Alternative Causes of Infectious Diarrhea in Patients with Negative Tests for Clostridoides Difficile

2021 ◽  
Author(s):  
Jennie H Kwon ◽  
Caroline A O’Neil ◽  
Tiffany Hink ◽  
Kimberly A Reske ◽  
Rachel E Bosserman ◽  
...  
Keyword(s):  
Agar Plate ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Hospitalized Patients ◽  
Blood Agar Plate ◽  
Infectious Diarrhea ◽  
Gastrointestinal Microbiota ◽  
Etiologic Agents ◽  
Toxigenic Culture ◽  
Clinical Signs And Symptoms

Abstract Background Hospitalized patients with diarrhea who have a negative Clostridoides difficile (C. difficile) test are not routinely evaluated for alternative causes of infectious diarrhea. This study assessed for potential infectious causes of diarrhea in hospitalized patients with an order for repeat C. difficile toxin enzyme immunoassay (tEIA) testing after an initial tEIA test was negative. Methods For patients age ≥18 years who had a second C. difficile tEIA test ordered within 96 h after a negative tEIA test, remnant fecal specimens from the first (negative) tEIA test were evaluated using the BioFire FilmArray Gastrointestinal Panel PCR, C. difficile toxigenic culture, and culture on a blood agar plate (BAP) to identify other potential causes of infectious diarrhea. Growth of organisms on the BAP was also used to assess potential disruptions in the gastrointestinal microbiota. Results Among 84 remnant specimens, toxigenic C. difficile was identified in 9 (11%) by culture or PCR, while potential alternative causes of infectious diarrhea, including norovirus, rotavirus, enteropathogenic Escherichia coli, and Salmonella, were identified in 11 specimens (13%) by PCR. For the majority of patients, no infectious cause of diarrhea was identified, but 84% exhibited disrupted gastrointestinal microbiota, which may contribute to diarrhea. Conclusions When a hospitalized patient has a negative C. difficile tEIA test but continues to have diarrhea, alternative infectious and noninfectious causes of diarrhea should be considered. If the patient has clinical signs and symptoms suggestive of infection or risk factors for gastrointestinal infection, laboratory testing for other etiologic agents may be appropriate.

P378Heart rhythm disorders in Acromegaly

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Melkozerov ◽  
E Przhiyalkovskaya ◽  
N Tarbaeva ◽  
V Kalashnikov ◽  
Z Belaya ◽  
...  
Keyword(s):  
Cardiac Arrhythmia ◽  
Clinical Signs ◽  
Heart Rhythm ◽  
Signs And Symptoms ◽  
Hospitalized Patients ◽  
Clear Correlation ◽  
Heart Rhythm Disorders ◽  
Clinical Signs And Symptoms ◽  
Magnetic Resonance Imaging Mri ◽  
Electrocardiogram Ecg

Abstract Aim to evaluate the prevalence of heart rhythm disorders among hospitalized patients with acromegaly Methods we enrolled patients with acromegaly hospitalized in our Endocrinology Research Center in 2018. Acromegaly was established based on the clinical signs and symptoms, elevated levels of insulin-like growth factor-1 (IGF-1) and presence of pituitary adenoma. All patients underwent clinical examination, routine electrocardiogram (ECG). In patients with changes in the resting ECG and/or complaints of heart rhythm disorders, echocardiography and Holter ECG monitoring were performed. We also performed cardiac magnetic resonance imaging (MRI) with contrast in cases of arrhythmia confirmation. Results Among 107 enrolled patients with acromegaly (61 women, mediana of age 51 [40; 58] years) arrhythmia was first diagnosed in 21 (19,6%) patients: 7 patients had sick sinus syndrome, 5 patients suffered from atrial fibrillation, 4 patients had AV block, 5 patients - ventricular arrhythmias (1 patient had sustained ventricular tachycardia). The median level of the GH was 1,77 [0,8; 5,4] ng/ml, and the median of IGF-1 - 348,95 [233,4; 557,4] ng/ml, 16 (76,1%) patients with arrhythmia had active acromegaly. 21 patients underwent MRI of the heart: median of ejection fraction 54 [48; 60] %, in 8 patients we revealed focal fibrosis of left ventricle myocardium. Diffuse accumulation of contrast agent was observed in 11 patients of different severity and localization, mainly endocardium of mitral and tricuspid valves. We didn’t find a clear correlation between the levels of hormones, changes in the MRI of the heart and the type of cardiac arrhythmia. We implanted pacemakers in 4 patients, 1 patient – implantable cardioverter defibrillator. Conclusion The prevalence of cardiac arrhythmia in hospitalized patients with acromegaly is about 20%. New cases of arrhythmia could occur despite normal level of GH and IGF-1 in patients with acromegaly. Patients with acromegaly and cardiac arrhythmia often have abnormalities in MRI of the heart, which requires further investigation.

scholarly journals Risk assessment and laboratory investigation of respiratory illness in travellers returning to Singapore 2012–2015: experience from the MERS-CoV Surveillance Programme

2016 ◽  
Vol 145 (2) ◽  
pp. 285-288 ◽  
Author(s):  
M. K. WIN ◽  
A. CHOW ◽  
H. J. HO ◽  
S. Y. TAY ◽  
Y. S. LEO
Keyword(s):  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Respiratory Illness ◽  
Hospitalized Patients ◽  
Care Hospital ◽  
Rt Pcr ◽  
Potential Benefits ◽  
Severe Respiratory Infection ◽  
Clinical Signs And Symptoms

