Digital Commons Network^™

Self-Powered Rapid Antigen-Specific T-Cell Response Assay For Mycobacterium Tuberculosis Infections, Bo Ning, Sutapa Chandra, Yongchun Pan, Riti Sharan, Ngan Ha, Sanjay Singh, Alexandra Portillo Varela, Lin Li, Qingli Wu, Alexander Kay, Gugu P Maphalala, Clement Adu-Gyamfi, Santiago Carrero Longlax, Anna M Mandalakas, Smriti Mehra, Christopher J Lyon, Edward A Graviss, Andrew R Dinardo, Tony Hu

Faculty, Staff and Students Publications

Interferon-gamma release assays (IGRAs) that evaluate an individual’s T-cell activation response to Mycobacterium tuberculosis (M.tb)-specific peptides serve an important role in diagnosing tuberculosis (TB). However, there are substantial challenges to the use of IGRAs in resource-limited settings. Further, IGRA diagnostic performance can also be compromised in anergic individuals. Here we describe a microfluidic chip-based antigen-specific T-cell response assay (ASTRA) that automates the detection of M.tb-specific T-cell activation responses to facilitate screening for latent M.tb infection and TB. We observe that ASTRA demonstrates high specificity for M.tb infection in independent patient cohorts. Compared with IGRA, ASTRA shows greater …

Factors Associated With The Severity Of Erythema Nodosum Leprosum Reactions, Ita Anggraini, Prima Kartika Esti, Eka Komarasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy is a chronic infection caused by Mycobacterium leprae. Leprosy reactions, including erythema nodosum leprosum (ENL), are induced by immune responses. ENL can cause neurological damage and deformities that result in disabilities. This study aimed to identify factors associated with the severity of ENL to help control the leprosy reactions.

Methods: This was an analytical study on 148 patients with ENL reactions, who were divided into two groups based on the severity of their reactions. A retrospective cross–sectional study was conducted in the medical record unit of Sitanala Hospital, Tangerang, Banten, Indonesia, from May 2022 to …

Herpes Zoster Reactivation Following Covid-19 Mrna Vaccination In An Elderly Patient: A Case Report, Ratu Siti Khadijah Sarah, Yari Castiliani Hapsari, Shannaz Nadia Yusharyahya, Eliza Miranda, Sarah Qanita Edwar

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Latent varicella-zoster virus (VZV) in nerve ganglia may reactivate into herpes zoster infection. The coronavirus disease (COVID-19) vaccine is suspected of triggering VZV reactivation, although the exact cause is unclear. This case report aims to raise awareness of the potential complications induced by the COVID-19 mRNA vaccine, particularly in elderly patients.

Case Illustration: A 62-year-old woman complained of itchy and painful unilateral dermatomal herpetiform blisters six days after mRNA COVID-19 vaccination. The vesicle first appeared on the left breast, spreading to the back. The patient has a history of hypertension. After the administration of 800 mg of acyclovir five …

Pneumococcal Colonization Dynamics Among Young Children With And Without Respiratory Symptoms During The First Year Of The Sars-Cov-2 Pandemic., Liset Olarte, Brian R. Lee, Dithi Banerjee, Douglas Swanson, Christopher J. Harrison, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Non-pharmaceutical interventions to mitigate the spread of SARS-CoV-2 were implemented across the United States in 2020. These public health measures might influence pneumococcal colonization in younger children and their subsequent risk of invasive pneumococcal disease. Our objective was to evaluate pneumococcal colonization rates in children ≤ 5 years of age with and without respiratory symptoms during the first 12 months of SARS-CoV-2 pandemic (April 2020 - March 2021).

