Infectious Diseases in Clinical Practice最新文献

{"title":"Drug-Induced Parotitis—A Rarity?","authors":"Sweatha Kumar, Vidya Devarajan, Ramya Sivaramakrishnan, Srinivasan Kalyanasundaram, Purushothaman P.K, Rufus Vasanth Raj","doi":"10.1097/ipc.0000000000001333","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001333","url":null,"abstract":"Unilateral parotitis is due to ductal obstruction. Bilateral parotitis occurs due to viral infections such as mumps, bacterial infections, Sjögren syndrome, and ductal obstruction. Drug-induced parotitis is a relatively uncommon adverse reaction, and it can be unilateral and bilateral. Unilateral causes of drug-induced parotitis can be due to clozapine, chlorpromazine, l-asparaginase, and α-methyldopa, whereas bilateral causes can be due to thioridazine, sulfadiazine, phenylbutazone, oxyphenylbutazone, nitrofurantoin, and valproic acid. Adverse reactions to sulfonamide are rare and manifest as rashes or urticaria. Herein, we report a case of acute unilateral parotitis occurring as a result of cotrimoxazole that resolved within 48 hours after discontinuation of therapy, which highlights that sulfonamide therapy can cause parotitis. Early clinical suspicion and discontinuation of therapy help in the prompt resolution of the allergic reaction to cotrimoxazole.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"87 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal Methicillin-Resistant Staphylococcus aureus Culture Screens in the Setting of Universal Decolonization","authors":"Arunava Saha, Erin E O'SHEA PAUDEL","doi":"10.1097/ipc.0000000000001328","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001328","url":null,"abstract":"The negative predictive value (NPV) of nasal methicillin-resistant Staphylococcus aureus (MRSA) screens has been compromised by universal decolonization practices. We aimed to determine the reliability of the nasal MRSA culture screen to deescalate antibiotic therapy in the setting of decolonization with ethyl alcohol. A retrospective observational cohort study was conducted using 62% ethanol solution intranasally per protocol. Patients were divided into 2 groups based on whether they received decolonization. Data were analyzed to determine NPV of the nasal MRSA culture screen with and without decolonization. A total of 505 cases were screened, and 128 subjects were included. One hundred two received decolonization, whereas 26 did not. Baseline characteristics were well balanced. Overall MRSA infection prevalence was 31.25%. The NPV was 73% in the decolonized group compared with 80% in the group without. Positive predictive value was 63% in the group receiving decolonization compared with 100% in the group without. There was also a higher specificity but lower sensitivity of the nasal MRSA culture screen in the decolonization group. Nine patients in the decolonization group required reescalation of antibiotics compared with nil in the other group. Culture-based nasal MRSA screens are less accurate than PCR tests, as ethyl alcohol leads to false-negative results. A lower NPV in the decolonization group predisposes to increased false negative results, leading to inappropriate antibiotic deescalation and often requiring reinitiation. Nasal MRSA culture screen is less reliable if alcohol has already been administered for decolonization and cannot be used as an appropriate tool to guide antibiotic deescalation.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"111 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139209475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Red Swollen Leg","authors":"Shivakumar Narayanan, Edward C. Traver, Aaron David Greenblatt","doi":"10.1097/ipc.0000000000001325","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001325","url":null,"abstract":"We present a case of pseudocellulitis in a patient with chronic wounds from active injection drug use and edema and edema from secondary amyloidosis and highlight diagnostic challenges and approaches to differentiate infection from vascular and other noninfectious causes as well as the opportunity to intervene at a reachable moment to try to mitigate risk related to injection drug use.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"27 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar Osteomyelitis and Epidural Abscess Caused by Cardiobacterium hominis—First Reported Case in the Pediatric Population: The Role of Universal 16S rRNA Gene PCR and Sequencing","authors":"Moamen Al Zoubi, Huma M. Khan, Sona Najafi","doi":"10.1097/ipc.0000000000001329","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001329","url":null,"abstract":"This report presents a case of a 14-year-old female patient diagnosed with lumbar (L2–L3) epidural abscess and vertebral osteomyelitis caused by Cardiobacterium hominis. The diagnosis was made using universal 16S rRNA polymerase chain reaction. To the best of our knowledge, this is the first reported case of C. hominis lumbar epidural abscess and vertebral osteomyelitis in pediatric population. This case serves to illustrate the potential value of polymerase chain reaction and DNA sequencing in diagnosing culture-negative vertebral osteomyelitis and the potential role of C. hominis in causing this infection.