months old. MethodThis retrospective cross-sectional study was conducted on 157 patients aged under 4 months old with UTI. All subjects had paired urinalysis and urine culture, which were collected via transurethral catheterization. According to the results of their urinalysis, the patients were then classified as UTI cases with pyuria and UTI cases without pyuria. The clinical characteristics and outcomes of both groups were analyzed. ResultAmong the 157 UTI patients, the prevalence of pyuria-negative UTI was 44%. Significant risk factors associated with pyuria-negative UTI included non-E.coli pathogens, younger age, shorter duration of fever prior to hospital visit, lower white blood cell (WBC) count upon hospital visit, and absence of microscopic hematuria. ConclusionsWe found that non-E.coli uropathogens were the strongest factor related to pyuria-negative UTI. The absence of pyuria cannot exclude the diagnosis of UTI in young infants, and it’s reasonable to perform both urinalysis and urine culture as a part of the assessment of febrile or ill-looking young infants.

Clinical manifestations of rhinovirus infections during the latest wave of COVID-19 in hospitalized children

Clinical manifestations of rhinovirus infections during the latest wave of COVID-19 in hospitalized children

Steroid-responsive encephalopathy in autoimmune thyroiditis in a 2-year-old child after COVID-19 infection: A case report

In pediatric patients, neurological manifestation of COVID-19 infection has been reported in acute and postinfectious stages. Hashimoto encephalopathy (HE) is the most common cause of hypothyroidism in children with prevalence being 1.2%. More than 200 cases of HE have been reported in adults. Only 60 cases have been reported in children. We present a case of a 2-year-old girl with status epilepticus and respiratory failure needing prolonged ventilation. Her COVID-19 antibody and antithyroid antibodies (anti-thyroid peroxidase and anti-thyroglobulin) were positive. Her thyroid profile was abnormal. Her clinical state improved after receiving an intravenous immunoglobulin and pulse dose of methylprednisolone. This suggests that complete recovery for such patients can be achieved with early detection and immunomodulatory treatment.

Anti-Herpes zoster vaccination in patients with dermatologic diseases: a position statement from the Italian SIDeMaST group of sexually transmitted, infectious and tropical diseases.

Herpes zoster (HZ) is a condition caused by the reactivation of varicella-zoster virus (VZV), the virus responsible for chickepox, which is the clinical manifestation of the primary infection. Congenital or acquired immune system deficiencies, as well as the physiological decline in immune response occurring in the elderly, known as immune senescence, can allow VZV reactivation and, consequently, HZ. One out of 3 people develops HZ during their lifetime. Moreover, thirty percent of the affected subjects develop post-herpetic neuralgia, the most frequent complication after HZ skin rash. Patients with dermatological conditions characterized by alteration of the immune system, such as systemic lupus erythematosus, psoriasis, atopic dermatitis, bullous diseases, and cutaneous lymphomas, are at higher risk of developing HZ and post-herpetic neuralgia, even when their disease is in remission. In the present work, we described the currently available vaccinations against HZ and provided recommendations for the vaccination against HZ in patients with dermatological diseases.

Descriptive Study of Chicken Pox in the Post Graduated Hospital Khost Afghanistan

Chicken pox is an acute infectious disease of viral etiology, characterized by the appearance of characteristic blistering rash against the background of a general intoxication syndrome. (13, 14) The causative agent of chickenpox is the herpes virus type 3, transmitted from a patient by airborne droplets. Chickenpox is one of the most common childhood infections. It is manifested by characteristic abundant itchy blistering rashes that appear at the height of fever and general infectious manifestations. (15, 16) A typical clinic allows you to diagnose the disease without conducting any additional research. Treatment of chickenpox is mainly symptomatic. To prevent secondary infection, antiseptic treatment of rash elements is recommended. Infants and Children are affects in all ages, but most severely infants, who experience the highest age-specific incidence and account for almost all Chickenpox hospitalizations and deaths. (17, 18, 19) Research Goal: Case of Chickenpox in the Khost post graduated hospital from the 1399/06/01 to 1399/12/30. Methodology: This is a descriptive study that was conducted in the form of a case series. This study was conducted on 43 patients affected by chicken pox.