STUDY DESIGN: This is a retrospective cross-sectional study evaluating pneumococcal colonization rates, density and serotype distribution across three study periods (April-July [Period 1], August-November [Period 2] and December-March [Period 3]) after …

Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was conducted to develop a clinical practice guideline (CPG) to address a gap at a southeastern hospital where frontline nurses often call rapid response teams for severe hypotension without a standard guideline for necessary interventions. Therefore, the practice gap identified at the project site was the lack of a CPG geared for rapid response nurses (RRNs) to use when responding to a call to intervene on a patient with hypotension. RRNs are nurses with advanced clinical training who provide immediate medical care to rapidly hemodynamically declining patients. The guiding question for this DNP …

Cannabis Use In Women And Sexual Dysfunction, Becky K. Lynn, Julia D. López, Morgan E. Link, E C. Campian

2020-Current year OA Pubs

No abstract provided.

Modeling Reemergence Of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination In The Us, Mathew V Kiang, Kate M Bubar, Yvonne Maldonado, Peter J Hotez, Nathan C Lo

Faculty, Staff and Students Publications

Importance: Widespread childhood vaccination has eliminated many infectious diseases in the US. However, vaccination rates are declining, and there are ongoing policy debates to reduce the childhood vaccine schedule, which may risk reemergence of previously eliminated infectious diseases.

Objective: To estimate the number of cases and complications in the US under scenarios of declining childhood vaccination for measles, rubella, poliomyelitis, and diphtheria.

Design, setting, and participants: A simulation model was used to assess the importation and dynamic spread of vaccine-preventable infectious diseases across 50 US states and the District of Columbia. The model was parameterized with data on area-specific estimates …

Trends In The Incidence Of Ovarian Cancer Among Premenopausal And Postmenopausal Women In The United States, 2001 To 2021, Victor Adekanmbi, Abbey B Berenson, Batul Shakir, Christine D Hsu, Thao N Hoang, Itunu O Sokale, Tolulope T Sajobi, Fangjian Guo

Faculty, Staff and Students Publications

Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions.

Methods: This population-based cross-sectional study analyzed data from the US Cancer Statistics (USCS) database, which covered the whole of the US population between 2001 and 2021. Joinpoint regression was used to compute the average annual percentage change (APC) with 95% confidence interval (CI) and age-standardized incidence rates per 1,000,000 population.

Results: The results showed that the IR of …

Human Alveolar Macrophage Response To Mycobacterium Tuberculosis: Immune Characteristics Underlying Large Inter-Individual Variability, Wolfgang Sadee, Ian H. Cheeseman, Audrey Papp, Maciej Pietrzak, Michal Seweryn, Xiaofei Zhou, Shili Lin, Hao Zhang, Blanca I. Restrepo, Yufeng Wang

School of Medicine Publications

Mycobacterium tuberculosis (M.tb) infection infects human alveolar macrophages (HAMs). In freshly isolated HAMs from 28 healthy adults, we observe large inter-individual differences in bacterial uptake and growth, with tenfold variation in M.tb load by 72 h. While M.tb infection triggers expression changes of numerous host mRNAs, we examined which genes are most variably expressed (VE genes) between donors, as potential biomarkers of individual tuberculosis (TB) risk. The HAM RNA transcriptome following infection revealed thousands of differentially expressed (DE) genes and differential secretion of 25/27 proteins. Yet only 324 DE genes represent VE genes detected exclusively among DE genes in …

Cancer Immunotherapy Clinical Trials To Support Urgently Needed Access In Low- And Middle-Income Countries: A Report From The Sitc Global Access And Impact Committee, Jennifer Dent, Thomas A Odeny, Et Al.

2020-Current year OA Pubs

Cancer is rapidly on the rise as a cause of morbidity and mortality in low- and middle-income countries (LMICs). However, despite the increasing importance of immune checkpoint inhibitors (ICIs) as a pillar of cancer therapy, access in these settings lags well behind that in high-income countries (HICs). Increasing the evaluation of ICIs through local clinical trials and demonstration projects, and inclusion in multinational clinical trials is the first step to improving access. In particular, the epidemiology and clinical presentation of cancer in LMICs is often distinct from that in HICs, and the impact of immune checkpoint blockade in these settings …

Potential Effect Of Statins As Adjuvant Anti‑Tuberculosis Agents: A Short Communication, Mehwish Hanif, Ayesha Tariq, Laiba Zahoor