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"33 2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Experience With Oral Antivirals for US Veterans With COVID-19 Infection","authors":"A. Njoroge, Morgan Froehlich, G. Psevdos","doi":"10.1097/ipc.0000000000001320","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001320","url":null,"abstract":"","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"100 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Atypical Presentation of Disseminated Varicella Infection","authors":"Derrick Ferguson, Javier Antonio Aguilar-Aragon, Imad Obeid","doi":"10.1097/ipc.0000000000001323","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001323","url":null,"abstract":"We present the case of a 61-year-old woman with a medical history of rheumatoid arthritis on immunosuppressive therapy who presented with generalized weakness, progressive dry cough, and dyspnea. She rapidly progressed to profound acute hypoxemic respiratory failure prompting initiation of mechanical ventilatory support. She was subsequently discovered to have diffuse vesicular rash about her abdomen without respect for dermatome borders that disseminated to her back and neck. Diagnostic testing confirmed varicella zoster virus with concomitant varicella pneumonia. Disseminated varicella infection is not uncommon and most frequently affects those with immunosuppression, but cases have been documented somewhat regularly in those without overt immunosuppression. Of the complications associated with disseminated varicella infection, varicella pneumonia is the most deadly. Mortality rate for disseminated varicella infection with varicella pneumonia ranges from 10% to 30%. However, for those with extreme respiratory failure requiring mechanical ventilation, mortality can reach as high as 50%. The most common presentation is a patient with cutaneous eruption that does not follow dermatomal distribution; this is followed by the onset of pulmonary symptoms within 2 to 5 days of rash. However, our case contributes another example of a rare presentation of varicella pneumonia, that being a case wherein the viral exanthem was preceded by the onset of respiratory failure. Recognizing the possibility of respiratory symptoms preceding the classic cutaneous manifestations of disseminated varicella infection is an important lesson, as it will allow for earlier detection and initiation of therapy. The profound mortality associated with varicella pneumonia is justification for further dedicated research into improved prevention and treatment, and increasing physician awareness of this clinical entity will be beneficial to that end.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"299 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ramadan Fasting","authors":"Bilal Irfan, Aneela Yaqoob, Ihsaan Yasin, Denise Kirschner","doi":"10.1097/ipc.0000000000001321","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001321","url":null,"abstract":"","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"15 1-2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139259586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nervous System Involvement in Hospitalized Patients With COVID-19","authors":"M. Harirchian, M. Ghabaee, P. Sarraf, Sakineh Ranji-Burachaloo, Elmira Agah, Seyed Vahid Mousavi, Aminreza Abkhoo, Kiana Amani, Nina Javadian, Ghasem Farahmand, Hanna Magrouni, Fatemeh Alizadeh Boroujeni, Fatemeh Nazari, S. Ghafouri, Maryam Hosseinzadeh, Sonya Enayati, Samaneh Kabiri, Yeganeh Pasebani, A. Rafati, Mehdi Azizmohammad Looha, Abbas Tafakhori, M. Jameie","doi":"10.1097/ipc.0000000000001332","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001332","url":null,"abstract":"COVID-19 patients with neurological manifestations have poorer outcomes. We investigated the association between clinicodemographic and laboratory findings with poorer outcomes among COVID-19 inpatients with neurological manifestations. This was a retrospective study of consecutive medical records (March–April 2020). Neurological manifestations (altered level of consciousness, acute cerebrovascular disease, ataxia, seizure, headaches, dizziness/vertigo, muscle weakness, and peripheral neuropathies) were categorized into serious and nonserious. Of 119 COVID-19 inpatients, 38 with neurological manifestations were included (age, 63.7 ± 13.4 years; male, 65.8%), of whom 27 (71.1%) had serious manifestations. Muscle weakness (57.9%), impaired consciousness (47.4%), and acute cerebrovascular disease (23.7%) were the most frequent manifestations. The in-hospital mortality rate was 28.9%. Patients with serious manifestations were significantly older (66.9 vs 55.7, P = 0.018), with significantly higher white blood cell count (6.8 vs 5.1 × 103/μL, P = 0.023), direct bilirubin (0.3 vs 0.2 mg/dL, P = 0.030), prothrombin time (PT) (15.4 vs 14.4 seconds, P = 0.006), international normalized ratio (1.2 vs 1.1, P = 0.005), and model for end-stage liver disease (MELD) scores (10 vs 7, P = 0.011), compared with those with nonserious manifestations. In addition, the nonsurvivors had higher potassium (4.5 vs 4.0 mEq/L, P = 0.021), total bilirubin (1.1 vs 0.6 mg/dL, P = 0.008), and MELD scores (12 vs 8, P = 0.025) compared with the survivors. After adjustment, we found significant impacts of age (adjusted odds ratio [aOR], 1.11; P = 0.032), PT (aOR, 5.04; P = 0.019), and MELD score (aOR, 1.27, P = 0.047) on poorer outcomes. Older age, higher white blood cell count, bilirubin, PT, international normalized ratio, potassium, and MELD scores were associated with poorer outcomes in COVID-19 inpatients with neurological manifestations.