scholarly journals Atypical Clinical Manifestations of Loiasis and Their Relevance for Endemic Populations

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Kevin G Buell ◽  
Charles Whittaker ◽  
Cédric B Chesnais ◽  
Paul D Jewell ◽  
Sébastien D S Pion ◽  
...  
Keyword(s):  
Large Scale ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Central Africa ◽  
Epidemiological Studies ◽  
True Rate ◽  
Public Health Burden ◽  
Wide Range ◽  
Atypical Manifestations ◽  
Atypical Presentations

Abstract Background Loiasis is mostly considered a relatively benign infection when compared with other filarial and parasitic diseases, with Calabar swellings and eyeworm being the most common signs. Yet, there are numerous reports in the literature of more serious sequelae. Establishing the relationship between infection and disease is a crucial first step toward estimating the burden of loiasis. Methods We conducted a systematic review of case reports containing 329 individuals and detailing clinical manifestations of loiasis with a focus on nonclassical, atypical presentations. Results Results indicate a high proportion (47%) of atypical presentations in the case reports identified, encompassing a wide range of cardiac, respiratory, gastrointestinal, renal, neurological, ophthalmological, and dermatological pathologies. Individuals with high microfilarial densities and residing in an endemic country were at greater risk of suffering from atypical manifestations. Conclusions Our findings have important implications for understanding the clinical spectrum of conditions associated with Loa loa infection, which extends well beyond the classical eyeworm and Calabar swellings. As case reports may overestimate the true rate of atypical manifestations in endemic populations, large-scale, longitudinal clinico-epidemiological studies will be required to refine our estimates and demonstrate causality between loiasis and the breadth of clinical manifestations reported. Even if the rates of atypical presentations were found to be lower, given that residents of loiasis-endemic areas are both numerous and the group most at risk of severe atypical manifestations, our conclusions support the recognition of loiasis as a significant public health burden across Central Africa.

Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Sofia Βenou ◽  
Shamez Ladhani ◽  
Gabriel Dimitriou ◽  
Despoina Gkentzi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Upper Respiratory Infection ◽  
Mild Disease ◽  
Atypical Manifestations ◽  
Novel Coronavirus ◽  
Atypical Presentations

Background: In December 2019, a local outbreak of pneumonia presented in Wuhan (China), and quickly identified to be caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 was named COVID-19 and was soon declared as pandemic because of the millions of infections and thousands of deaths worldwide. Children infected with SARS-CoV-2 usually develop asymptomatic or mild disease compared to adults. They are also more likely to have atypical and non-specific clinical manifestations than adults. Methods: A literature search was performed in PubMed and Scopus to summarize the extrapulmonary manifestations of SARS-CoV-2 infection in children since the beginning of the pandemic. Peer-reviewed papers in English were retrieved using the following keywords and combinations: ‘pediatric’, ‘child’, ‘infant’, ‘neonate’, ‘novel coronavirus’, ‘SARS-CoV-2’, ‘COVID 19’ and ‘gastrointestinal’, ‘renal’, ‘cardiac’, ‘dermatologic’ or ‘ophthalmologic’. We included published case series and case reports providing clinical symptoms and signs in SARS-CoV2 pediatric patients. Results: Although fever and symptoms of upper respiratory infection are the most frequently presented, a variety of other atypical presentations has also been reported. The clinical spectrum includes dermatological, ophthalmological, neurological, cardiovascular, renal, reproductive, and gastrointestinal presentations. In addition, a rare multi-inflammatory syndrome associated with SARS-CoV-2 infection has been reported in children, often leading to shock requiring inotropic support and mechanical ventilation. Conclusions: Clinicians need to be aware of the wider range of extrapulmonary atypical manifestations of SARS-CoV-2 infection in children, so that appropriate testing, treatment, and public health measures can be implemented rapidly.

scholarly journals Genetic recombination in fast-spreading coxsackievirus A6 variants: a potential role in evolution and pathogenicity

