Infectious Disease Commons^™

A Fatal Case Of Primary Amoebic Meningoencephalitis (Pam) Complicated With Diabetes Insipidus (Di): A Case Report And Review Of The Literature, Zain Mushtaq, Saad Bin Zafar Mahmood, Adil Aziz

Section of Internal Medicine

Naegleria fowleri is a highly infective free-living amoeba usually isolated from soil and fresh water and is primarily found to infect the central nervous system (CNS) resulting in primary amoebic meningoencephalitis (PAM). PAM as a cause of meningitis is often overlooked for other, more common causes of meningitis. Despite all the advances in antimicrobial therapy and supportive care systems, the mortality rate of this rare infection remains above 95% with the bulk of the cases being found in developed countries. We are presenting a case of a 44-year-old male with fever, worsening headache, and generalized weakness. Lumbar puncture showed a …

Coverage Of The 2019 Eastern Equine Encephalitis Virus Outbreak On News Media, Corey H. Basch, Joseph Fera, Christie Jaime, Nasia Quininoes

Publications and Research

Background: The media plays as an important role in delivering information about emergent issues, such as the Eastern equine encephalitis virus (EEEV) outbreak of 2019. As such, there has been an increase in news coverage of vector-borne disease coverage due to a rise in emerging or re-emerging arboviruses.

Methods: The purpose of this study was to describe the content of news clips related to the recent (2019) EEEV outbreak in the United States.

Results: Only 3 of the important topics identified were mentioned in a majority of the 110 videos analyzed. These topics were, mosquito mentioned as transmitter, prevention by …

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

Convalescent Plasma In Covid-19, Ranjit S. Banwait, Joshua K. Salabei, Troy J. Fishman, Uma G. Iyer

HCA Healthcare Journal of Medicine

The recent pandemic of SARS-CoV-2, which causes novel coronavirus disease 2019 (Covid-19), has had devastating impact on a global and national scale. In order to overcome this outbreak it is imperative we find treatments that are safe and effective. To date, no definitive treatment is available that can curtail the spread of this viral syndrome. Convalescent plasma (CP) is one such option that has repeatedly served as an important tool in treatment of various bacterial and viral infections, especially in the setting of no specific antimicrobial or vaccination against an infectious disease. Herein, we review the history of CP, prior …

A Case Of Disseminated Nocardia Beijingensis In An Immunocompetent Patient, Manifesting As Subcutaneous And Cns Nocardiosis., Scott Cathcart, Patricia Stogsdill, Rebecca Bell

Journal of Maine Medical Center

Introduction

Nocardiosis is an uncommon infection, typically encountered in immunocompromised patients. With only 5 cases reported thus far in the United States, we present a case of disseminated Nocardia beijingensis in an immunocompetent patient, involving the lung, subcutaneous tissue, and CNS.

Clinical Findings

A 60-year-old immunocompetent male with no significant medical history presents to our institution after a complicated medical course, beginning with vague respiratory complaints. Initial work-up revealed a large right upper lung mass of unclear etiology. A month later he had a syncopal episode followed by the development of focal neurologic deficits.

Main Diagnoses, Therapeutics Interventions, and Outcomes …

A Rare Case Of Leprosy In West Florida, Adrian Lugo, Taylor Studsrud, Nemer Dabage, James Demaio

West Florida Division GME Research Day 2020

• Leprosy is caused by acid-fast bacilli of the M. leprae complex, which includes M. leprae and M. lepromatosis.
• Transmission in the U.S. is rare, but has been documented in hunters who handle wild ninebanded armadillo.
• The origins of M. leprae infection among armadillos, the geographic range of the infected animals, and the potential risks infected armadillos present to people have been topics of concern.
• The infection originated amongst armadillos decades before they were ever used in leprosy research, and numerous surveys have confirmed that armadillos in the southern United States are a large natural reservoir for M. leprae; its prevalence …

A Case Of Pott's Disease: Typical Presentation Of An Uncommon Disease In The United States, Neha Patel, Ravi Patel, Marek Krysztofiak, K V. Sundaresh

West Florida Division GME Research Day 2020

Pott’s disease (PD), also known as tuberculosis spondylitis, is a rare disease of the spine which is typically caused by extraspinal infection. The basic lesion in Pott's disease is a combination of osteomyelitis and arthritis, usually affecting more than one vertebra. The anterior aspect of the vertebral body adjacent to the subchondral plate is commonly involved. Spinal TB can include any of the following: progressive bone destruction leading to vertebral collapse and kyphosis, cold abscess formation (due to extension of infection into adjacent ligaments and soft tissues), spinal canal narrowing by abscesses, granulation tissue or direct dural invasionresulting in spinal …

Pasteurella Multocida Bacteremia Secondary To Multiple Cat Scratches, Charles Boadu, Andrea Hernandez, Bassem Zeidan, John T. Young, Johnathan Frunzi

