scholarly journals When fever is not malaria in Latin America: a systematic review

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
José Moreira ◽  
Janaina Barros ◽  
Oscar Lapouble ◽  
Marcus V. G. Lacerda ◽  
Ingrid Felger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Fungal Infections ◽  
National Laboratory ◽  
Febrile Illness ◽  
Parasitic Infections ◽  
Surveillance Systems ◽  
Emerging Infections

Abstract Background In malaria-endemic countries, febrile episodes caused by diseases other than malaria are a growing concern. However, limited knowledge of the prevalent etiologic agents and their geographic distributions restrict the ability of health services to address non-malarial morbidity and mortality through effective case management. Here, we review the etiology of fever in Latin America (LA) between 1980 and 2015 and map significant pathogens commonly implicated in febrile infectious diseases. Methods A literature search was conducted, without language restrictions, in three distinct databases in order to identify fever etiology studies that report laboratory-confirmed fever-causing pathogens that were isolated from usually sterile body sites. Data analyses and mapping was conducted with Tableau Desktop (version 2018.2.3). Results Inclusion criteria were met by 625 publications corresponding to data relative to 34 countries. Studies using serology (n = 339) predominated for viral infections, culture (n = 131) for bacteria, and microscopy (n = 62) for fungi and parasites. The pathogen groups most frequently reported were viral infections (n = 277), bacterial infections (n = 265), parasitic infections (n = 59), fungal infections (n = 47), and more than one pathogen group (n = 24). The most frequently reported virus was dengue virus (n = 171), followed by other arboviruses (n = 55), and hantavirus (n = 18). For bacteria, Staphylococcus spp. (n = 82), Rickettsia spp. (n = 70), and Leptospira spp. (n = 55) were frequently reported. Areas with biggest gaps on etiology of fever were apparent. Conclusions This review provides a landscape of pathogens causing febrile illness other than malaria in LA for over 30 years. Our findings highlight the need to standardize protocols and report guidelines for fever etiology studies for better comparability of results and improved interpretation. Lastly, we should improve existing national laboratory surveillance systems, especially from low- to middle-income countries, to inform global fever policy priorities and timely identify emerging infections threats. Study registration PROSPERO systematic review registration number: CRD42016049281

scholarly journals Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Africa, 1980–2015

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jeanne Elven ◽  
Prabin Dahal ◽  
Elizabeth A. Ashley ◽  
Nigel V. Thomas ◽  
Poojan Shrestha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Global Health ◽  
Selection Criteria ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Febrile Illness ◽  
Fever Virus ◽  
Diagnostic Tools ◽  
Parasitic Infections ◽  
Care Providers

Abstract Background The availability of reliable point-of-care tests for malaria has heralded a paradigm shift in the management of febrile illnesses away from presumptive antimalarial therapy. In the absence of a definitive diagnosis, health care providers are more likely to prescribe empirical antimicrobials to those who test negative for malaria. To improve management and guide further test development, better understanding is needed of the true causative agents and their geographic variability. Methods A systematic review of published literature was undertaken to characterise the spectrum of pathogens causing non-malaria febrile illness in Africa (1980–2015). Literature searches were conducted in English and French languages in six databases: MEDLINE, EMBASE, Global Health (CABI), WHO Global Health Library, PASCAL, and Bulletin de la Société Française de Parasitologie (BDSP). Selection criteria included reporting on an infection or infections with a confirmed diagnosis, defined as pathogens detected in or cultured from samples from normally sterile sites, or serological evidence of current or past infection. A number of published articles (rather than incidence or prevalence) reporting a given pathogen were presented. Results A total of 16,523 records from 48 African countries were screened, of which 1065 (6.4%) met selection criteria. Bacterial infections were reported in 564 (53.0%) records, viral infections in 374 (35.1%), parasitic infections in 47 (4.4%), fungal infections in nine (0.8%), and 71 (6.7%) publications reported more than one pathogen group. Age range of the study population was not specified in 233 (21.9%) publications. Staphylococcus aureus (18.2%), non-typhoidal Salmonella (17.3%), and Escherichia coli (15.4%) were the commonly reported bacterial infections whereas Rift Valley fever virus (7.4%), yellow fever virus (7.0%), and Ebola virus (6.7%) were the most commonly reported viral infections. Dengue virus infection, previously not thought to be widespread in Africa, was reported in 54 (5.1%) of articles. Conclusions This review summarises the published reports of non-malaria pathogens that may cause febrile illness in Africa. As the threat of antimicrobial resistance looms, knowledge of the distribution of infectious agents causing fever should facilitate priority setting in the development of new diagnostic tools and improved antimicrobial stewardship. Trial registration PROSPERO, CRD42016049281

