scholarly journals Utilization of Teledentistry in Antimicrobial Prescribing and Diagnosis of Infectious Diseases during COVID-19 Lockdown

2020 ◽  
Vol 14 (S 01) ◽  
pp. S20-S26
Author(s):  
Najla Dar-Odeh ◽  
Hamzah Babkair ◽  
Ahmad Alnazzawi ◽  
Shaden Abu-Hammad ◽  
Abdalla Abu-Hammad ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Fungal Infections ◽  
Clinical Manifestations ◽  
Lymphoid Hyperplasia ◽  
Diagnostic Features ◽  
Treatment Protocols ◽  
Professional Advice ◽  
Oral Infections ◽  
Antimicrobial Prescribing ◽  
Dental Practitioners

Abstract Objectives This study aimed to analyze Jordanian dentists’ inquiries on oral infections and antimicrobial prescribing using dental professional WhatsApp groups during coronavirus disease lockdown period. Materials and Methods Three professional WhatsApp groups of Jordanian dentists were reviewed and analyzed for inquiries posted during the period from January to May 2020. Inquiries were sent from patients to their dentists who posted these inquiries to the professional WhatsApp dental groups for consultation and professional advice. All queries regarding oral infections and antimicrobial prescribing were extracted and analyzed. Results Three WhatsApp professional groups with a total numbers of members of 750 dentists who posted queries about their patients were included in this study. Dentist members posted queries about their patients to these professional WhatsApp groups. There was a total of 32 inquiries regarding oral lesions and 11 consultations regarding prescribing and dental management of medically compromised patients giving a total of 43 consultations. Among which there were 19 inquiries on oral infections and 9 inquiries on antimicrobial prescribing giving a total of 28 consultations. Most common inquiries were on bacterial infections (localized dentoalveolar abscess, pericoronitis, cellulitis, and lymphoid hyperplasia of the tongue), viral herpetic infections, and Candida infections (erythematous and pseudomembranous candidiasis). Conclusions Many dental practitioners cannot distinguish the correct diagnostic features of oral infections particularly viral and fungal infections. Continuing education should be considered to focus on clinical manifestations of various oral infections. Further, educational activities that focus on variations in treatment protocols for various infections should be introduced particularly those that concern indications for antimicrobial prescribing.

scholarly journals Good’s syndrome, a rare form of acquired immunodeficiency associated with thymomas

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Antonio Tamburello ◽  
Laura Castelnovo ◽  
Paola Faggioli ◽  
Daniela Bompane ◽  
Bruno Brando ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
B Lymphocyte ◽  
Fungal Infections ◽  
Early Recognition ◽  
Pneumocystis Jiroveci ◽  
Treatment Protocols ◽  
Gradual Improvement ◽  
Good’S Syndrome ◽  
Cold Sores ◽  
Tract Infections

Good’s syndrome (GS) or thymomaassociated immunodeficiency is a rare clinical entity that should be ruled out in patients with thymoma who develop severe, recurrent bacterial infections and opportunistic viral and fungal infections. There are no treatment protocols established, hence, early recognition is imperative to avoid complications. We report the case of a 42-year-old female, known for a previous thymectomy for giant thymoma who has suffered for a long time from recurrent pulmonary and urinary tract infections and cold sores. In March 2016 she referred to our unit complaining of fever, cough, chest pain, and cold sores due to Herpes simplex virus (HSV), confirmed serologically as HSV-1. Chest X-ray showed left pneumonia due to Streptococcus pneumoniae. She started antibiotics (amoxicillin/clavulanic acid associated with azithromycin) with gradual improvement. Given her history she was studied for an underlying immunodeficiency: IgG, IgA, and IgM were significantly low or absent, as well as all IgG subclasses; blood and bone marrow aspirate leucocyte immunophenotyping showed complete absence of B lymphocytes and reduced CD4+ T cells. In light of: i) thymoma; ii) B lymphocyte deficit; iii) hypogammaglobulinemia; iv) recurrent infections, GS was diagnosed and pre-emptive immunoglobulin treatment, associated with HSV and Pneumocystis jiroveci prophylaxis (Acyclovir for HSV and Sulfamethoxazole- Trimethoprim for P. jiroveci) were started. Since then the patient has no longer presented any infectious episodes.