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Yang Song ◽  
Yong Zhang ◽  
Zhenzhi Han ◽  
Wen Xu ◽  
Jinbo Xiao ◽  
...  
Keyword(s):  
Large Scale ◽  
Genetic Recombination ◽  
Mainland China ◽  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Capsid Gene ◽  
Global Epidemic ◽  
Public Health Burden ◽  
Coxsackievirus A6 ◽  
Fast Spreading

Abstract Hand, foot, and mouth disease (HFMD) is a common global epidemic. From 2008 onwards, many HFMD outbreaks caused by coxsackievirus A6 (CV-A6) have been reported worldwide. Since 2013, with a dramatically increasing number of CV-A6-related HFMD cases, CV-A6 has become the predominant HFMD pathogen in mainland China. Phylogenetic analysis based on the VP1 capsid gene revealed that subtype D3 dominated the CV-A6 outbreaks. Here, we performed a large-scale (near) full-length genetic analysis of global and Chinese CV-A6 variants, including 158 newly sequenced samples collected extensively in mainland China between 2010 and 2018. During the global transmission of subtype D3 of CV-A6, the noncapsid gene continued recombining, giving rise to a series of viable recombinant hybrids designated evolutionary lineages, and each lineage displayed internal consistency in both genetic and epidemiological features. The emergence of lineage –A since 2005 has triggered CV-A6 outbreaks worldwide, with a rate of evolution estimated at 4.17 × 10−3 substitutions site-1 year−1 based on a large number of monophyletic open reading frame sequences, and created a series of lineages chronologically through varied noncapsid recombination events. In mainland China, lineage –A has generated another two novel widespread lineages (–J and –L) through recombination within the enterovirus A gene pool, with robust estimates of occurrence time. Lineage –A, –J, and –L infections presented dissimilar clinical manifestations, indicating that the conservation of the CV-A6 capsid gene resulted in high transmissibility, but the lineage-specific noncapsid gene might influence pathogenicity. Potentially important amino acid substitutions were further predicted among CV-A6 variants. The evolutionary phenomenon of noncapsid polymorphism within the same subtype observed in CV-A6 was uncommon in other leading HFMD pathogens; such frequent recombination happened in fast-spreading CV-A6, indicating that the recovery of deleterious genomes may still be ongoing within CV-A6 quasispecies. CV-A6-related HFMD outbreaks have caused a significant public health burden and pose a great threat to children’s health; therefore, further surveillance is greatly needed to understand the full genetic diversity of CV-A6 in mainland China.

scholarly journals Atypical presentations of malignant otitis externa

2010 ◽  
Vol 124 (11) ◽  
pp. 1205-1208 ◽  
Author(s):  
Z Vourexakis ◽  
M-I Kos ◽  
J-P Guyot
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Skull Base ◽  
Diagnostic Criteria ◽  
Otitis Externa ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Diabetic Patients ◽  
Malignant Otitis Externa ◽  
Life Threatening ◽  
Atypical Presentations

AbstractIntroduction:Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical.Case reports:We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis.Discussion:The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.

scholarly journals A curated transcriptome dataset collection to investigate inborn errors of immunity

2019 ◽  
Author(s):  
Salim Bougarn ◽  
Sabri Boughorbel ◽  
Damien Chaussabel ◽  
Nico Marr
Keyword(s):  
Web Application ◽  
Large Scale ◽  
Mononuclear Cells ◽  
Ex Vivo ◽  
Clinical Manifestations ◽  
Inherited Disorders ◽  
Transcriptional Responses ◽  
Control Subjects ◽  
A Genome ◽  
Wide Range