scholarly journals PREVALENCE OF CHILDHOOD SKIN DISORDERS ATTENDING AT OUTPATIENT PEDIATRIC HOSPITAL

2020 ◽  
pp. 131-135
Author(s):  
NANDINI THUMMANAPALLY ◽  
KAVITHA LAWDYAVATH ◽  
CHARANDAS GURUVA ◽  
DEEPTHI ENUMULA ◽  
SASTRY PVK ◽  
...  
Keyword(s):  
Rural Area ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Skin Diseases ◽  
Fungal Infections ◽  
Pediatric Population ◽  
Parasitic Infections ◽  
Skin Disorders ◽  
Prior Approval ◽  
Bacterial Skin Infections

Objective: The objective of the study was to study the prevalence of various skin diseases in pediatric population. Methods: A prospective observational study was conducted at private children’s outpatient clinic in Warangal from March to August 2018 with the prior approval from the Institutional Ethical Committee BIPS/IEC/2018/P8. A total of 200 patients with various skin diseases of age group <17 years were included in the study. Results: Out of 200 pediatric skin disorders, male children 138 (69%) outnumbered female children 62 (31%). The mean age of the study population was found to be 5.85±4.11 years. About 64% of the patients are from rural area and 36% are from urban. The percentage of skin disorders is allergic infections (26%), bacterial infections (23%), viral infections (11%), fungal infections (7.5%), parasitic infections (6%), autoimmune disorders (4%), and skin adnexa (2.5%). Conclusion: Our study concludes that the prevalence of allergic and bacterial skin infections was found to be common among male children from rural area

scholarly journals A study of dermatological disorders with primary psychiatric illness from South India

2020 ◽  
Vol 6 (6) ◽  
pp. 766
Author(s):  
Jeena Dixon D. ◽  
Rajesh Rajagopal
Keyword(s):  
Bacterial Infections ◽  
Psychiatric Illness ◽  
South India ◽  
Viral Infections ◽  
Skin Diseases ◽  
Fungal Infections ◽  
Psychiatric Patients ◽  
Parasitic Infections ◽  
Dermatological Examination ◽  
Dermatological Disorders

<p><strong>Background:</strong> Dermatological disorders are frequent among patients with psychiatric illness. The interaction between skin and mind is complex. Pre-existing skin diseases may be modified in psychiatric illness due to self induced changes which may delay the diagnosis and treatment of skin diseases and result in complications. There are only few published studies about skin diseases in psychiatric patients from south India. We are undertaking this study to highlight the importance of dermatology consultation in psychiatric patients.</p><p><strong>Methods:</strong> 200 patients with primary psychiatric disorders who accepted for the study were subjected to history taking and general examination. Detailed dermatological examination was carried out by visual inspection and clinical examination.</p><p><strong>Results:</strong> Out of 200 patients, 65 were diagnosed with major depressive disorder, 42 patients were with bipolar disorder, 40 with schizophrenia, 30 with obsessive compulsion disorder, 23 with anxiety disorder. 153 (76.5%) patients had dermatological findings, in which 84 (55%) had infectious disease, 35 (22.9%) had parasitic infections, 26 (17%) had fungal infections, 15 (9.8%) had bacterial infections, 8 (5.23%) had viral infections. 56 (36.6%) had non-infectious skin findings, 22 (14.4%) had acne, 15 (9.8%) had pruritis, 12 (7.84%) had eczema, 5 (3.3%) had psoriasis and 2 (1.3%) had vitiligo. 13 (8.4%) patients had psychodermatological problems, 10 (6.53%) had neurotic excoriation, 2 (1.3%) had delusion of parasitosis and 1 (0.6%) had trichotillomania.</p><p><strong>Conclusions</strong>: This study implies that there is a definite association of dermatology and psychiatry.</p>

Skin Infections

2018 ◽  
Author(s):  
Jan V. Hirschmann
Keyword(s):  
Bacterial Infections ◽  
Tinea Pedis ◽  
Viral Infections ◽  
Fungal Infections ◽  
Treatment Options ◽  
Tinea Corporis ◽  
Microsporum Canis ◽  
Plantar Surface ◽  
Fournier Gangrene ◽  
Tinea Versicolor