A study on fungal speciation and drug susceptibility testing

2020 ◽  
Vol 10 (2) ◽  
pp. 57-62
Author(s):  
Shaik Mujafar ◽  
Boddu Ganesh ◽  
Kesani Meghana ◽  
Nuthalapati Amani ◽  
Shaik Faizan Ali
Keyword(s):  
Candida Albicans ◽  
Bacterial Infections ◽  
Susceptibility Testing ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Candida Rugosa ◽  
Clinical Manifestations ◽  
Drug Susceptibility Testing ◽  
Important Species

Fungal infections affect many people but most of these do not come to light as they are mild in clinical presentation. Candidiasis is the frequent fungal infection involving mucosa, skin, nails and internal organs caused by different species of Candida and Candida albicans being the prototype. The clinical manifestations vary with duration and severity. It occurs mostly as a comorbid disease with a primary disease or disorder. Candida comes under the phylum Fungi Imperfecti, order Moniliales and family Cryptococcaceae. Genus Candida comprises of 20 important species recognised as pathogenic in humans, of which 7 are renowned opportunistic pathogens. The following are some of the known species: Candida albicans, Candida tropicalis, Candida krusei, Candida glabrata, Candida guilliermondii, Candida parapsilosis, Candida lusitaniae, Candida kefyr, Candida rugosa, Candida dubliniensis and Candida viswanathii. Among all the fungi, 600 species are identified to be causing infections in human. Candida albicans being one of the normal human commensals may cause infections from mild to severe forms, which is influenced by molecules that helps in adhesion and invasion, hydrolases, yeast to hyphal transition, biofilms etc. In general, equal importance has not been give to fungal infections as is being given for bacterial infections. Nowadays newly emerging species are on the tract as to cause infections and their identification profile being indeterminate, which could be confirmed only by molecular methods. Overall C.tropicalis was the frequent species causing infections clinically and resistance was demonstrated against azoles and caspofungin by C.albicans and C.krusei. This may be due to extensive use of echinocandins as empirical therapy without susceptibility testing which can increase the development of resistance and may deduct treatment options. Hence, routine antifungal susceptibility testing has to be done. Out of all these things accurate epidemiological analysis and data can be provided regarding the burden of fungal infections around the globe. As tip of the iceberg, most of the fungal infections are not being reported as it is unnoticed without prominent clinical presentation and due to lack of complete documentation.

Cesarean scar defects: diagnosis and treatment in non-pregnant women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 6-10
Author(s):  
Sergey A. Martynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Genital Tract ◽  
Conservative Therapy ◽  
Clinical Manifestations ◽  
Subsequent Pregnancy ◽  
Resonance Imaging ◽  
Diagnostic Features ◽  
Pregnancy And Childbirth

The aim of the review was to summarize information on clinical manifestations, diagnostic features, as well as methods for correction of scar defects after cesarean section (CS) outside pregnancy. Lack of the scar after CS, niche, isthmocele are a myometrium defect in the area of scar after CS, which is most often detected by ultrasound, sonohysterography or magnetic resonance imaging and is manifested by postmenstrual bleeding from the genital tract. In some cases, it can cause menorrhagia, dyspareunia, pelvic pain, infertility, uterine rupture during subsequent pregnancy and childbirth. Conservative therapy or surgical treatment with laparoscopy, laparotomy or vaginal approach is carried out depending on the symptoms, size of the defect, the thickness of the residual myometrium, as well as the womans reproductive plans.

Application of Innovative Hydroxyapatite Materials in 3D Printing for Biocompatible Voice Implants

2018 ◽  
Vol 69 (4) ◽  
pp. 840-842
Author(s):  
Wojciech Musialik ◽  
Marcin Nabialek ◽  
Slawomir Letkiewicz ◽  
Andrei Victor Sandu ◽  
Katarzyna Bloch
Keyword(s):  
3D Printing ◽  
Surgical Procedures ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Colloidal Silver ◽  
Bone Implants ◽  
External Ring ◽  
Voice Prostheses ◽  
3D Printers ◽  
Silver Composite

The paper presents the possibility of using an innovative hydroxyapatite filament Ca10(PO4)6(OH)2 for printing in 3D printers of bone implants and the possibility of using it during implantation with voice prostheses. The introduction of an additional colloidal silver composite in voice implants will contribute to the reduction of bacterial infections, fungal infections and granulomatous hyperplasia. The creation of a stable external ring of the vocal fistula will remove complications associated with it with enlargement of the fistula and leakiness of voice implants. The ability to print with a hydroxyapatite filament will allow digital pre-surgery modeling of bone implants suited to the needs of surgical procedures.