Digital Journal of Clinical Medicine

Tuberculosis is a chronic pulmonary infectious disease caused by Mycobacterium tuberculosis and can affect other parts of the body such as bones, brain, and lymph nodes (extra pulmonary Tb). Statins, primarily used for hyperlipidemia, have demonstrated anti-inflammatory and immunomodulatory properties that may help prevent and manage TB. They inhibit HMG-CoA reductase, reduce cholesterol synthesis and interfere with phagocytosis crucial for TB infection. Given the rise in resistance to first-line anti-tubercular therapies, Statins have shown promise as adjunctive agents by potentially shortening treatment duration, reducing adverse effects, and improving outcomes, particularly in immunocompromised and diabetic patients. Based on these findings, Statins …

Genetic Characterization Of Lpai-H4n2 And H4n8 Viruses Recovered From Free-Grazing Ducks In Thailand, Supanat Boonyapisitsopa, Supassama Chaiyawong, Kamonpan Charoenkul, Kitikhun Udom, Ekkapat Chamsai, Napawan Bunpapong, Somsak Pakpinyo, Alongkorn Amonsin Prof. Dr.

The Thai Journal of Veterinary Medicine

nfluenza A viruses (IAVs) can infect birds and various mammals. In this study, we retrospectively isolated and characterized IAVs (n=8) from oropharyngeal and cloacal swab samples of free-grazing ducks collected during December 2018 to December 2021, by using egg inoculation and whole-genome sequencing. The IAVs could be subtyped as IAV-H4N2 (n = 3) and IAV-H4N8 (n = 5) using real-time RT-PCR assays. Genetic and phylogenetic analyses revealed that all eight genes of Thai IAV-H4 belong to the Avian Eurasian lineage. Both Thai IAV-H4N2 and IAV-H4N8 exhibited low pathogenic avian influenza (LPAI) characteristics and were susceptible to oseltamivir and amantadine. This …

Health Impacts And Medical Assistance After Libyan Flood Disaster: Emergency Medical Teams’ Responses, Hakan Güner, Okan Maden, Muhammed Saltuk Deni̇z, Kerem Dost Bi̇lmez, Şükrü Yorulmaz, Mehmet Enes Gökler

Turkish Journal of Medical Sciences

Background/aim: Floods are the most frequent natural disasters and pose direct and indirect health risks, some well-documented and others poorly understood. Epidemiological studies help bridge these gaps and guide effective public health responses.In September 2023, Storm Daniel caused severe flooding in Libya, damaging infrastructure, including healthcare facilities. The disaster affected 250,000 people, displaced 48,000, and claimed 15,000 lives, making it the second deadliest natural disaster of the year. This study aims to assess the characteristics of flood-affected patients to improve disaster preparedness.

Materials and methods: This descriptive study examined disaster victims who visited three clinics established as part of an …

The Role Of The Hemoglobin-Albumin-Lymphocyte-Platelet (Halp) Score In Deep Neck Infections And Its Relationship With Clinical Parameters, Ayşe Seçi̇l Kayali Di̇nç, Nagi̇han Gülhan Yaşar, Agah Yeni̇çeri̇, Çeti̇n Şahutoğlu, İbrahi̇m Sevi̇m, Meli̇h Çayönü

Turkish Journal of Medical Sciences

Background/aim: Deep neck infections (DNI) are suppurative infections of the cervical spaces, which may lead to life-threatening complications. The HALP score is a laboratory parameter reflecting a patient’s nutritional and inflammatory status. The aim of this study was to compare the HALP scores of patients with DNI with those of a control group. A secondary objective was to investigate the potential relationship between the HALP score and clinical parameters, and to assess its role in determining disease severity.

