Ovarian vein thrombophlebitis (OVT) is a rare but serious complication, most often described postpartum but also possible after abortion or pelvic surgery. It represents part of a spectrum that includes ovarian vein thrombosis, OVT and septic pelvic thrombophlebitis (SPT). Clinical features are non-specific, with pelvic pain and persistent fever often mimicking endometritis, urinary tract infection or other abdominal conditions, which contributes to delayed diagnosis. Imaging, particularly contrast-enhanced CT, is crucial for confirmation.We report the case of a woman in her 20s who developed OVT after an abortion at 16 weeks' gestation, an exceedingly uncommon setting for this condition. Diagnosis was established by clinical features, inflammatory markers and CT showing right ovarian vein thrombosis. She was successfully treated with broad-spectrum antibiotics and anticoagulation, transitioning from low-molecular-weight heparin to rivaroxaban, with complete recovery.

ABSTRACTFeline calicivirus (FCV) is a primary cause of upper respiratory tract infections and oral ulcerative disease in cats and exhibits substantial genetic diversity that complicates prevention and control. In this study, we isolated the FCV‐BJ616 strain, established a reverse‐genetics system, and investigated its pathogenic mechanisms, thereby providing a foundation for antibody‐based therapies and broad‐spectrum vaccine development. The virus was purified by three rounds of plaque cloning, and its morphology was examined by electron microscopy. VP1 expression was confirmed by immunofluorescence and Western blotting. Using integrated systems‐biology and reverse‐genetics approaches, an infectious clone of rFCV‐BJ616 was successfully assembled and rescued, exhibiting genetic stability comparable to that of the parental strain. In vivo infection experiments showed that rFCV‐BJ616 retained wild‐type virulence, causing persistent high fever, weight loss, and multiorgan pathology in infected cats. Proteomic analysis indicated that infection with FCV‐BJ616 or rFCV‐BJ616 markedly activated cytokine‐mediated inflammatory signaling pathways. Both FCV‐BJ616 and rFCV‐BJ616 significantly upregulated the expression of IL‐8, S100A8/A9, and TLR3, which are associated with acute inflammation and tissue damage. Furthermore, elevated IFN‐β levels concomitant with STAT1 downregulation suggested a transient attenuation of antiviral signaling during early immune activation. These findings were corroborated by ELISA‐based validation of serum cytokine profiles. Collectively, this study provides new insights into the molecular pathogenesis and evolution of FCV‐BJ616 and establishes a robust reverse‐genetics platform for precise genome manipulation and future vaccine development.

This letter systematically evaluated a retrospective comparative study by Qiu et al investigating ultrasound-guided percutaneous catheter drainage (PCD) for pyogenic liver abscess management during the non-liquefaction phase. The results demonstrated that early ultrasound-guided PCD significantly shortened hospitalization duration, accelerated fever resolution, and promoted > 50% abscess volume reduction compared to delayed intervention after liquefaction, without increasing procedural risks. While challenging the conventional “wait-for-liquefaction” paradigm, the evidence quality limitations warrant caution, highlighting the need for multicenter prospective randomized controlled trials. Current clinical practice recommends early PCD for severe manifestations (persistent fever, leukocytosis) or immunocompromised patients (including those with diabetes), while prioritizing antibiotic therapy for small abscesses (diameter < 3 cm) or mild cases. Dynamic imaging reassessment and multidisciplinary collaboration remain essential for individualized management. This study provides critical evidence supporting the paradigm shift from empirical observation to precision intervention in pyogenic liver abscess management, though risk-benefit evaluation should precede widespread clinical adoption.

Brucellosis is a common zoonotic disease, yet pulmonary involvement is rare and often mimics tuberculosis or malignancy. We report the case of a 62-year-old woman with diabetes and chronic hookah use presented with persistent fever and cough. Imaging revealed right lower lobe cavitary consolidation with bilateral nodules. Even after extensively investigating, her diagnosis was inconclusive. A detailed dietary history revealed raw milk consumption, while serology confirmed brucellosis. She improved with doxycycline, rifampicin, and streptomycin therapy. This case highlights the diagnostic challenge of pulmonary brucellosis in nonendemic areas and underscores the importance of thorough history and appropriate serological testing.

