Case report: first symptomatic Candidatus Neoehrlichia mikurensis infection in Slovenia

Abstract Background Candidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients. Apart from one described case found in the literature where cultivation was successful, all cases so far were diagnosed by using broad-range 16S rDNA PCR. Case presentation Our patient presented with a prolonged febrile state of unknown origin. Clinical presentation, extensive medical workup and classic microbiologic testing were non-conclusive. Several infectious agents and other causes for the febrile state were excluded. In the end, a broad-range 16S rDNA PCR was to be performed to confirm the diagnosis of CNM infection. Treatment was successful with doxycycline. Conclusions Due to the obscurity of the pathogen, diagnostic workup in CNM is prolonged and challenging. More awareness is need about this emerging infectious disease in countries with high prevalence of tick-borne diseases as standard microbiological methods are not successful in confirming the diagnosis.

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DETECTING MYCOBACTERIUM TUBERCULOSIS RAPIDLY AND MYCOBACTERIUM TUBERCULOSIS STRAINS WITHOUT IS6110 SEQUENCE BY PCR ASSAY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.1.2 ◽

2012 ◽

pp. 15-19

Author(s):

Thi Chau Anh Nguyen ◽

Hoang Bach Nguyen ◽

Hai Duong Huynh ◽

Nu Xuan Thanh Le ◽

Xuan Cuong Le ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

16S Rdna ◽

False Negative ◽

Clinical Samples ◽

Tuberculosis Complex ◽

Pcr Assay ◽

Complex Objects ◽

Method Performance ◽

Gene Coding ◽

16S Rdna Pcr

Background: The Nested IS6110 PCR is used for detecting tuberculosis, however IS6110 sequence is not present in the genome of all strains of M.tuberculosis, the result may be false negative. The gene coding 16S ribosome always contains a short sequence specific to M. tuberculosis complex. Objects: Performance of the 16S Real-time PCR to detect M. tuberculosis and combining to the nested IS6110 PCR to determine the rate of Mtb strains without IS6110 from clinical samples. Materials and method: Performance of 16S rDNA PCR by commercial kit of Viet A Inc. for all 480 samples, the samples which were positive with the 16S rDNA PCR were retested in IS6110 PCR assay by in-house kit. Results: The Realtime 16S rDNA PCR detected 258 cases (53.8%) of tuberculosis. There were 3 (1.2 %) M. tuberculosis strains which do not harbor IS6110 sequence in genome. Conclusion: The IS6110 nested PCR can be applied more widely than the 16S rDNA realtime PCR. In case of using IS6110 PCR assay, results may show a low proportion of false negative. Combining 16S rDNA PCR with the IS6110 based PCR allowed detection of deletion of IS6110 sequence in M. tuberculosis isolates.

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Incidental whole-body MRI evidence of COVID-19 in an asymptomatic patient in a high prevalence region

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00288-x ◽

2020 ◽

Vol 51 (1) ◽

Cited By ~ 1

Author(s):

Valentina Angelini ◽

Alberta Villanacci ◽

Angelo Belotti ◽

Francesca Castagnoli ◽

Barbara Frittoli ◽

...

Keyword(s):

Asymptomatic Patient ◽

Whole Body ◽

Diagnostic Tools ◽

Historical Period ◽

Case Presentation ◽

Whole Body Mri ◽

High Prevalence ◽

Chest X Ray ◽

Full Knowledge ◽

Polymerase Chain

Abstract Background The purpose of this case report is to emphasize the importance of curing any clinical radiological elements in this historical period, especially in the area of endemic to coronavirus disease 19 (COVID-19) such as Lombardy and to stress the importance of the management of the asymptomatic patient, their crucial role in the spread of contagion. Case presentation We reported the case of incidental diagnosis of interstitial pneumonia by first finding on whole-body MR (WB-MR) in the patient affected by multiple myeloma (MM), with a negative respiratory symptoms at the time and with previous (1 month before) negative chest X-ray. The patient was promptly subjected to chest CT, which confirmed the suspicion of interstitial COVID-19 pneumonia and, in hospitalization, performed nasopharyngeal swabs for real-time polymerase chain reaction (RNA-PCR), with a doubtful outcome. Once the bacterial nature of the alterations was serologically and radiologically excluded, the patient was definitively diagnosed with COVID-19 and appropriately treated in hospitalization. Conclusion The clinical choices must, therefore, to make use of all the diagnostic tools available and full knowledge of the limitation of each of them.

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Isolation of Enterobacter sakazakii from Stable Flies, Stomoxys calcitrans L. (Diptera: Muscidae)†

Journal of Food Protection ◽

10.4315/0362-028x-69.3.671 ◽

2006 ◽

Vol 69 (3) ◽

pp. 671-673 ◽

Cited By ~ 22

Author(s):

F. MRAMBA ◽

A. BROCE ◽

L. ZUREK

Keyword(s):