Heterocycle Compounds with Antimicrobial Activity

2020 ◽  
Vol 26 (8) ◽  
pp. 867-904 ◽  
Author(s):  
Maria Fesatidou ◽  
Anthi Petrou ◽  
Geronikaki Athina
Keyword(s):  
Heterocyclic Compounds ◽  
Bacterial Infections ◽  
Scientific Community ◽  
Antimicrobial Agents ◽  
Fungal Infections ◽  
Biological Activities ◽  
Literature Survey ◽  
New Findings ◽  
Wide Range ◽  
Number Of Microorganisms

Background: Bacterial infections are a growing problem worldwide causing morbidity and mortality mainly in developing countries. Moreover, the increased number of microorganisms, developing multiple resistances to known drugs, due to abuse of antibiotics, is another serious problem. This problem becomes more serious for immunocompromised patients and those who are often disposed to opportunistic fungal infections. Objective: The objective of this manuscript is to give an overview of new findings in the field of antimicrobial agents among five-membered heterocyclic compounds. These heterocyclic compounds especially five-membered attracted the interest of the scientific community not only for their occurrence in nature but also due to their wide range of biological activities. Method: To reach our goal, a literature survey that covers the last decade was performed. Results: As a result, recent data on the biological activity of thiazole, thiazolidinone, benzothiazole and thiadiazole derivatives are mentioned. Conclusion: It should be mentioned that despite the progress in the development of new antimicrobial agents, there is still room for new findings. Thus, research still continues.

scholarly journals Community-acquired and hospital-acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kirstine K. Søgaard ◽  
Veronika Baettig ◽  
Michael Osthoff ◽  
Stephan Marsch ◽  
Karoline Leuzinger ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Bloodstream Infection ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Icu Patients ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Abstract Objectives SARS-CoV-2 may cause acute lung injury, and secondary infections are thus relevant complications in patients with COVID-19 pneumonia. However, detailed information on community- and hospital-acquired infections among patients with COVID-19 pneumonia is scarce. Methods We identified 220 SARS-CoV-2-positive patients hospitalized at the University Hospital Basel, Switzerland (between 25 February and 31 May 2020). We excluded patients who declined the general consent (n = 12), patients without clinical evidence of pneumonia (n = 29), and patients hospitalized for < 24 h (n = 17). We evaluated the frequency of community- and hospital-acquired infections using respiratory and blood culture materials with antigen, culture-based, and molecular diagnostics. For ICU patients, all clinical and microbial findings were re-evaluated interdisciplinary (intensive care, infectious disease, and clinical microbiology), and agreement reached to classify patients with infections. Results In the final cohort of 162 hospitalized patients (median age 64.4 years (IQR, 50.4–74.2); 61.1% male), 41 (25.3%) patients were admitted to the intensive care unit, 34/41 (82.9%) required mechanical ventilation, and 17 (10.5%) of all hospitalized patients died. In total, 31 infections were diagnosed including five viral co-infections, 24 bacterial infections, and three fungal infections (ventilator-associated pneumonia, n = 5; tracheobronchitis, n = 13; pneumonia, n = 1; and bloodstream infection, n = 6). Median time to respiratory tract infection was 12.5 days (IQR, 8–18) and time to bloodstream infection 14 days (IQR, 6–30). Hospital-acquired bacterial and fungal infections were more frequent among ICU patients than other patients (36.6% vs. 1.7%). Antibiotic or antifungal treatment was administered in 71 (43.8%) patients. Conclusions Community-acquired viral and bacterial infections were rare among COVID-19 pneumonia patients. By contrast, hospital-acquired bacterial or fungal infections were frequently complicating the course among ICU patients.

Not just vegetations: focal myocardial changes in patients with fungal infections

2020 ◽  
pp. 1-6
Author(s):  
Nicole M. Cresalia ◽  
Sonal T. Owens ◽  
Terri L. Stillwell ◽  
Mark D. Norris ◽  
Sunkyung Yu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Positive Culture ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Similar Proportion ◽  
Retrospective Case ◽  
Fungal Endocarditis ◽  
Catheter Tip