ABSTRACTPrimary immunodeficiencies (PIDs) are a heterogeneous group of inherited disorders, frequently caused by loss-of-function and less commonly by gain-of-function mutations, which can result in susceptibility to a broad or a very narrow range of infections but also in inflammatory, allergic or malignant diseases. Owing to the wide range in clinical manifestations and variability in penetrance and expressivity, there is an urgent need to better understand the underlying molecular, cellular and immunological phenotypes in PID patients in order to improve clinical diagnosis and management. Here we have compiled a manually curated collection of public transcriptome datasets mainly obtained from human whole blood, peripheral blood mononuclear cells (PBMCs) or fibroblasts of patients with PIDs and of control subjects for subsequent meta-analysis, query and interpretation. A total of nineteen (19) datasets derived from studies of PID patients were identified and retrieved from the NCBI Gene Expression Omnibus (GEO) database and loaded in GXB, a custom web application designed for interactive query and visualization of integrated large-scale data. The dataset collection includes samples from well characterized PID patients that were stimulated ex vivo under a variety of conditions to assess the molecular consequences of the underlying, naturally occurring gene defects on a genome-wide scale. Multiple sample groupings and rank lists were generated to facilitate comparisons of the transcriptional responses between different PID patients and control subjects. The GXB tool enables browsing of a single transcript across studies, thereby providing new perspectives on the role of a given molecule across biological systems and PID patients. This dataset collection is available at: http://pid.gxbsidra.org/dm3/geneBrowser/list.

scholarly journals MINOR CARDIAC ABNORMALITIES IN CHILDREN OF KHARKIV: PECULIARITIES OF STRUCTURE AND DISTRIBUTION

2019 ◽  
Vol 7 (4) ◽  
pp. 365-371
Author(s):  
T. A. Filonova ◽  
V. M. Savvo ◽  
Yu. V. Sorokolat
Keyword(s):  
Cardiovascular Diseases ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Epidemiological Studies ◽  
Modern Medicine ◽  
Primary Diagnosis ◽  
High Detection Rate ◽  
Cardiovascular Pathology ◽  
Cardiac Abnormalities

Cardiovascular pathology is one of the urgent problems of modern medicine, including children. The peculiarity of most cardiovascular diseases in children lies in their prolonged formation, tendency to chronic course, less apparent clinical manifestations in the first stages of the disease. Objective. In childhood, large-scale clinical epidemiological studies have not yet become widespread. But the available statistics allows analyzing trends and patterns that reflect the features of cardiovascular pathology in childhood, its role in health of the child population, which was the objective of this paper. Materials and methods. The analysis of medical and statistical documents of 1825 children aged 0–18 years followed up for cardiomyopathies of dysplastic genesis (DGC) in healthcare facilities of Kharkiv. The indications for following up were clinical symptoms and cardiac ultrasound findings during outpatient or inpatient examination in the absence of organic cardiovascular diseases. Results. Most often, clinical manifestation and, accordingly, diagnosis were observed from 4 to 11 years. Most minor cardiac abnormalities persist over the lifetime, and clinical significance may increase with age, contributing to the development of pathology or becoming a risk factor for cardiac pathology. Conclusions. The structure of minor cardiac abnormalities among the children of the dispensary group is heterogeneous: prolapse of the mitral valve (mostly isolated), abnormal chords of the left ventricle and open foramen ovale are most frequently recorded; prolapse of other valves and aneurysms of the atrial septum are very rare. Primary diagnosis of minor cardiac abnormalities mainly takes place at age 4 to 11 years. Summarizing the findings, it can be noted that minor cardiac abnormalities have a relatively high detection rate and constitute a large and heterogeneous dispensary monitoring group.