The paper describes the case of a 15-year-old competitive swimmer who presented to the Emergency Unit with a persistent fever and chest pain exacerbated by deep inspiration, following a recent flu-like illness. Although initial examinations were unremarkable and the pain was attributed to musculoskeletal causes, the patient returned three days later due to persistent symptoms and new-onset epigastric pain. Subsequent clinical evaluation revealed muffled heart sounds and pericardial friction rubs, while an ECG demonstrated diffuse ST-segment elevation. These findings led to a diagnosis of pericarditis and highlighted the clinical necessity of careful monitoring for post-infectious chest pain in adolescents, even when initial screenings appear normal.

A 6-month-old boy presented with complaints of irritability, decreased feeding and high-grade intermittent fever for 20 days. He had moderate hepatosplenomegaly. Baseline cultures were negative but urinary Cytomegalovirus polymerase chain reaction was positive. He was started on Inj. Ganciclovir 5 mg/kg/dose twice daily for 14 days. Bone marrow aspiration (BMA) yielded a dry tap. Bone marrow biopsy (BMB) showed marked myelofibrosis with suppressed trilineage hematopoiesis. In view of persistent cytopenia and fever, a repeat BMA was done, revealing 22% blasts. Immunophenotyping by flow cytometry revealed 5.4% blasts with megakaryocytic differentiation. Subsequent cytogenetic analysis revealed Trisomy 8 and 19, with no evidence of Down syndrome. He was started on Down syndrome AML induction therapy followed by Cytarabine-Idarubicin-Etoposide therapy, but ultimately, he succumbed to infection and persistent disease. This case highlights the significance of looking for blasts even in a diluted marrow, so AMKL in a fibrotic marrow will not be missed.

Delayed gastric emptying during acute illness may prevent adequate medication absorption, causing therapeutic failure. We present three cases of refractory fever and headache that responded rapidly to proton pump inhibitor and antiemetic combinations. A 60-year-old female with severe headache unresponsive to paracetamol and mefenamic acid experienced complete relief 15 minutes after receiving pantoprazole 40mg with domperidone 30mg. A six-year-old with fever persisting at 101°F despite ibuprofen achieved defervescence within 20 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. A two-year-old with febrile seizure and persistent fever at 102°F unresponsive to combination antipyretics normalized temperature within 15 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. We hypothesize that acute illness induces transient gastroparesis impairing drug absorption, and that PPI-antiemetic combinations restore gastric function allowing absorption of previously administered but unabsorbed medications. This warrants controlled investigation.

Delayed gastric emptying during acute illness may prevent adequate medication absorption, causing therapeutic failure. We present three cases of refractory fever and headache that responded rapidly to proton pump inhibitor and antiemetic combinations. A 60-year-old female with severe headache unresponsive to paracetamol and mefenamic acid experienced complete relief 15 minutes after receiving pantoprazole 40mg with domperidone 30mg. A six-year-old with fever persisting at 101°F despite ibuprofen achieved defervescence within 20 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. A two-year-old with febrile seizure and persistent fever at 102°F unresponsive to combination antipyretics normalized temperature within 15 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. We hypothesize that acute illness induces transient gastroparesis impairing drug absorption, and that PPI-antiemetic combinations restore gastric function allowing absorption of previously administered but unabsorbed medications. This warrants controlled investigation.

Background: Typhoid fever remains a major public health concern in developing countries, particularly in pediatric populations due to unsafe drinking water, inadequate sanitation, overcrowding, and limited vaccination coverage. Children are more vulnerable to enteric fever and its complications because of immature immunity and higher exposure risk. Although gastrointestinal manifestations such as abdominal pain, diarrhea, and constipation are common, acute appendicitis secondary to Salmonella typhi infection is rarely recognized and frequently misdiagnosed due to overlapping clinical features. Case Presentation: We present a detailed case of a 10-year-old male child with laboratory-confirmed typhoid fever who subsequently developed severe acute appendicitis. Persistent high-grade fever and progressive localization of abdominal pain to the right lower quadrant prompted further diagnostic evaluation. Ultrasonography revealed classical features of acute appendicitis, and emergency appendectomy was performed. The child showed complete clinical recovery following combined medical and surgical management. Results: Early identification of evolving localized abdominal pathology, timely radiological assessment, and prompt surgical intervention resulted in an uneventful postoperative course and prevention of complications such as perforation and peritonitis. Conclusion: Acute appendicitis shall be considered an important yet under-recognized complication of typhoid fever in children presenting with persistent or localized abdominal pain. Increased awareness and early imaging can significantly reduce morbidity and improve outcomes in endemic regions