The European Academy of Neurology NeuroCOVID-19 Task Force: A lesson for the future.

The COVID-19 pandemic has made its mark on world history forever causing millions of deaths, and straining health systems, economies, and societies worldwide. The European Academy of Neurology (EAN) reacted promptly. A special NeuroCOVID-19 Task Force was set up at the beginning of the pandemic to promote knowledge, research, international collaborations, and raise awareness about the prevention and treatment of COVID-19-related neurological issues. Activities carried out during and after the pandemic by the EAN NeuroCOVID-19 Task Force are described. The main aim was to review all these initiatives in detail as an overarching lesson from the past to improve the present and be better prepared in case of future pandemics. During the pandemic, the Task Force was engaged in several initiatives: the creation of the EAN NEuro-covid ReGistrY (ENERGY); the launch of several surveys (neurological manifestations of COVID-19 infection; the pandemic's impact on patients with chronic neurological diseases; the pandemic's impact of restrictions for clinical practice, curricular training, and health economics); the publication of position papers regarding the management of patients with neurological diseases during the pandemic, and vaccination hesitancy among people with chronic neurological disorders; and the creation of a dedicated "COVID-19 Breaking News" section in EANpages. The EAN NeuroCOVID-19 Task Force was immediately engaged in various activities to participate in the fight against COVID-19. The Task Force's concerted strategy may serve as a foundation for upcoming global neurological emergencies.

COVID-19 vaccine breakthrough infection among health care workers at MODHS hospitals in Saudi Arabia: A multicenter study

BackgroundWe investigated the clinical manifestation and severity of COVID-19 infection represented as a composite outcome (hospital or ICU admission, or in-hospital death) among infected fully vaccinated HCWs, the RT-PCR test Ct value (Cycle Threshold) of positive fully vaccinated HCWs, and we measure the interval from the second vaccine to acquiring the infection. MethodsA multicenter retrospective cohort study was conducted in different regions at (16) Ministry of Defense Health Services (MODHS) hospitals. Data were restricted to fully vaccinated (minimum of 2 doses) HCWs who had a confirmed positive PCR test and employed in MODHS hospitals from August 2021 to March 2022. ResultsA total of 45862 HCWs were vaccinated as of Aug 2021. Of these 1253 participants met the selection criteria and were included in the study. The average age of infected HCWs was 35.27 years (SD = ± 8.10) of which 57% were females. The HCWs were employed as doctors (24%), nurses (33%), and other (43%). The most administered vaccine type was mRNA (44%) followed by Adenovirus Viral Vector (39%) and mixed vaccine (17%). The incidence of COVID-19 vaccine breakthrough (BT) infection among HCWs was observed at 2.73% (m-RNA 3.19%, Viral Vector 2.83% and mixed 1.87%). Conclusionthe overall COVID-19 (BT) infection incidence proportion was (2.73%), with the Mixed vaccine group showing the lowest (BT) incidence proportion (1.87%). The most commonly reported symptoms among (BT) infections were cough (51%), sore throat (51%), fever (47%), headache (31%), and runny nose (23%), with overall (6%) asymptomatic (BT) infections. We had (1%) hospital admissions, Zero ICU admission, and Zero deaths. our finding may indicate that infection affecting fully vaccinated patients were less severe and mostly affected the upper respiratory tract.

Epidemiological and clinical aspects of HFRS in the territory of the Voronezh region