Abstract Background: Fungal endocarditis classically involves dense heterogenous vegetations. However, several patients with fungal infections were noted to have myocardial changes ranging from focal brightening to nodular thickening of chordae or papillary muscles. This study evaluates whether these findings are associated with fungal infections. Methods: In a retrospective case–control study, paediatric inpatients with fungal infections (positive blood, urine, or catheter tip culture) in a 5-year period were matched 1:1 to inpatients without positive fungal cultures. Echocardiograms were scored on a 5-point scale by two independent readers for presence of myocardial brightenings, nodular thickenings, and vegetations. Clinical data were compared. Results: Of 67 fungal cases, positive culture sites included blood (n = 44), vascular catheter tip (n = 7), and urine (n = 29); several had multiple positive sites. “Positive” echo findings (score ≥ 2+) were more frequent in the Fungal Group (33 versus 18%, p = 0.04). Fungal Group patients with “positive” versus “negative” echo findings had similar proportion of bacterial infections. Among fungal cases, those with “positive” echo findings had longer hospital length of stay than cases with “negative” echos (median 58 versus 40 days, p = 0.03) but no difference in intensive care unit admission, extracorporeal membranous oxygenation support, or mortality. Conclusions: Myocardial and papillary muscle brightening with nodular thickening on echocardiogram appear to be associated with fungal infections. There may be prognostic implications of these findings as patients with “positive” echo have longer length of stay. Further studies are needed to better understand the mechanism and temporal progression of these changes and determine the prognostic value of this scoring system.

scholarly journals Primary immune deficiencies with defects in neutrophil function

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Mary C. Dinauer
Keyword(s):  
Fungal Infections ◽  
Leukocyte Adhesion ◽  
Genetic Disorders ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Adaptor Protein ◽  
Invasive Fungal Disease ◽  
Neutrophil Function ◽  
Microbial Pathogens ◽  
Immune Deficiencies

Abstract Immune deficiencies resulting from inherited defects in neutrophil function have revealed important features of the innate immune response. Although sharing an increased susceptibility to bacterial and fungal infections, these disorders each have distinctive features in their clinical manifestations and characteristic microbial pathogens. This review provides an update on several genetic disorders with impaired neutrophil function, their pathogenesis, and treatment strategies. These include chronic granulomatous disease, which results from inactivating mutations in the superoxide-generating nicotinamide dinucleotide phosphate oxidase. Superoxide-derived oxidants play an important role in the control of certain bacterial and fungal species, and also contribute to the regulation of inflammation. Also briefly summarized are updates on leukocyte adhesion deficiency, including the severe periodontal disease characteristic of this disorder, and a new immune deficiency associated with defects in caspase recruitment domain–containing protein 9, an adaptor protein that regulates signaling in neutrophils and other myeloid cells, leading to invasive fungal disease.

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

Cirrhosis and Complications of Portal Hypertension

2018 ◽  
Author(s):  
Andres Cardenas ◽  
Isabel Graupera ◽  
Elsa Sola ◽  
Pere Ginès
Keyword(s):  
Liver Transplantation ◽  
Portal Hypertension ◽  
Variceal Bleeding ◽  
Bacterial Infections ◽  
Hepatorenal Syndrome ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Decompensated Cirrhosis ◽  
Ultrasound Images

Cirrhosis is the most advanced stage of all the different types of chronic liver diseases. It is defined as a diffuse disorganization of normal hepatic structure by extensive fibrosis associated with regenerative nodules. Hepatic fibrosis is potentially reversible if the causative agent is removed. However, advanced cirrhosis leads to major alterations in the hepatic vascular bed and is usually irreversible. Cirrhosis is a progressive and severe clinical condition associated with considerable morbidity and high mortality. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension. Major complications of portal hypertension include ascites, gastrointestinal (GI) variceal bleeding, hepatic encephalopathy (HE), renal failure, and bacterial infections. In recent years, major advances in the understanding of the natural history and pathophysiology of cirrhosis and the treatment of its complications have led to improved management, quality of life, and life expectancy of patients with this disease. Cirrhosis is also a risk factor for developing hepatocellular carcinoma (HCC). Decompensated cirrhosis carries a poor short-term prognosis; thus, orthotopic liver transplantation (OLT) should always be considered in suitable candidates. This chapter describes the epidemiology, etiology and genetic factors, pathogenesis, diagnosis, general management, and treatment of cirrhosis. Complications of cirrhosis are discussed, including ascites, spontaneous bacterial peritonitis, dilutional hyponatremia, hepatorenal syndrome, variceal bleeding, hepatopulmonary syndrome and postpulmonary hypertension, HE, and HCC. Indications and contraindications for liver transplantation are described. Figures show liver biopsy results and ultrasound images in cirrhosis from hepatitis C, a patient with tense ascites, transjugular intrahepatic portosystemic shunting (TIPS), large esophageal varices with red spots, and HCC. Tables outline the main causes of cirrhosis and the diagnostic methods for identifying them, the Child-Pugh score, diagnostic criteria for hepatorenal syndrome, grades of HE, and indications for liver transplantation.This chapter contains 6 highly rendered figures, 8 tables, 73 references.

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