Materials and methods: The study retrospectively included patients who were hospitalized and treated for DNI. Data were extracted from the hospital’s electronic …

Medicolegal Evaluation Of Pediatric Patients With Injection Neuropathy, Hizir Asliyüksek, Caner Beşkoç, Ömer Faruk Şi̇mşeker, Ni̇han Hande Akçakaya, Adem Karbuz

Turkish Journal of Medical Sciences

Background/aim: Injection neuropathy (IN) is a rare but preventable form of iatrogenic nerve injury, particularly affecting the sciatic nerve when intramuscular injections are administered incorrectly. While IN is uncommon in high-income countries, it remains a sig- nificant public health issue in Türkiye, especially in pediatric populations. The aim of this study is to evaluate pediatric IN cases referred to the Council of Forensic Medicine and highlight medicolegal aspects to inform clinical and legal preventive strategies.

Materials and methods: We retrospectively analyzed 67 pediatric cases (age range: 1–17 years; mean age: 10.5 years; 57 boys, 10 girls) referred to the Council …

Monoclonal Antibodies Targeting The Fimh Adhesin Protect Against Uropathogenic E. Coli Uti, Edward D B Lopatto, Jesús M Santiago-Borges, Denise A Sanick, Sameer Kumar Malladi, Philippe N Azimzadeh, Morgan W Timm, Isabella F Fox, Aaron J Schmitz, Jackson S Turner, Shaza M Sayed Ahmed, Lillian Ortinau, Nathaniel C Gualberto, Jerome S Pinkner, Karen W Dodson, Ali H Ellebedy, Andrew L Kau, Scott J Hultgren

2020-Current year OA Pubs

As antimicrobial resistance increases, urinary tract infections (UTIs) are expected to pose an increased burden in morbidity and expense on the health care system, increasing the need for alternative antibiotic-sparing treatments. Most UTIs are caused by uropathogenic

Nosocomial Sepsis Triggered By Pluralibacter Gergoviae In A Pediatric Intensive Care Unit: A Case Report And Literature Review, Abdulrahman Özel, Nurettin Onur Kutlu, Servet Yüce, Cenk Özdalgiçoğlu, Meltem Erol

Journal of Pediatric Infectious Diseases

Pluralibacter gergoviae is a rare opportunistic gram-negative bacillus in humans and exhibits resistance to preservatives in cosmetic products. In this case report, we present nosocomial P. gergoviae sepsis that developed through contamination from a cleaning product in a previously healthy child without known chronic diseases, pediatric intensive care unit care. Contamination with the same microorganism was detected even in unused samples of the cleaning product, leading to a recall of these items. This report highlights the case of hospital-acquired P. gergoviae sepsis to emphasize the importance of adherence to antiseptic protocols by health care work as well as the necessity …

New Insights On The Clinical Significance Of Mycoplasma Pneumoniae-Dna Load In Mycoplasma Pneumoniae Pneumonia, Chen Yu, Lin Chenxi, Huang Rui, Chen Qi, Zhang Min, Chen Ling, Lai Xingqian

Journal of Pediatric Infectious Diseases

Objective: This study aimed to assess the consistency of MP-DNA load in the respiratory tracts, its correlation with Mycoplasma pneumoniae pneumonia (MPP) manifestations, and its predictive value for refractory M. pneumoniae pneumonia (RMPP).

Methods: A retrospective study was performed on a cohort of MPP cases, including 215 patients with positive nasopharyngeal aspirate (NPA) MP-DNA and 59 with positive bronchoalveolar lavage fluid (BALF) MP-DNA. Patients were categorized into two groups based on MP-DNA load: low-load (≤106/mL) and high-load (>106/mL). The consistency of MP-DNA load in NPA and BALF was determined by Spearman’s correlation coefficient. Clinical, laboratory, and radiological data were …

Comparison Of Delta Neutrophil Index And Inflammatory Markers In The Diagnosis Of Late-Onset Neonatal Sepsis In Preterm Infants, Aybuke Yazici, Hayriye Gozde Kanmaz Kutman, Gulsum Kadioglu Simsek, Betul Siyah Bilgin, Fuat Emre Canpolat, Bedia Dinc, Serife Suna Oguz

Journal of Pediatric Infectious Diseases

Objective: To assess the performance of the relatively new hematological marker delta neutrophil index (DNI) and other inflammatory markers in proven sepsis of the very preterm infant.

