COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescent—case study and literature review

Abstract Acute genital ulcers can affect females of all ages. In children, they often appear as an emergency and remain a diagnostic challenge for pediatricians, gynecologists and dermatologists. Prompt diagnosis and identification of disease- related factors help to implement appropriate treatment. Firstly, it is crucial to properly compile the past medical history of the patient. Past infectious, autoimmune, malignant or traumatic conditions, as well as vaccinations may contribute to the occurrence of acute genital ulcers. Moreover, new infectious agents, such as severe acute respiratory syndrome coronavirus 2 and vaccinations against Coronavirus disease of 2019, may play a significant role in the development of atypical clinical symptoms. Here we present a case of a 12-year-old girl with acute genital ulcers. Additional symptoms accompanying the ulcer included: abdominal pain, nausea, vomiting, dysuria, vulvar pain and fever. Blood test showed leukocytosis, especially neutrophilia and monocytosis and increased levels of c-reactive protein and procalcitonin. Serological tests for the most common infections were negative. Moreover, the patient had a history of autoimmune diseases. She had periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, and IgA vasculitis, also known as Henoch-Schönlein purpura in her past medical history. Additionally, she was vaccinated against SARS-CoV-2 shortly before the lesions appeared

Determination and Removal of Selected Pharmaceuticals and Total Organic Carbon from Surface Water by Aluminum Chlorohydrate Coagulant

In the present research, the removal of Total Organic Carbon (TOC) and erythromycin (ERY), fluoxetine (FLX), amoxicillin (AMO), colistin (COL), ethynylestradiol (EE), and diclofenac (DIC) from surface water by coagulation is studied. The concentration of selected pharmaceuticals in 24 surface water samples originating from some rivers located in Lesser Poland Voivodeship and Silesia Voivodeship, Poland, was determined. The removal of TOC and pharmaceuticals was carried out using the application of Design of Experiments (DOE), Response Surface Methodology (RSM), and by addition of aluminum chlorohydrate (ACH) as a coagulant. The study found that the concentration ranges of ERY, FLX, AMO, COL, EE, and DIC in analyzed water samples were 7.58–412.32, 1.21–72.52, 1.22–68.55, 1.28–32.01, 5.36–45.56, 2.20–182.22 ng/L, respectively. In some cases, concentrations lower than 1 ng/L were determined. In optimal conditions of coagulation process of spiked surface water (pH = 6.5 ± 0.1, ACH dose = 0.35 mL/L, Time = 30 min; R2 = 0.8799, R2adj = 0.7998), the concentration of TOC, ERY, FLX, AMO, COL, EE, and DIC was decreased by 88.7, 36.4, 24.7, 29.0, 25.5, 35.4, 30.4%, respectively. Simultaneously, turbidity, color, Total Suspended Solids (TSS), Chemical Oxygen Demand (COD), Total Nitrogen (Total N), and Ammonium-Nitrogen (N-NH4) were decreased by 96.2%, >98.0%, 97.8%, 70.0%, 88.7%, 37.5%, respectively. These findings suggest that ACH may be an optional reagent to remove studied pharmaceuticals from contaminated water