West Florida Division GME Research Day 2020

Pasteurella multocida(P. multocida)is part of the normal gastrointestinal and upper respiratory flora of domestic and wild animals such as dogs, cats, rabbits, opossums, boars, tigers, lions and horses ^{(1, 2)}. Transmission of P. multocidais usually through scratches and bites leading to infections of the soft tissue and skin ^(3,4). P. multocida bacteremia is rare, but occurs in individuals with major risk factors including chronic pulmonary disease, diabetes mellitus, end state renal disease (ESRD), and an immunocompromised state ^(3,4). Non traumatic infections of P. multocida in immunocompromised individuals,are more likely to require care in the intensive care unit …

Outcomes Of Patients Hospitalized With Community-Acquired Pneumonia With Liver Disease Or Cirrhosis., Bibodh Jung Karki, Sravan K. Ponnekanti, Vidyulata Salunkhe, Nishita Tripathi, Mahder A. Tella, Stephen P. Furmanek, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Liver disease and cirrhosis are common causes of mortality worldwide. Community-acquired pneumonia is recognized as a significant cause of morbidity and mortality in this population of adults. There is a lack of data regarding outcomes or prognosis in patients with liver dysfunction who develop CAP. The objective of this study was to evaluate the clinical characteristics, incidence, and outcomes of hospitalized patients with CAP and liver disease.

Methods: This was a secondary analysis of the University of Louisville Pneumonia Study, which was a prospective population-based cohort study of adults hospitalized with community-acquired pneumonia. All patients were divided into three …

Unusual Echocardiographic Findings Of Myocarditis Mimicking An Aortic Run-Off Lesion, Sarah Studyvin, Barbara A. Pahud, Christine Symes

Research Days

No abstract provided.

Characterization Of A Plasmid-Based Dna Vaccine For Simian Immunodeficiency Virus, Priya Sanipara

Honors Theses

Described as one of the world’s worst pandemics, HIV (Human Immunodeficiency Virus) infects millions of people each year and is the cause for AIDS (Acquired Immunodeficiency Syndrome). Despite the development of vaccines for numerous infectious diseases such as polio, small pox, and influenza, a vaccine for HIV remains elusive due to the virus’s high mutation rate and ability to evade the immune system. HIV causes depletion of CD4+ lymphocytes, resulting in a weakened immune system. However, the development of a plasmid-based DNA vaccine approach may help revolutionize vaccine development for HIV due to its ability to confer cellular and humoral …

Pneumonia: An Unexpected Graveyard Visitor?, Daniel A. Casas, Jigar Chauhan, Melanie Williams, Jan Sambataro, David Sukhai, Pablo G. Dubon, Jorge Perez

West Florida Division GME Research Day 2020

Community acquired pneumonia caused by Influenza can present with superinfection. On rare occasions, an unexpected organism is discovered.

Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, William R. Judson, John D. Murphy, Phillip H. Sussman, John N. Harker

West Florida Division GME Research Day 2020

• Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.^{1, 2}
• Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.¹ The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.^{3, 4}
• Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy. …

Can Technology Help Improve Diarrhoea Management?, Zulfiqar Ahmed Bhutta

Woman and Child Health

No abstract provided.

A Case Of Babesiosis Seen Outside Of Its Endemic Area And Outside Of Its Incubation Period, Kiran Tirumalasetty, Jinal K. Patel, Gauthier L. Stepman, Bassem Zeidan, K V. Sundaresh, Parth R. Desai, Johnathan Frunzi

West Florida Division GME Research Day 2020

Babesiosis Microti is a parasitic alveolate that is usually transmitted by Ixodes scapularis ticks. In the United States, the endemic areas of Babesiosis include the Northeast and Upper Midwestern regions [1]. Symptoms include fever, malaise, fatigue, vomiting, and jaundice [1]. Current therapy primarily consists of a combination of azithromycin and atovaquone. Clindamycin and quinine may be administered in severe cases. For its emerging health risk worldwide, clinicians must be aware of the several presenting manifestations of babesiosis. Since 2017, the Centers Disease Control and Prevention (CDC) has deemed Babesiosis is a reportable disease. This case focuses on the importance of …

Clinical Features, Diagnosis And Management Of Covid-19 Patients In The Outdoor Setting, Bushra Jamil

Department of Medicine

In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, …

How Immune T-Cell Augmentation Can Help Prevent Covid-19: A Possible Nutritional Solution Using Ketogenic Lifestyle, Ravi K. Kamepalli Md,Fidsa,Cwsp

The University of Louisville Journal of Respiratory Infections

No abstract provided.

484— Modeling Social Distancing Methods And Their Effectiveness In Combating The Spread Of Ebola, Rachel Fair

GREAT Day Posters

Ebola Virus Disease (EVD) is a rare but severe disease that is transmitted among humans through direct-contact with, and close proximity to, infected bodily fluids. From 2014-16, West Africa experienced the largest Ebola outbreak ever recorded, infecting over 28,000 people, and killing over 11,000. Although the symptoms of EVD are treatable, the disease can be extremely deadly, with an average of 50% EVD cases resulting in fatality. In areas where healthcare is scarce and vaccinations are not readily available, the practices of social distancing and self-quarantining have been shown to be highly effective in combating the spread of EVD. To …

Coronavirus Disease 2019 (Covid-19), Matthew Dunbar

Pharmacy Student Scholarship

No abstract provided.