Methods: Infants with a gestational age of <32 weeks and examined for suspected late-onset sepsis (LOS) were evaluated retrospectively. Demographic characteristics, laboratory findings, and neonatal morbidity and mortality were compared between infants with blood culture-confirmed sepsis and clinical sepsis.

Results: The study included 358 infants, 90 with proven sepsis and 268 with clinical sepsis. The mean gestational ages in these groups were 28.2±2 and 28.2±2.1 weeks, and the mean birth weight was 1139±372 and 1148±370 g, respectively (p>0.05). The proven sepsis group had higher DNI (median 7.1% [range, 0.1-74] vs. 0.6% [range, 0.1-24.7%], p<0.01], CRP (median 5 [range, 1-38] mg/L vs. 1 [range, 1-15] mg/L, p<0.001), interleukin 6 (median 620 [range, 6.9-5500] pg/mL vs. 42.2 [range, 2.2-5500] pg/mL, p<0.01), and procalcitonin (median 6.2 [range, 0.26-86] μg/L vs. 0.6 [range, 0.06-25.7] μg/L, p=0.002). According to ROC analysis, interleukin 6 had the highest area under the curve (AUC) at 0.74 (95% CI 0.60-0.88, p<0.01). The AUC values were 0.73 (95% CI 0.59-0.88, p=0.01) for procalcitonin, 0.62 (95% CI 0.44-0.80, p=0.18) for DNI, and 0.66 (95% CI 0.50-0.82, p=0.05) for CRP.

Conclusion: The delta neutrophil index showed a statistically significant elevation …

Diagnostic Value Of Lncrna Fgd5-As1 Sponge Mir-223-3p In Infantile Pneumonia And Its Prognostic Effect On Rehabilitation, Hong-Ping Ren, Hong-Lin Wen, Ya-Nan Liu, Lin Cai

Journal of Pediatric Infectious Diseases

Objective: This study aimed to uncover the value of long non-coding RNA FGD5-AS1 (lncRNA FGD5-AS1) in the diagnosis of infantile pneumonia and explore its pathological mechanism in lung fibroblasts. This research may provide a potential biomarker for diagnosing patients and predicting their rehabilitation outcomes.

Methods: This study included 92 children with infantile pneumonia as the research object, and an equal number of healthy children were introduced as controls. The FGD5-AS1 content was detected using real-time quantitative polymerase chain reaction (RT-qPCR) assay. The diagnostic value of FGD5-AS1 was evaluated by receiver operating characteristic (ROC) and logistic analysis. The molecular mechanism of …

Hematological Parameters And Systemic Inflammatory Markers In Children With Viral Acute Lower Respiratory Tract Infections, Sadiye Sert, Fatma Sargin, Şerife Karaçal Say, Berna Erayman, Ebru Buldu

Journal of Pediatric Infectious Diseases

Objective: Viral acute lower respiratory tract infections (ALRTIs) are a leading cause of morbidity and mortality in children, particularly those under 5 years. Accurate diagnosis and timely management are crucial to improve outcomes. This study aimed to address the lack of comparative analysis between hematological and systemic inflammatory markers concerning established disease severity scores in children with viral ALRTIs. We sought to evaluate the correlations between these markers and severity scores to identify which parameters provide the most reliable predictive value for assessing the severity of ALRTI diagnoses in this population.

Methods: This retrospective cross-sectional study included 191 children hospitalized …

Evaluation Of Gastrointestinal Pathogens In Children With Inflammatory Bowel Disease Using Multiplex Polymerase Chain Reaction, Yeliz Çağan Appak, Özgür Appak, Betül Aksoy, Büşra Emi̇r, Ayça Arzu Sayiner, Maşallah Baran

Journal of Pediatric Infectious Diseases

Objective: Impaired gastrointestinal mucosa and immunosuppressant therapies increase the risk of secondary infection in patients with inflammatory bowel disease (IBD). This study evaluated the detection of pathogens in children with IBD using a gastrointestinal panel (GP). This is the first study to compare this method with clinical data from pediatric IBD patients.