At this time, hemorrhagic fever with renal syndrome remains one of the most common infectious diseases in the Russian Federation. An active natural focus of HFRS is the Voronezh region, where the natural reservoir of hantaviruses and the source of infection for people are wild rodents — bank vole, field mouse, and gray vole. The highest incidence rates of HFRS in the Voronezh region were recorded in 2019, significantly exceeding the rates of other years. The article presents data on the features of the epidemiology of HFRS and analyzes in detail the characteristic clinical manifestations of the disease. Important epidemiological aspects of hantavirus infection in the Voronezh region are the summer-autumn seasonality, the predominance in the structure of sick young men of working age living within the city. The pronounced summer-autumn seasonality of HFRS is due to contacts of patients with natural objects in both foci of infection. The clinical picture revealed a cyclical course of the disease, prolonged febrile-intoxication syndrome, enlarged liver and spleen, hemorrhagic syndrome, signs of renal pathology, thrombocytopenia. At the initial stage of the disease, typical manifestations of infection — symptoms of kidney damage, hemorrhagic manifestations, ophthalmological complaints, dry mouth and thirst — are rare or not clearly expressed. The studied features of the epidemiological aspects and clinical manifestations of HFRS in the Voronezh region are of great practical importance for differential diagnosis and early diagnosis at the prehospital stage for the purpose of timely hospitalization of the patient.

Mesenchymal Stem Cell-Derived Exosomes Attenuate Murine Cytomegalovirus-Infected Pneumonia via NF-κB/NLRP3 Signaling Pathway.

Reactivation and infection with cytomegalovirus (CMV) are frequently observed in recipients of solid organ transplants, bone marrow transplants, and individuals with HIV infection. This presents an increasing risk of allograft rejection, opportunistic infection, graft failure, and patient mortality. Among immunocompromised hosts, interstitial pneumonia is the most critical clinical manifestation of CMV infection. Recent studies have demonstrated the potential therapeutic benefits of exosomes derived from mesenchymal stem cells (MSC-exos) in preclinical models of acute lung injury, including pneumonia, ARDS, and sepsis. However, the role of MSC-exos in the pathogenesis of infectious viral diseases, such as CMV pneumonia, remains unclear. In a mouse model of murine CMV-induced pneumonia, we observed that intravenous administration of mouse MSC (mMSC)-exos reduced lung damage, decreased the hyperinflammatory response, and shifted macrophage polarization from the M1 to the M2 phenotype. Treatment with mMSC-exos also significantly reduced the infiltration of inflammatory cells and pulmonary fibrosis. Furthermore, in vitro studies revealed that mMSC-exos reversed the hyperinflammatory phenotype of bone marrow-derived macrophages infected with murine CMV. Mechanistically, mMSC-exos treatment decreased activation of the NF-κB/NLRP3 signaling pathway both in vivo and in vitro. In summary, our findings indicate that mMSC-exo treatment is effective in severe CMV pneumonia by reducing lung inflammation and fibrosis through the NF-κB/NLRP3 signaling pathway, thus providing promising therapeutic potential for clinical CMV infection.

Clinical experience in the use of local antiviral therapy for glossitis caused by the herpes virus type IV

Herpetic infections are one of the most common anthroponotic diseases. The prevalence of herpes virus types, their combined manifestation in the body of one person, as well as the increase in the number of people with secondary immunodeficiency make the problem of diagnosis and treatment of herpes-associated diseases the most urgent [1,2].As is known, herpes virus type IV (Epstein-Barr, EBV) is one of the frequently encountered members of the herpesvirus family [3]. According to the researches of many authors, by the age of 45 they have infected up to 100% of the world's population [4,5]. Persisting in the tissues of the mucous membrane of the oral cavity (lymphoepithelial pharyngeal ring of Pirogov-Valdeier, stroma of salivary glands, epithelial cells), reactivation of the virus occurs in the case of a decrease in immunity. [8,9]. At the same time, the number of diseases caused by EBV increases annually and depends on the phase of virus activity [10,11].One of the relatively "young" EBV-associated diseases is the corresponding glossitis, the clinical and laboratory characteristics of which are poorly presented in the literature. For this reason, the therapy of oral manifestations of chronic EBV infection is considered from the position of treating infectious mononucleosis [6,7], which is ineffective. Ignorance of dentists about the reliable clinical and laboratory signs of EBV caused by glossitis leads to incorrect diagnosis and inadequate treatment, generalization of infection, and the appearance of opportunistic diseases.