16S Rdna ◽

Foodborne Pathogen ◽

Animal Manure ◽

Stomoxys Calcitrans ◽

Fecal Coliforms ◽

Stable Fly ◽

Enterobacter Sakazakii ◽

Stable Flies ◽

16S Rdna Pcr ◽

Glucose Agar

Enterobacter sakazakii is an opportunistic foodborne pathogen that causes meningitis, enterocolitis, and sepsis, primarily in immunocompromised infants. Previously, it was suggested that stable flies, Stomoxys calcitrans, were a vector or reservoir of this pathogen. In our study, by means of a culturing approach combined with 16S rDNA PCR–restriction fragment length polymorphism genotyping and sequencing, we screened 928 individual stable flies collected in Kansas and Florida. Two stable flies (0.2%) were positive for E. sakazakii. In addition, 411 (44%) stable flies carried bacteria-forming red colonies (presumably enterics) on a violet red bile glucose agar (mean count = 6.4 × 104 CFU per fly), and 120 (13%) stable flies carried fecal coliforms (mean count = 8.7 × 103 CFU per fly). Sequencing of 16S rDNA showed that enterics from violet red bile glucose agar were represented by several genera, including Escherichia, Shigella, Providencia, Enterobacter, Pantoea, Proteus, Serratia, and Morganella. Our study shows that stable flies carry bacteria typically present in animal manure (a developmental site of stable fly larvae), which indicates that the natural reservoir of E. sakazakii is the digestive tract or manure of domestic animals. The low prevalence of E. sakazakii associated with stable flies suggests that stable flies do not play a major role as a reservoir or vector of this pathogen.

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Leptospirosis presenting as severe cardiogenic shock: A case report

Journal of the Intensive Care Society ◽

10.1177/1751143718754993 ◽

2018 ◽

Vol 19 (4) ◽

pp. 351-353

Author(s):

E Forbat ◽

MJ Rouhani ◽

C Pavitt ◽

S Patel ◽

R Handslip ◽

...

Keyword(s):

Case Report ◽

Cardiogenic Shock ◽

Social History ◽

Rare Case ◽

Clinical Course ◽

Unknown Origin ◽

Case Presentation ◽

Pyrexia Of Unknown Origin ◽

Severe Cardiogenic Shock ◽

Infectious Illness

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

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Incidental Findings of Brugada Syndrome Type-1 and Epsilon-Like Pattern in Otherwise Healthy Man: a Case Report

10.21203/rs.3.rs-1247914/v1 ◽

2022 ◽

Author(s):

Brian Mendel ◽

Valerie Dirjayanto ◽

Radityo Prakoso ◽

Sisca Siagian

Keyword(s):

Brugada Syndrome ◽

Unknown Origin ◽

Initial Assessment ◽

Structural Abnormality ◽

Bundle Branch Block ◽

Case Presentation ◽

Electrophysiology Study ◽

Esc Guidelines

Abstract Background: Brugada Syndrome (BrS) and arrhythmogenic right ventricle dysplasia (ARVD) are rare cardiomyopathies predisposing to sudden cardiac death (SCD). Comprehending the electrocardiographic features of these cardiomyopathies are crucial especially in emergency settings.Case presentation: A 25-year old medical student presented with no complaints, but had episodes of syncope, chest pain, and palpitations of unknown origin 10 years ago. The initial assessment showed stable hemodynamics. During examination, the ECG demonstrated incomplete right bundle branch block, Brugada-type 1 pattern, with signs of Epsilon wave. The following year, assessment of the ECG was repeated and findings were found suggestive of Brugada syndrome, although his echocardiography showed no structural abnormality. According to ESC guidelines, asymptomatic Brugada patients should undergo electrophysiology study.Conclusion: Careful follow-up with electrophysiology study is recommended for this patient in order to identify the likelihood of true Brugada and suitability for radiofrequency ablation or implantation of implantable cardioverter defibrillator (ICD).

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Comparison of Efficacy and Side Effect Between Albendazole, Albendazole-Levamisole and Mebendazole-Levamisole Againts Soil-Transmitted Helminths Infection at a Public Elementary School-Age Children on The Deli Serdang Regency

JURNAL ILMU KEFARMASIAN INDONESIA ◽

10.35814/jifi.v15i2.511 ◽

2017 ◽

Vol 15 (2) ◽

pp. 167

Author(s):

Endy Julianto

Keyword(s):

Elementary School ◽

Mixed Infection ◽

Side Effect ◽

School Age Children ◽

Cure Rate ◽

Double Blind ◽

Public Elementary School ◽

Elementary School Age ◽

Infection Treatment ◽

High Prevalence

Intestinal worm infection in particular of Soil Transmitted Helminth is still a global problem with high prevalence on the tropic and subtropic regions including Indonesia especially in the rural community. Double Blind Randomized Trial that started from April to June 2015 in which the samples are collected from public elementary school children on the Deli Serdang Regency to compare the effectivity and side effect of STH infection treatment by using Albendazole 400 mg, Albendazole 400 mg-Levamisol 50 mg/100 mg, Mebendazole 500 mg-Levamisol 50 mg/100 mg. The samples of Albendazole, Albendazole-Levamisol and Mebendazole-Levamisol groups consist of 60 children in each group in which the ones that have STH infection are Ascariasis 92 children 51.11%, Trichuriasis 37 children 20.55%, and mixed infection 51 children 28.33%. In this research, researcher doesn’t found hookworm infection in any of the groups. From the result ofstool examination, researcher found 100% of cure rate for A. lumbricoides infection on all groups, cure rate of T. trichiura infection 66.7%, 94.7%, 92.3% for each Albendazole, Albendazole-Levamisol, and Mebendazole-Levamisol groups meanwhile cure rate for mixed infection are 28.6%, 85.7%, and 66.7% for each Albendazole, Albendazole-Levamisoland Mebendazole- Levamisol groups. For mild T.trichiura infection treatment with singledose of Albendazole-Levamisolgroup is better than both of Albendazole and Mebendazole- Levamisole groups (p=0.01). In this research, researcher found nausea and diarrhea as treatment of side effect and no signifi cant difference of side effect in all groups of treatment.

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