SUMMARYSince the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV), Singapore has enhanced its national surveillance system to detect the potential importation of this novel pathogen. Using the guidelines from the Singapore Ministry of Health, a suspect case was defined as a person with clinical signs and symptoms suggestive of pneumonia or severe respiratory infection with breathlessness, and with an epidemiological link to countries where MERS-CoV cases had been reported within the preceding 14 days. This report describes a retrospective review of 851 suspected MERS-CoV cases assessed at the adult tertiary-care hospital in Singapore between September 2012 and December 2015. In total, 262 patients (31%) were hospitalized. All had MERS-CoV infection ruled out by RT–PCR or clinical assessment. Two hundred and thirty (88%) of the hospitalized patients were also investigated for influenza virus by RT–PCR. Of these, 62 (27%) tested positive for seasonal influenza. None of the patients with positive influenza results had been vaccinated in the year prior to hospital admission. Ninety-three (36%) out of the 262 hospitalized patients had clinical and/or radiological evidence of pneumonia. This study demonstrates the potential benefits of pre-travel vaccination against influenza and pneumococcal disease.

scholarly journals Dementia and Major Neurocognitive Disorders: Some Lessons Learned One Century after the first Alois Alzheimer’s Clinical Notes

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
Donatella Rita Petretto ◽  
Gian Pietro Carrogu ◽  
Luca Gaviano ◽  
Lorenzo Pili ◽  
Roberto Pili
Keyword(s):  
Young Woman ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Neurocognitive Disorders ◽  
Lessons Learned ◽  
Alzheimer Dementia ◽  
Clinical Notes ◽  
Alois Alzheimer ◽  
Clinical Signs And Symptoms

Over 100 years ago, Alois Alzheimer presented the clinical signs and symptoms of what has been later called “Alzheimer Dementia” in a young woman whose name was Augustine Deter [...]

scholarly journals Correction to: Levoketoconazole improves clinical signs and symptoms and patient-reported outcomes in patients with Cushing’s syndrome

Pituitary ◽  
2020 ◽  
Author(s):  
Eliza B. Geer ◽  
Roberto Salvatori ◽  
Atanaska Elenkova ◽  
Maria Fleseriu ◽  
Rosario Pivonello ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Patient Reported Outcomes ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cushing's Syndrome ◽  
Original Version ◽  
Patient Reported ◽  
Author Group ◽  
Clinical Signs And Symptoms

The original version of the article unfortunately contained an error in the first name and the surname of one of the authors in the author group. The last author name was incorrectly published as ‘F. Pecori Giraldi’ and the corrected name is ‘Francesca Pecori Giraldi’ (First name: Francesca; Surname: Pecori Giraldi).

scholarly journals A 38-year demographic study of central and peripheral giant cell granulomas of the jaws

2016 ◽  
Vol 15 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Shadi Saghafi ◽  
Reza Zare-Mahmoodabadi ◽  
Narges Ghazi ◽  
Mohammad Zargari
Keyword(s):  
Giant Cell ◽  
Medical Science ◽  
Age Distribution ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Posterior Maxilla ◽  
Frequent Site ◽  
Male Patients ◽  
Clinical Signs And Symptoms ◽  
Anterior Mandible

Objective: The purpose of this study was to retrospectively analyze the demographic characteristics of patients with central giant cell granulomas (CGCGs) and peripheral giant cell granulomas (PGCGs) in Iranian population.Methods: The data were obtained from records of 1019 patients with CGCG and PGCG of the jaws referred to our department between 1972 and 2010. This 38-year retrospective study was based on existing data. Information regarding age distribution, gender, location of the lesion and clinical signs and symptoms was documented. Results: A total of 1019 patients were affected GCGLs including 435 CGCGs and 584 PGCGs during the study. The mean age was 28.91 ± 18.16. PGCGs and CGCGs had a peak of occurrence in the first and second decade of life respectively. A female predominance was shown in CGCG cases (57.70%), whereas PGCGs were more frequent in males (50.85%). Five hundred and ninety-eight cases of all giant cell lesions (58.7 %) occurred in the mandible. Posterior mandible was the most frequent site for both CGCG and PGCG cases. The second most common site for PGCG was posterior maxilla (21%), whereas anterior mandible was involved in CGCG (19.45%). The majority of patients were asymptomatic. Conclusions: In contrast to most of previous studies PGCGs occur more common in the first decade and also more frequently in male patients. Although the CGCGs share some histopathologic similarities with PGCGs, differences in demographic features may be observed in different populations which may help in the diagnosis and management of these lesions.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.220-223

scholarly journals Is Bisphosphonate-Related Osteonecrosis of the Jaw an Infection? A Histological and Microbiological Ten-Year Summary

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
A. M. Hinson ◽  
C. W. Smith ◽  
E. R. Siegel ◽  
B. C. Stack
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
Large Scale ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Osteonecrosis Of The Jaw ◽  
Multifactorial Disease ◽  
Clinical Signs And Symptoms ◽  
Surgical Treatments

The role of infection in the etiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is poorly understood. Large-scale epidemiological descriptions of the histology and microbiology of BRONJ are not found in the literature. Herein, we present a systematic review of BRONJ histology and microbiology (including demographics, immunocompromised associations, clinical signs and symptoms, disease severity, antibiotic and surgical treatments, and recovery status) validating that infection should still be considered a prime component in the multifactorial disease.

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