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"2 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139259565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Use in Patients With COVID-19","authors":"Niloofar Hooshmand, Batool Zarei, Zahra Sadat Mireskandari, F. Sheybani, Mahboubeh Haddad, Sepideh Elyasi, N. Morovatdar, Hamed Hossein Abdollahi Dashtbayaz","doi":"10.1097/ipc.0000000000001324","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001324","url":null,"abstract":"Antimicrobial resistance is a serious threat to public health. The ongoing antimicrobial resistance pandemic has been fueled by the COVID-19 pandemic. We analyzed patients 15 years or older with COVID-19 who were admitted to a teaching hospital in Mashhad, Iran, during the period between the third and fourth COVID-19 waves. COVID-19 was diagnosed if the SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction test was positive in patients with compatible clinical syndromes. Overall, 532 episodes of COVID-19 were diagnosed. The median age of patients was 61 years (interquartile range, 48–73). One hundred twenty-five patients (23.4%) with COVID-19 died, and 165 (31%) experienced major complications. Over the study period, 134 DDD (defined daily dose) per 100 hospital bed days of antibacterial were used. Glycopeptides, third-generation cephalosporins, and carbapenems were the antibacterials most frequently used, based on the DDD per 100 hospital bed days. In a multivariate analysis, factors associated with antibacterial prescription in COVID-19 patients were lung involvement of greater than 50% (odds ratio [OR], 14.6), C-reactive protein of greater than 100 mg/L (OR, 3.35), and hypoxia (OR, 3.06). Univariate but not multivariate analysis showed that antibiotic use in COVID-19 patients was associated with 4 times increase in the chance of death (OR, 4.23). Our study highlights a high rate of antibacterial use in COVID-19 patients. Hypoxia, C-reactive protein of greater than 100 mg/L, and severe lung involvement were associated with a higher rate of antibacterial prescription. The patients who received antibiotics died 4.23 times more often than patients treated without antibiotics. These findings emphasize the need for integrating antimicrobial stewardship programs as an integral part of the pandemic response and the need for improving diagnostic tests for early detection of bacterial coinfections in COVID-19 patients.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"285 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting Serogical Markers in Hepatitis B Virus Infection","authors":"Yasmeen Ahmed, Mohamed El-Kassas","doi":"10.1097/ipc.0000000000001322","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001322","url":null,"abstract":"Abstract Hepatitis B virus (HBV) is considered a global health-related problem. The World Health Organization estimates an incidence of approximately 1.5 million new cases annually despite an available effective vaccine, and approximately 296 million people worldwide are living with chronic hepatitis B. This large number of patients require continuous monitoring of the treatment efficacy, disease progression, and screening for the HBV-related liver complications. Recently, it has become more evident that we need better predictive markers to allow treatment cessation when there is a reduced risk of viral reactivation, in addition to the present need to predict disease outcome and improve the management of people living with chronic hepatitis B. Novel HBV biomarkers are focused on in this minireview. These new markers include quantification of serum HBV RNA, hepatitis B core–related antigen, quantitative hepatitis B surface antigen, quantitative anti–hepatitis B core antigen, and detection of HBV nucleic acid–related antigen. The target of finding new markers for HBV replication is to provide crucial clinical data in a noninvasive way for detecting the replicative and transcriptional activity of the virus. This may support better management of patients compared with the criterion-standard invasive marker for detecting the intrahepatic replication and transcription of HBV, which is the quantification of covalently closed circular DNA.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":"47 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}