Traditional Funeral And Burial Rituals And Ebola Outbreaks In West Africa: A Narrative Review Of Causes And Strategy Interventions, Chulwoo Park

Faculty Publications

Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in …

Screening For Hepatitis C Virus Infection In Adolescents And Adults: Updated Evidence Report And Systematic Review For The Us Preventive Services Task Force, Roger Chou, Tracy Dana, Rongwei Fu, Bernadette Zahker, Jesse Wagner, Shaun Ramirez, Sara Grusing, Janice H. Jou

OHSU-PSU School of Public Health Faculty Publications and Presentations

IMPORTANCE: A 2013 review for the US Preventive Services Task Force (USPSTF) of hepatitis C virus (HCV) screening found interferon-based antiviral therapy associated with increased likelihood of sustained virologic response (SVR) and an association between achieving an SVR and improved clinical outcomes. New direct-acting antiviral (DAA) regimens are available.

OBJECTIVE: To update the 2013 review on HCV screening to inform the USPSTF.

DATA SOURCES: Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through February 2019, with surveillance through September 2019.

STUDY SELECTION: Randomized clinical trials (RCTs) and nonrandomized treatment studies of HCV …

A Novel Case Of Bacterial Meningitis In A Patient With Loeys-Dietz, Lacey D. Colvin Do, Christy Fagg

Infectious Disease

No abstract provided.

A Decerebrating Female: A Rare Presentation Of Acute Disseminated Encephalomyelitis Due To Measles, Natasha Del Rio, Yordan Orive, Andres Sobrado, Ruben Cabrera, Ilde Manuel Lee, Troy Hoang, Sherard Lacaille, Ricardo Garcia-Rivera, Robert Hernandez

Internal Medicine

No abstract provided.

A Ten-Year Retrospective Evaluation Of Acute Flaccid Myelitis At 5 Pediatric Centers In The United States, 2005-2014., Margaret M. Cortese, Anita K. Kambhampati, Jennifer E. Schuster, Zaid Alhinai, Gary R. Nelson, Gloria J. Guzman Perez-Carrillo, Arastoo Vossough, Michael A. Smit, Robert C. Mckinstry, Timothy Zinkus, Kevin R. Moore, Jeffrey M. Rogg, Meghan S. Candee, James J. Sejvar, Sarah E. Hopkins

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Acute flaccid myelitis (AFM) is a severe illness similar to paralytic poliomyelitis. It is unclear how frequently AFM occurred in U.S. children after poliovirus elimination. In 2014, an AFM cluster was identified in Colorado, prompting passive US surveillance that yielded 120 AFM cases of unconfirmed etiology. Subsequently, increased reports were received in 2016 and 2018. To help inform investigations on causality of the recent AFM outbreaks, our objective was to determine how frequently AFM had occurred before 2014, and if 2014 cases had different characteristics.

METHODS: We conducted a retrospective study covering 2005-2014 at 5 pediatric centers in 3 …

Severe Malaria Due To Plasmodium Falciparum, Hamid Hussaini, Rage Geringer Md, Gregory Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Social Values For Health Technology Assessment In Canada: A Scoping Review Of Hepatitis C Screening, Diagnosis And Treatment, Caroline O'Keefe-Markman, Kristina Dawn Lea, Christopher Mccabe, Elaine Hyshka, Tania M. Bubela

Office of the Provost

Background: Health care system decision makers face challenges in allocating resources for screening, diagnosis and treatment of hepatitis C. Approximately 240,000 individuals are infected with the hepatitis C virus (HCV) in Canada. Populations most affected by HCV include Indigenous people, people who inject drugs, immigrants and homeless or incarcerated populations as well as those born between 1946 and 1965. Curative but expensive drug regimens of novel direct acting antivirals (DAAs) are available. We aim to identify social values from academic literature for inclusion in health technology assessments.
Methods: We conducted a scoping review of academic literature to identify and analyze …

Prevalence Of The Hypervirulent Nap1/Bi/027 Strain Of C. Difficile In Southwestern Virginia And Risk Factors Associated With Infection, Andrew O. Hanna, Anthony Baffoe-Bonnie, Shikha Vasudeva

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

C. difficile infection (CDI) incidence has increased over the last several decades. The BI/NAP1/027 ribotype was discovered in 2005 and has since been responsible for multiple outbreaks in the US and Canada. This subtype of C. Difficile is known to be more virulent in vivo and produce more severe disease. Limited regional data of the prevalence of this ribotype is available, which could help guide treatment. Using infection control data from a large regional hospital and a VA medical center, this study documented the prevalence of the 027 ribotype in Southwest Virginia. Patients were included if they were tested at …

Endothelial Injury And Glycocalyx Degradation In Critically Ill Coronavirus Disease 2019 Patients: Implications For Microvascular Platelet Aggregation, Douglas Fraser

Data and Test Instruments

No abstract provided.