Introduction: Influenza remains a significant public health concern in the paediatric population, contributing to substantial morbidity, risk of complications, and burden on healthcare systems both globally and nationally. In Poland, between several hundred thousand and several million influenza cases are reported annually, with a considerable proportion occurring among preschool- and school-aged children. Objective: To analyse the incidence, clinical course, and selected laboratory parameters in children diagnosed with influenza in 2024 at the Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland. Materials and methods: A retrospective analysis was conducted on medical records of 166 children aged 6 months to 16 years with laboratory-confirmed influenza. Demographic characteristics, viral type, clinical course, vaccination status, laboratory findings, treatment setting, and therapeutic management were assessed. Results: The most frequently affected group comprised preschool-aged children (median age: 4 years; interquartile range, IQR: 2.0–7.0). Influenza type A was the predominant etiological agent (74.1%). Most infections occurred during the winter season (70.5% of cases). Hospitalisation was required in 7.8% of patients, primarily due to persistent fever unresponsive to antipyretic treatment. Household transmission was reported in 19.3% of cases. Influenza vaccination was documented in 18.1% of children. Antibiotic therapy was administered to 15.1% of patients. Conclusions: Influenza in 2024 was characterised was characterised by typical seasonality and a predominance of influenza type A virus. Low vaccination coverage among children contributed to viral transmission, increased incidence, and hospitalisations. The findings highlight the need to intensify educational efforts promoting vaccination as a key preventive strategy.

A 2-year-old boy presented to the paediatric emergency department with a 5-day history of persistent high fever reaching 40°C, marked irritability, reduced oral intake, and non-productive cough. The child's mother reported onset of symptoms following a minor upper respiratory infection two weeks earlier, initially managed at home with oral paracetamol and later with oral antibiotics (amoxicillin) prescribed by a primary care physician, which failed to resolve the fever or other emerging symptoms. On examination, the child exhibited bilateral non-exudative conjunctival injection, strawberry tongue with red cracked lips, anterior cervical lymphadenopathy (right sided, 2 cm node), polymorphous erythematous rash across the trunk and extremities sparing the diaper area, and indurative oedema of the hands and feet. These findings fulfilled the diagnostic criteria for complete Kawasaki disease (KD), prompting immediate hospital admission for further evaluation and treatment.

BackgroundInfective endocarditis (IE) is a serious condition with a broad range of clinical manifestations. Despite advances in diagnostic and therapeutic strategies, its morbidity and mortality have not significantly decreased over the years.MethodsWe conducted a retrospective, descriptive study of cases meeting the modified Duke criteria for definite IE from 2010 to 2020. Our aim was to describe the clinical and epidemiological characteristics, complications, and mortality among this patient cohort.ResultsA total of 113 patients with definite IE were included. Male sex: 64%. Median age: 48.6 years (range 17–87). Comorbidities: chronic kidney disease 15.8%, heart failure 12.3%, DM 12%. Preexisting cardiovascular conditions: rheumatic heart disease: 9.6%, valvular disease 37.5% and aortic regurgitation 55.5%. IE Localization: aortic valve: 44% (87.7% native), mitral valve: 39.8% (88.8% native), tricuspid valve: 10.6%, pulmonary valve: 0.88%, mural endocardium: 0.88%. Diagnostic modalities: TTE 79%, TEE 81.4%. Microbiological findings: positive blood cultures 86.7%. Most frequent pathogens: Staphylococcus aureus (33.6%), Streptococcus spp. (27.5%) and Enterococcus spp. (16.3%). In-hospital complications: persistent positive blood cultures: 28.3%, persistent fever despite appropriate antibiotic therapy: 26.5%, new neurological events: 23.8%. Surgical management: indication for surgery 57.2%, underwent surgery 75.3% (elective 36.7%, urgent: 32.6%, emergent: 30.6%). Overol mortality: 38%. Device-associated IE mortality: 25%. Factors associated with increased mortality: HF at admission (p = 0.004), persistent bacteremia (p = 0.002), worsening HF (p < 0.0001).ConclusionIn this 10-year retrospective study, IE affected native aortic valves, with S. aureus and Streptococcus spp. as the most common pathogens. Relatively young median age (48 y) and high overall mortality (38%) reflect the local demographic context and possible delays in diagnosis and treatment. Improving access to early diagnostic tools and specialized care is essential to reduce morbidity and mortality in this setting.DisclosuresAll Authors: No reported disclosures

Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis complex and primarily affects the lungs. It is defined as multifocal tuberculosis (MFT) when at least two non-contiguous extrapulmonary sites are involved, with or without pulmonary involvement. Pediatric tuberculosis accounts for approximately 9–12% of all tuberculosis cases. We report the case of a 30-month-old infant with multifocal tuberculosis hospitalized at the University Hospital of Dakar. Case Presentation: A 30-month-old infant presented with polymorphic symptoms including weight loss, apathy, and persistent fever. Diagnosis was delayed due to atypical clinical presentation and inconclusive initial investigations. Tuberculosis was confirmed after 27 days of hospitalization through computed tomography findings and a positive Xpert MTB/RIF test performed on gastric aspirate. The child received antituberculous therapy and nutritional rehabilitation but died four months later. Conclusion: This case highlights the diagnostic challenges associated with multifocal tuberculosis in young children and emphasizes the importance of thorough clinical assessment and early therapeutic decision-making.