Fibromyalgia: transformation of views

2021 ◽  
pp. 12-17
Author(s):  
E. G. Filatova ◽  
N. A. Melikova
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Manifestations ◽  
Sensory Information ◽  
Cognitive Disorders ◽  
Pain Syndrome ◽  
Epidemiological Studies ◽  
Chronic Widespread Pain ◽  
Modern Concept ◽  
Central Nervous System Dysfunction ◽  
Wide Range

Fibromyalgia (FM) is a mystery of modern rheumatology. Despite the high prevalence of FM according to special epidemiological studies, clinicians make this diagnosis rarely. The modern concept of fibromyalgia was created by Smythe and Moldofsky in the mid-70s. They introduced a new term «fibromyalgia», thereby emphasizing that this condition is more due to pain syndrome than inflammation of connective tissue. A disturbance of sensory information processing in the central nervous system (dysfunction of the pain system with the formation of central sensitization, CS) plays a key role in the pathogenesis of FM. Clinical manifestations of FM include chronic widespread pain associated with a wide range of psychosomatic disorders (sleep disorders, cognitive disorders [fibro fog], anxiety, depression, fatigue, morning stiffness, etc.). The diagnostic criteria for fibromyalgia have undergone significant changes. The latest FM diagnostic criteria were developed by the American College of Rheumatology (ACR) in 2016. According to the ACR (2016) FM criteria, a diagnosis of FM does not exclude the presence of other clinically important illnesses. Concomitant FM among patients with rheumatic diseases (RD) occurs 2–3 times more often than in the general population. Diagnostics and treatment of FM are extremely difficult for clinicians, it is especially difficult with comorbidity of FM with RD. Therefore, FM requires a multidisciplinary approach within a biopsychosocial model of pain syndrome: the treatment of a patient with RD and FM should combine anti-inflammatory therapy with a complex of methods (medications and nondrug therapy) used for FM therapy. The diagnostics of comorbid FM in patients with RD will allow for personalized and more effective analgesic therapy.

scholarly journals Optimization of Analytical Parameters for Inferring Relationships among Escherichia coli Isolates from Repetitive-Element PCR by Maximizing Correspondence with Multilocus Sequence Typing Data

2006 ◽  
Vol 72 (9) ◽  
pp. 6049-6052 ◽  
Author(s):  
Tony L. Goldberg ◽  
Thomas R. Gillespie ◽  
Randall S. Singer
Keyword(s):  
Escherichia Coli ◽  
Multilocus Sequence Typing ◽  
Large Scale ◽  
Repetitive Element ◽  
Phylogenetic Analyses ◽  
Epidemiological Studies ◽  
Genetic Distances ◽  
Accurate Information ◽  
Data Types ◽  
Wide Range

ABSTRACT Repetitive-element PCR (rep-PCR) is a method for genotyping bacteria based on the selective amplification of repetitive genetic elements dispersed throughout bacterial chromosomes. The method has great potential for large-scale epidemiological studies because of its speed and simplicity; however, objective guidelines for inferring relationships among bacterial isolates from rep-PCR data are lacking. We used multilocus sequence typing (MLST) as a “gold standard” to optimize the analytical parameters for inferring relationships among Escherichia coli isolates from rep-PCR data. We chose 12 isolates from a large database to represent a wide range of pairwise genetic distances, based on the initial evaluation of their rep-PCR fingerprints. We conducted MLST with these same isolates and systematically varied the analytical parameters to maximize the correspondence between the relationships inferred from rep-PCR and those inferred from MLST. Methods that compared the shapes of densitometric profiles (“curve-based” methods) yielded consistently higher correspondence values between data types than did methods that calculated indices of similarity based on shared and different bands (maximum correspondences of 84.5% and 80.3%, respectively). Curve-based methods were also markedly more robust in accommodating variations in user-specified analytical parameter values than were “band-sharing coefficient” methods, and they enhanced the reproducibility of rep-PCR. Phylogenetic analyses of rep-PCR data yielded trees with high topological correspondence to trees based on MLST and high statistical support for major clades. These results indicate that rep-PCR yields accurate information for inferring relationships among E. coli isolates and that accuracy can be enhanced with the use of analytical methods that consider the shapes of densitometric profiles.

scholarly journals Nasopharyngeal Tuberculosis: Epidemiology, Mechanism of Infection, Clinical Manifestations, and Management