Papilledema as the Sole Primary Manifestation of HSV-1 Infection: A Case Report (P1-13.001)

Papilledema as the Sole Primary Manifestation of HSV-1 Infection: A Case Report (P1-13.001)

Association between early manifestations of infection or sepsis and prognosis in a high complexity hospital in the city of Medellín

ObjectiveTo identify the first symptoms and signs of patients with suspected infection or sepsis and their association with the composite outcome of admission to the Intensive Care Unit (ICU) or mortality. DesignProspective cohort study between June 2019 and March 2020. SettingHospital Universitario San Vicente Fundación, Colombia. PatientsOver 18 years of age with suspicion or confirmation of sepsis, which required hospitalization. InterventionsNone. Main variables of interestSymptoms and signs associated with infection, with their time of evolution, specified in the study. ResultsFrom 1005 eligible patients, 261 were included. After multivariable adjustment with a logistic regression model, the main factors for ICU admission or mortality were heart rate (OR 1.04 with 95% CI 1.04–3.7), respiratory rate (OR 1.19 with 95% CI 1.0−1.4) and capillary refill time (OR 3.4 with 95% CI 1.9−6.1). ConclusionsHeart rate, respiratory rate, and capillary refill may behave as early predictors of ICU admission and mortality in cases of sepsis.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ИСХОДОВ БЕРЕМЕННОСТИ ПОСЛЕ ИНФЕКЦИИ COVID-19, ПЕРЕНЕСЕННОЙ ВО ВТОРОМ И ТРЕТЬЕМ ГЕСТАЦИОННЫХ ПЕРИОДАХ

Introduction. Issues of providing medical care to pregnant women in the setting of COVID-19 infection remain a priority for physicians of many health professions, since it is this disease an increased incidence of adverse outcomes for both mothers and fetuses is associated with in recent years. Aim. To study the peculiarities of pregnancy course and outcomes after COVID-19 infection that has developed in the second and/or third gestation periods. Materials and Methods. Birth histories for 2021 were analyzed. Group 1 (n=30) consisted of patients with COVID-19 infection developed in the second trimester, group 2 (n=69) of those with the infection developed in the third trimester. We studied the anamnesis details, pregnancy and labor complications, and perinatal outcomes. Statistical analysis has been performed using Excel MS and Statistica 7.0 programs. The data obtained are presented as mean values (M) and standard deviation (SD), as well as the absolute (n) and relative (%) frequencies of observations. To establish the significance of differences between two mean values of parameters, Student’s t-test was used, and Pearson’s χ2 criterion was used for qualitative parameters (differences at p<0.05 were considered significant). Results and Discussion. It was found that the course of pregnancy after COVID-19 infection, regardless of the disease manifestation times (p>0.05), is associated with developing placental insufficiency (30.0 % in group 1 and 50.7 % in group 2), the symptoms of threatened abortion (46.7 and 53.6%, respectively), hypertensive disorders (18.7 and 24.6%, respectively), anemia (43.3 and 46.4%, respectively), colpitis (10.0 and 27.5%, respectively), bacterial vaginosis (20.0 and 17.4%, respectively), and the premature rupture of fetal membranes (16.6 and 15.9%, respectively), with the prevalence of at term deliveries (86.7 and 97.1%, respectively; p=0.05), but with an increase in the incidence of the infantile asphyxia in 53.3 and 52.2%, respectively. Cerebral ischemia (40.0 and 36.2%, respectively), congenital developmental anomalies (30.0 and 10.1%, respectively; p=0.01), perinatal hypoxic damage of the central nervous system (23.3 and 5.8%, respectively; p=0.01), neonatal jaundice (23.3 and 4.7%, respectively; p=0.004), and intrauterine pneumonia (10.0 and 5.8%, respectively) prevailed in the structure of neonatal morbidity. Conclusions. Pregnant women are 2.3 times more likely to be infected with COVID-19 in the third trimester compared to the incidence in the second trimester. The course of pregnancy after COVID-19 infection is accompanied by forming placental insufficiency with the development of gestational complications, without affecting the timing of delivery, but increasing the frequency of the need for surgical aids in labor in the manifestation of infection in the third trimester. The incidence of neonatal morbidity increases statistically significantly with the clinical manifestations of COVID-19 infection in mothers in the second trimester.