The skin can become infected by viruses, fungi, and bacteria, including some that ordinarily are harmless colonizing organisms. The most common fungal infections are caused by dermatophytes, which can involve the hair, nails, and skin. Potassium hydroxide (KOH) preparations of specimens from affected areas typically demonstrate hyphae, and either topical or systemic antifungal therapy usually cures or controls the process. The most common bacterial pathogens are Staphylococcus aureus and group A streptococci, which, alone or together, can cause a wide variety of disorders, including impetigo, ecthyma, and cellulitis. Topical antibiotics may suffice for impetigo, but ecthyma and cellulitis require systemic treatment. S. aureus, including methicillin-resistant strains, can also cause furuncles, carbuncles, and cutaneous abscesses. For these infections, incision and drainage without antibiotics are usually curative. Warts are the most common cutaneous viral infection, and eradication can be difficult, especially where the skin is thick, such as the palms and soles, or the patient is immunocompromised. Most therapies consist of trying to destroy the viruses by mechanical, chemical, or immune mechanisms. This review covers dermatophyte infections, yeast infections, bacterial infections, and viral infections of the skin. Figures show the classic annular lesion of tinea corporis, a typical kerion presenting as a zoophilic Microsporum canis infection of the scalp (tinea capitis), tinea corporis, tinea barbae, tinea pedis between and under the toes and on the plantar surface, inflammatory tinea pedis, tinea unguium, tinea manuum, angular cheilitis, prominent satellite lesions of discrete vesicles associated with candidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema and edema on the cheeks, eyelids, and nose, furuncle, carbuncle, nasal folliculitis, pitted keratolysis, trichomycosis axillaris, necrotizing fasciitis, Fournier gangrene, folliculitis, plantar wart, condyloma acuminatum, and benign lesions of bowenoid papulosis. Tables list dermatophyte species, terminology of dermatophyte infections, topical agents for dermatophyte infections, treatment options for impetigo (adult doses), and treatment options for erythrasma.   This review contains 28 highly rendered figures, 5 tables, and 33 references

Neopterin as a marker of inflammation

2015 ◽  
Vol 51 (2) ◽  
pp. 153-156
Author(s):  
Magdalena Bartold ◽  
Joanna Matowicka-Karna
Keyword(s):  
Blood Serum ◽  
Human Body ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Immunological Response ◽  
Body Fluids ◽  
Parasitic Infections ◽  
Specific Marker ◽  
Neopterin Concentration ◽  
Living Bacteria

Neopterin is a non-specific marker of immunological response of human body of cellular type. It belongs to the chemical group known as pteridines. Neopterin has been widely associated with inter alia viral infections, bacterial infections (by intracellular living bacteria), parasitic infections, skin burns or autoimmune diseases. Neopterin is a very important parameter diagnostically not only in diagnosis and monitoring of treatment but also a reliable indicator of macrophages’ activity. Most frequently neopterin concentration is measured in body fluids like blood, serum or urine, but it may be used as an indicator in other body fluids.

Treatment: infectious diseases

2018 ◽  
Author(s):  
David A. Warrell ◽  
Matthew Dryden ◽  
Alastair Miller ◽  
Clare Morgan ◽  
David A. Warrell
Keyword(s):  
Infectious Diseases ◽  
Sexually Transmitted Infections ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Emerging Infections ◽  
Sexually Transmitted

Introduction: infectious diseases - Viral infections - Bacterial infections - Malaria - Other protozoal infections - Filarial worms - Worm infections - Flukes - Emerging infections - Sexually transmitted infections

High IL-15 Serum Levels on Day 7 After Hematopoietic Cell Transplantation Are Associated with a Low Likelihood of Graft-Vs-Host Disease and a High Likelihood of Infections

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1271-1271
Author(s):  
Laura M Hagel ◽  
Yiping Liu ◽  
Alejandra Ugarte-Torres ◽  
Tyler S Williamson ◽  
James A Russell ◽  
...  
Keyword(s):  
Cd8 T Cells ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Multivariate Analyses ◽  
Fungal Infections ◽  
Subsequent Development ◽  
Serum Levels ◽  
High Likelihood ◽  
Infection Rates ◽  
Cytokine Levels