The diagnostic criteria for TAFRO syndrome exclude autoimmune diseases, and they have been considered to be mutually independent. However, several cases of autoimmune diseases with TAFRO signs have been reported in recent years. Also, similarities in cytokine profiles in COVID-19 and TAFRO syndrome have been previously reported. Our patient, a 53-year-old Japanese man, was diagnosed with COVID-19 and had a persistent fever. Two weeks later, pain, numbness, and oedema appeared, mainly in the right lower leg but gradually spreading to the distal extremities. Subsequently, purpura appeared on his forearms and lower legs, and 10weeks after the COVID-19 diagnosis he presented to our hospital. On admission, in addition to fever, polyangiitis, and purpura of the extremities, he had splenomegaly, lymphadenopathy, and anasarca. Skin and renal histopathology revealed fibrinoid necrotising vasculitis of small and medium-sized arteries. In addition, his platelet count was low, Alkaline phosphatase (ALP) was elevated, and there was anasarca, fever, and renal failure. A diagnosis of polyarteritis nodosa with TAFRO signs was made. On the 20th day of admission, high-dose glucocorticoids and high-dose intravenous cyclophosphamide were started. The platelet count initially improved, with gradual improvement of vasculitis and symptoms of fever, purpura, and neuropathy. However, there was another decrease in platelets, progression of renal dysfunction, and worsening of fluid retention. Tocilizumab was added, but the disease could not be controlled, and on the 51st day, necrotising fasciitis developed and the patient died. This case suggests that COVID-19, TAFRO syndrome, and vasculitis may be interrelated in their pathogeneses.

ABSTRACTAcute empyema typically occurs in elderly or immunocompromised individuals, and its development in healthy, non‐elderly adults is uncommon. We report a case of acute empyema caused by Gemella morbillorum following COVID‐19 infection in a previously healthy man in his mid‐40s. He developed persistent fever and cough after COVID‐19, and left pleural effusion was detected 3 weeks later. Despite meropenem therapy, his symptoms persisted, prompting referral to our institution. Imaging showed multiloculated pleural effusion compatible with stage II empyema, and video‐assisted thoracoscopic surgery was performed. G. morbillorum was isolated from intraoperative specimens, and he recovered uneventfully. This case highlights that even healthy, non‐elderly individuals may develop significant bacterial superinfection after COVID‐19. Clinicians should therefore consider secondary bacterial infections, including empyema, when persistent or recurrent symptoms occur following COVID‐19.

The case describes a patient with mild acute pancreatitis (AP) who developed a persistent high fever during ulinastatin treatment. This highlights the possibility of drug-induced fever, which is a rare but important adverse reaction of ulinastatin and is often overlooked in clinical practice. A 58-year-old male patient with mild AP had a persistent high fever during the treatment with ulinastatin, but there was no evidence of infection. Mild AP, ulinastatin-related drug fever. The initial conservative treatment for AP included fasting, rehydration and taking ulinastatin. Antibiotics (ceftriaxone, later changed to imipenem) were used for suspected infection. After excluding infection, ulinastatin was discontinued. Within 48 hours of stopping ulinastatin, the patient's fever symptoms were relieved and his subsequent condition stabilized. This case highlights the importance of considering drug-induced fever in clinical practice. Recognizing it promptly and discontinuing the drug can prevent unnecessary interventions and improve outcomes.

Development of a potent protective felinized chimeric antibody C8A8 targeting feline and canine parvovirus.

Therapeutic potential of traditional herbal medicine against multidrug-resistant pulmonary infections: Based on clinical and pharmacodynamic evidence.

Explore the chemical components of Angong Niuhuang Pill and its potential mechanisms for fever treatment based on UHPLC-Q-Exactive orbitrap HRMS, transcriptomics, and experiment verification.

Emergence of a novel triple - lineage recombinant PRRSV with twelve complex hotspots in China.