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Chonticha Srivanitchapoom ◽  
Pichit Sittitrai
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Diagnostic Techniques ◽  
Disease Treatment ◽  
Tuberculosis Epidemiology ◽  
Nasopharyngeal Biopsy ◽  
Wide Range ◽  
Multiple Case ◽  
Serious Disease

Nasopharyngeal tuberculosis (NPTB) is a noteworthy disease especially in its worldwide spread of theMycobacteriuminfection. Although NPTB has been identified in less than one percent of TB cases, recent multiple case reports indicate an either increased awareness or incidence of this disease. The most helpful diagnostic tool is an uncomplicated nasopharyngeal biopsy. However, NPTB is usually ignored because it has varied clinical manifestations and similar presentations with other more common head and neck diseases. Furthermore, the most common presenting symptom is cervical lymphadenopathy mimicking nasopharyngeal carcinoma, a more common and serious disease. Treatment outcomes of NPTB are good in both HIV-positive or HIV-negative patients. In addition, pulmonary tuberculosis association was reported in wide range between 8.3% and 82% which should be considered in a treatment program. In conclusion, early diagnosis and management in NPTB can be achieved by (1) increased awareness of this disease, (2) improvement in knowledge regarding clinical manifestations, and (3) improvement of diagnostic techniques.

scholarly journals The Wide Range of Clinical Manifestations in Leprous Neuropathy: Two Case Reports

2011 ◽  
Vol 50 (19) ◽  
pp. 2223-2226 ◽  
Author(s):  
Haruki Koike ◽  
Rina Hashimoto ◽  
Minoru Tomita ◽  
Yuichi Kawagashira ◽  
Masahiro Iijima ◽  
...  
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Wide Range

scholarly journals The current situation of Angiostrongylus vasorum in Romania: a national questionnaire-based survey

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Georgiana Deak ◽  
Eduardo Berriatua ◽  
Andrei Daniel Mihalca
Keyword(s):  
Pulmonary Arteries ◽  
Clinical Manifestations ◽  
Epidemiological Studies ◽  
Domestic Dogs ◽  
Angiostrongylus Vasorum ◽  
Intermediate Hosts ◽  
Red Foxes ◽  
Neurological Signs ◽  
Wide Range ◽  
The Right

Abstract Background Angiostrongylus vasorum (Nematoda, Metastrongyloidea) is a vascular nematode that resides in the pulmonary arteries and the right side of the heart of a wide variety of carnivores, with an indirect life cycle using coprophagic gastropods as intermediate hosts. For domestic dogs, the infection with A. vasorum can be asymptomatic, but more frequently, it is associated with a wide range of clinical manifestations like cardio-respiratory signs, bleedings, neurological signs, and ocular problems which can lead to death when not treated accordingly. Angiostrongylosis was confirmed for the first time in Romania in red foxes (Vulpes vulpes) in 2017 and two years later a seroepidemiologic study was conducted among domestic dogs. However, to this date, no clinical canine angiostrongylosis cases were published in Romania. The aim of the present paper was to evaluate the knowledge about canine angiostrongylosis among veterinarians in Romania and to update the distribution of this disease using a national wide anonymous questionnaire. Results Overall, 147 unique responses were submitted, from 31 out of 42 counties. Twelve veterinarians (8%) from 8 counties (26%) acknowledged diagnosing a case of angiostrongylosis including 5 from the Bucharest and 1 from each of the remaining seven counties. All affected dogs had respiratory distress, 75% suffered cardiopathy, 16% coagulopathies and 8% neurological signs. Case diagnosis was based mostly on larval detection by coprology (67%) and serological antigen detection test (42%). Conclusions Romanian veterinarians are aware of canine angiostrongylosis and a significant number have clinical experience with the disease. Epidemiological studies are now needed to assess its distribution in the country, and further efforts are required to improve understanding of the disease, its diagnostic and treatment methods among veterinarians.

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