Methods: Children with newly diagnosed IBD or experiencing disease flares were included. Demographic data, clinical and laboratory findings, treatments, treatment durations, and disease activity were analyzed. Stool samples were assessed using multiplex real-time polymerase chain reaction with QIAstat-Dx GP®. Results were compared between groups.

Results: Thirty-five patients with …

Abdominal Tuberculosis In Children, Melike Emiroglu, Gulsum Alkan, Meltem Kiymaz, Sadiye Kubra Tuter Oz, Hatice Turk Dagi, Mehmet Öztürk, Zeliha Esin Çelik

Journal of Pediatric Infectious Diseases

Objective: To provide an insight into the presentation, diagnosis and management of gastrointestinal tuberculosis in children.

Methods: We reviewed the medical records of children who were diagnosed with gastrointestinal tuberculosis, between October 2013 and October 2023. The analysis was performed using descriptive statistics.

Results: During the study period, 11 of 76 tuberculosis pediatric patients (14.5%) were diagnosed with gastrointestinal tuberculosis. Six of 11 patients (54.5%) were female. The median age of the patients was 60 months (51-205 months). Eight of 11 patients had intra-abdominal lymph node involvement, 3 of 11 patients had intestinal tuberculosis and 2 of 11 patients had …

Urgent Implementation Of Point-Of-Care Testing For Group A Streptococcal Infection In A Uk Children’S Emergency Department, Ruth Shorrocks, Philip J. Turner, Thomas Fanshawe, Umasha Ukwatte, Jim Gray, James Taylor, Liliana Graveto, Gail Hayward, Chris Bird

Journal of Pediatric Infectious Diseases

Objective: In late 2022, Western Europe and the United States experienced increased incidences of scarlet fever and life-threatening invasive group A strepto- coccal (iGAS) infections, especially among children. The outbreak was widely reported in the media in the United Kingdom, leading to increased emergency department (ED) attendances and threatened supplies of antibiotics. Our ED rapidly introduced point-of-care testing for GAS pharyngitis with the aim of rationalizing antibiotic prescribing.

Methods: We rapidly implemented the use of a molecular-based (polymerase chain reaction) point-of-care test for all children scoring 3 or higher on the McIsaac clinical prediction rule for GAS pharyngitis in children …

Epidemiology Of Acute Infectious Diarrhea-Associated Viruses In Children In Hangzhou, China, 2023, Ya-Jun Guo, Lin Li, Qin-Rui Lai, Wei Li

Journal of Pediatric Infectious Diseases

Objective: To investigate the epidemiological characteristics of children infected with diarrheal virus in Hangzhou, China, 2023.

Methods: From January 2023 to December 2023, 20,939 stool samples from children with acute infectious diarrhea were collected for detection of rotavirus A and human adenovirus, using Latex agglutination detection kits; 7584 stool samples were collected for detection of norovirus, using real‐time PCR reagent.

Results: 639 (3.0%, 639/20,939) tested positive for rotavirus A, and 1,201 (5.7%, 1,201/20,939) positive samples were detected by Colloidal gold method. The positive rates of norovirus were 42.2% (3,203/7,585). Among all age groups, the rotavirus A positive detection rate was …

Evaluation Of Pediatric Patients Diagnosed With Measles: A Retrospective Study In Istanbul, Zehra Yazi, Nahide Haykir Zehi̇r, Merve Akçay, Ufuk Yükselmiş, Ceren Çetin, Ayşe Karaaslan, Yasemin Akin

Journal of Pediatric Infectious Diseases

Objective: Measles, predominantly impacting the pediatric population, manifests symptoms encompassing fever, rash, rhinorrhea, cough, conjunctivitis, accompanied by infrequent yet plausible life-threatening complications.