General Manifestations of Tick-Borne Infections in the Amur Region in 2014–2023

Introduction: Tick-borne infections (TBI) require special attention of health professionals owing to their high epidemic significance. High rates of tick bite visits are registered in Russia while the incidence rates of tick-borne diseases range dramatically across different regions of the country. Objective: To describe several features of epidemiological manifestations of tick-borne infections in the Amur Region. Materials and methods: The analysis of TBI incidence rates registered in the population of the Amur Region by disease, age, sex, and administrative area was based on data of statistical observation forms No. 1, 2 “Information about infectious and parasitic diseases” and annual state reports on sanitary and epidemiological well-being of the population of the Amur Region for the years 2014 to 2023. Annual rates of tick bite visits and frequency of pathogen detection in the removed ticks were calculated. Statistical data analysis was carried out in Excel 2013. Results: Epidemiological analysis revealed a trend towards a decrease in TBI incidence from 4.81 %000 in 2014 to 0.26 %000 in 2021; predominance of tick-borne rickettsiosis (56.77 %; 95 % CI: 48.98–64.57 %) in the structure of long-term incidence of the regional population; registration of most disease cases in steppe landscape zones (57.42 %; 95 % CI: 48.38–66.46 %) and among the adult population (85.81 %; 95 % CI: 80.32–91.30 %); a statistical correlation between tick bite visits and TBI prevalence (r = 0.64) and ixodid tick-borne borreliosis (r = 0.82), as well as the correlation between the incidence of ixodid tick-borne borreliosis and the frequency of detecting borrelia in ticks removed from patients (r = 0.677). Conclusion: Further development of the TBI situation in the Amur Region will be defined by changes in forest cover area related to both anthropogenic transformations and natural emergencies.

A Case Report on Unusual Manifestations of Acquired Cytomegalovirus Infection in Preterm Baby

Cytomegalovirus (CMV) infection in early infancy arises more commonly as congenital infection or less commonly is acquired postnatally, although exact differentiation between both categories could be difficult. We hereby describe the case of severe CMV infection in a 2-month-old infant who was born prematurely of a twin pregnancy at 29.4 weeks. The baby presented with an array of skin manifestations comprising target lesions, papulovesicles, ulcers, and crusting along with systemic involvement (bronchopneumonia). We report this case to highlight the various unusual cutaneous manifestations of CMV infection in infancy and to raise the awareness among clinicians for the early diagnosis and prompt treatment.

Construction of Composite Correlation Index Matrix and Analysis of Cultural Properties of Representatives of Mycobacterium abscessus Complex Isolated from Patients with Cystic Fibrosis.

Microbiological diagnosis of mycobacteriosis is often difficult, as it is necessary to differentiate between transient colonization and active infection. We studied the cultural properties of Mycobacterium abscessus complex (MABSc) strains obtained from cystic fibrosis patients, and also analyzed composite correlation index (CCI) values in patients with repeated MABSc inoculation and their correlation with the presence of clinical and radiological manifestations of mycobacteriosis. As a result, MABSc more often grew in S-form colonies in patients without clinical manifestations of chronic infection, while R-form colonies were characteristic of patients with chronic infection and clinical symptoms. At the same time, in patients examined once, no growth of colonies in the R-form was recorded, and all strains produced growth in the form of either S-colonies or in the S- and R-forms simultaneously. Statistically significant results were obtained for the relationship of the CCI with the clinical and radiological picture. In addition, a heterogeneous MABSc population with low CCI score values correlated with the development of mycobacteriosis in patients. In patients with high CCI score values (homogeneity of isolated strains), on the contrary, there were no radiological or clinical signs of the disease. These data make it possible to build a strategy for monitoring patients depending on changes in CCI score values. The use of CCI matrix to evaluate microorganisms' identification results is a potentially new method that expands the use of matrix-assisted laser desorption ionization time-of-flight mass spectrometry.