26 research outputs found

    The Longest Infectious Virus Shedding in a Child Infected With the G614 Strain of SARS-CoV-2

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    COVID-19 spread globally and caused over 97 million cases with more than 2 million deaths. There is still ongoing discussion on the duration of infectious interval SARS-CoV-2 infection. Symptomatic children had longer virus shedding and there are some reports of prolonged infectious virus shedding in adults particularly patients having an immunocompromised status. A missense mutation, D614G, in the spike protein of SARSCoV-2, which has emerged as a predominant clade in Europe and is spreading worldwide that can result in higher viral loads in patients. Herein, we described the longest infectious virus shedding in a previously healthy child infected with SARS-CoV-2 expressing spike D614G substitution

    Cervical abscess caused by methicillin-susceptible Staphylococcus aureus in an infant infected with SARS-CoV-2: Diagnostic dilemma

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    A new inflammatory disease has emerged in children after the COVID-19 disease and has been named multisystem inflammatory syndrome in children (MIS-C). We report a case of cervical abscess in an infant with COVID-19 who was first considered to have MIS-C due to persistent fever, high inflammatory markers. A 10-month-old boy was admitted to the emergency department due to a 3-day fever and cervical lymphadenopathy. SARS-CoV-2 RNA was detected by a real-time reverse transcriptase-polymerase chain reaction in the nasopharyngeal swab specimen of the patient. Regarding initial clinical and laboratory findings, the patient was diagnosed to have MIS-C and bacterial co-infection. Clindamycin and ceftriaxone treatments were initiated for bacterial co-infection. Despite treatment, his fever persisted and acute phase reactants compatible with MIS-C were elevated and intravenous immunoglobulin (IVIG) was administered. After IVIG treatment, his fever persisted and the patient developed local inflammatory signs including erythema, tenderness, fluctuation developed. Cervical ultrasonography and magnetic resonance imaging demonstrated the findings compatible with the cervical abscess. Drainage of the cervical abscess was performed by an otolaryngologist. Methicillin-susceptible Staphylococcus aureus was isolated from the abscess culture. After abscess drainage, fever and acute phase reactants declined. His nasopharyngeal swab was negative for SARS-CoV-2 on the 7th day. He was discharged on the 21st day of hospitalization with full recovery. To the best of our knowledge, no cases of COVID-19 with cervical abscess caused by Staphylococcus aureus in children had been reported previously. Bacterial co-infection should be kept in mind in children infected with SARS-CoV-2 and showing MIS-C findings. (c) 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved

    Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis

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    Objective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease. Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2 +/- 9.6 years. The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT). Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques. Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.Cíl: V této studii jsme zkoumali vztah mezi charakteristikami aterosklerotického plátu a symptomatickým postižením karotických tepen. Materiál a metody: Do studie bylo zařazeno 22 pacientů (13 mužů a 9 žen průměrného věku 60,2 ± 9,6 roku) po endarterektomii karotických tepen. Závažnost stenózy karotické tepny se pohybovala v rozmezí 75 % až 99 %. Osm pacientů bylo asymptomatických a zbývajících 14 symptomatických. Deset pacientů prodělalo cévní mozkovou příhodu. V anamnéze měl jeden pacient recidivující tranzitorní ischemické příhody, čtyři pacienti uváděli presynkopální stav a u jednoho byla stanovena diagnóza amaurosis fugax. Odstraněné pláty byly vyšetřeny skenující akustickou mikroskopií (scanning acoustic microscopy, SAM) a mikrovýpočetní tomografi í (micro-computerized tomography, micro-CT). Výsledky: U pacientů po cévní mozkové příhodě byly nalezeny nižší hodnoty akustické impedance ukazující na tvorbu plátů s vysokým obsahem kolagenu, zatímco u asymptomatických pacientů byly vyšší hodnoty akustické impedance spojeny s tvorbou plátů bohatých na vápník. Závěry: Spíše než spoléhání se na závažnost stenózy u pacientů s postižením karotických tepen může při vyhledávání pacientů vyžadujících intervenci napomáhat určení charakteristik plátů moderními radiografi ckými metodami.Türkiye Cumhuriyeti Kalkınma Bakanlığ
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