Methods: This retrospective study conducted between January 2022 and July 2023 at a 1105-bed tertiary hospital in Istanbul, Türkiye, was focused on children diagnosed with measles and aged(PCR) were defined as definite measles cases.

Results: A total of 78 pediatric patients were diagnosed with measles, of whom 40 were evaluated as definite (51.3%) cases. Among the definite cases, 29 (72.5%) and 11 (27.5%) were girls and boys, respectively. Their median age was 78 (42–158) months. It was observed …

Risk Factors For Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol For A Multicenter, Retrospective Case-Control Study, Sriram Ramgopal, Paul Aronson, Douglas Lorenz, Alexander Joseph Rogers, Andrea Tania Cruz

Faculty, Staff and Students Publications

Background: Hypothermia in young infants presenting to the emergency department (ED) may indicate a serious bacterial infection (SBI) such as a urinary tract infection, bacteremia, or bacterial meningitis. Improved understanding of the epidemiology of SBI in infants with hypothermia and the development of prediction models can help avoid unnecessary invasive procedures and antimicrobial exposure.

Objective: The aim of the study is to (1) describe the epidemiology of SBI and herpes simplex virus (HSV) among infants with hypothermia, (2) assess the role of biomarkers in predicting SBI, and (3) derive and internally validate a multivariable predictive model for SBI among infants …

From Er To Mortality In 48 Hours: A Fatal Case Of Overwhelming Post-Splenectomy Infection, Miriam Stern, Ba, Blaise O’Malley, Bs, Amry Majeed, Md, Michael Grodsky, Md

The Medicine Forum

Overwhelming post-splenectomy infection (OPSI) is a known complication of asplenia.^1,2 While the precise rates of morbidity and mortality are unknown, estimates range from 38% to as high as 70%.² Because the spleen plays an important role in protecting against infections with encapsulated microorganisms, OPSI is most commonly caused by infection with encapsulated bacteria, specifically Streptococcus pneumoniae.^1–3 While pneumococcal vaccines have been shown to improve immunogenicity in asplenic people, OPSI remains a danger to both vaccinated and unvaccinated patients.^4,5 Additional measures to protect asplenic patients from overwhelming infection have been proposed, but the evidence remains mixed. …

String Theory - A Case Of Hypermucoviscous Klebsiella Pneumoniae Causing Distant Necrotizing Infections, Natasa Kostic, Md, Marina Gonzalez, Md

The Medicine Forum

Klebsiella pneumoniae is a Gram-negative, encapsulated bacterium belonging to the Enterobacteriaceae family. It is more frequently associated with nosocomial infections and is one of several bacteria developing high rates of antibiotic resistance.¹ Since the mid-1980s, there have been reported cases of Klebsiella pneumoniae causing life-threatening, invasive infections acquired in the community by otherwise healthy individuals. The propensity to form metastatic foci of infection in immunocompetent hosts is unusual for an enteric, Gram-negative pathogen.² This hypervirulent variant of K. pneumoniae was originally noted only in Asian-Pacific countries but is now being identified globally.³ The variant has unique mucoid …

Negative Urine Nucleic Acid Amplification Testing In A Case Of Disseminated Gonococcal Infection Presenting As Migratory Arthritis, Benjamin Richter, Md

The Medicine Forum

Disseminated gonococcal infection (DGI) is a well-documented complication of Neisseria gonorrhoeae infection, most characteristically presenting as migratory arthritis, tenosynovitis, and dermatitis. Although modern nucleic acid amplification tests (NAATs) and cultures from mucosal sites have significantly improved diagnostic capabilities, discrepancies between clinical manifestations and laboratory findings still occur.¹ One such challenge arises when the urine gonorrhea test returns negative despite strong clinical evidence pointing toward gonococcal involvement.

Migratory arthritis—a transient, shifting pattern of joint inflammation—has long been recognized as a hallmark of DGI.² Typically, the pathogen is detected in blood, synovial fluid, or from mucosal specimens; however, negative urine …