Abstract Abstract 1271 Background: High levels of soluble IL-2 receptor alpha, IL-5, IL-6, IL-7, IL-15, soluble TNF alpha receptor and vascular endothelial growth factor have been associated with a high likelihood of GVHD. The levels were typically measured during or shortly before the development of GVHD. As preemptive therapy of GVHD would likely be efficacious if started early posttransplant, we set out to determine whether the levels of the above cytokines/cytokine receptors (hereafter referred to as “cytokines”) on day 7 are associated with subsequent development of GVHD and, if yes, whether the levels are also associated with relapse or infections. Patients and Methods: In a cohort of 153 consecutive allogeneic transplant recipients in Calgary who gave consent we determined serum levels of the above cytokines. All patients were adults, received myeloablative conditioning including rabbit antithymocyte globulin and typically filgrastim-mobilized blood mononuclear cells from HLA-matched unrelated donors or siblings, typically for hematologic malignancy. Cytokine levels were measured using sandwich ELISA (R&D). For each cytokine, levels in patients with versus without aGVHD (grade 2–4), cGVHD (needing systemic therapy) or relapse were compared using Mann-Whitney-Wilcoxon test, and correlation between the cytokine level and infection rates (number of infections per number of days at risk) was evaluated using Spearman rank correlation test. For each cytokine for which the levels appeared to be significantly associated with aGVHD, cGVHD, relapse or an infection rate, multivariate analyses were performed (using log-binomial regression for aGVHD, cGVHD or relapse, and Poisson regression for infection rates) adjusting for recipient age (continuous), donor type (HLA-matched sibling versus other), donor/recipient sex (M/M versus other), stem cell source (marrow versus blood stem cells) and, for relapse, also disease/disease stage (good vs poor risk) and, for infections, also engraftment day (continuous) and aGVHD or cGVHD (yes/no) using days at risk as the offset. Results: In univariate analyses, the only cytokine levels significantly associated with subsequent development of aGVHD or cGVHD were IL-15 levels (median 29 vs 40 pg/mL in patients with vs without aGVHD, p=.02, and median 25 vs 40 pg/mL in patients with vs without cGVHD, p=.02). IL-15 levels were similar in patients who did vs did not develop relapse (30 vs 39 pg/mL, p=0.60). There was a significant or near-significant positive correlation between IL-15 levels and the rates of definite (microbiologically documented) infections (p=.008), total (definite or presumed) infections (p=.008), viral infections (p=.06), bacterial infections (p=.06) and fungal infections (p=0.03) occurring between day 7 and 83. In multivariate analyses, IL-15 levels above31.0 pg/mL were associated with a 0.38-fold risk of aGVHD (p=0.005), and levels above 31.3 pg/mL with a 0.35-fold risk of cGVHD (p<.008). For a unit increase of IL-15 level (change of 1 pg/mL), the rate of infections increased 1.02-fold (p<.001) for definite infections, 1.03-fold for total infections (p<.001), 1.03-fold for viral infections (p<.001), 1.02-fold for bacterial infections (p<.001) and 1.03-fold for fungal infections (p=.06). Conclusion: Unexpectedly, high IL-15 levels were associated with a low likelihood of GVHD. For this we do not have an explanation. High IL-15 levels were also associated with a high likelihood of infections. This may reflect the fact that the most lymphopenic patients (at the highest risk of infections) may have had the highest levels of IL-15, a homeostatic growth factor for CD8 T cells and NK cells. Consistent with that, post-hoc analyses showed negative correlations between day 7 IL-15 levels and day 28 counts of CD8 T cells (p=.0002), NK cells (p=.06) and total lymphocytes (p=.03). Disclosures: No relevant conflicts of interest to declare.

scholarly journals Dermatological manifestations of acquired immunodeficiency syndrome: an observational study among HAART naive patients from an ART centre of excellence

2017 ◽  
Vol 3 (4) ◽  
pp. 506
Author(s):  
Lalremruati Sailo ◽  
Th Bijayanti Devi ◽  
Th Bhimo Singh ◽  
Bishurul N. A. Hafi
Keyword(s):  
Bacterial Infections ◽  
Viral Infections ◽  
Fungal Infections ◽  
Cd4 Count ◽  
Hairy Leukoplakia ◽  
Centre Of Excellence ◽  
Common Skin ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Rare Endemic

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Dermatological manifestations can be a window to the clinical and immunological status of patients with HIV infection. Introduction of HAART has dramatically shifted the pattern of HIV associated dermatoses. The present study has been carried out to find out the same among HIV infected patients not started on HAART therapy</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Two hundred (200) HIV-positive, HAART-naïve patients attending ART centre of excellence were examined between November 2005 to July 2007, for the presence of mucocutaneous manifestations, correlation with CD4 count and analyzed using SPSS software</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of the 200 patients examined, 64.5% (n=129) were found to have mucocutaneous manifestations. Out of those 129 patients 70 (54.3%) were male and 59 (45.7%) were females. Age of the patients ranged from 5 to 62 years with a mean±S.D of 32.08±11.48 yrs. Fungal infections (n=67, 51.9%) were the most common infectious dermatoses, followed by viral infections (n=35, 27.1%), scabies infestations (n=17, 13.2%) and bacterial infections (n=2, 1.6%). Of all the fungal infections, candidiasis (43.28%) was the commonest. Majority (64.5%) of the mucocutaneous manifestations were seen in patients with CD4 count &lt;200 cells/mm<sup>3</sup> and difference in CD4 count was significantly associated with cutaneous penicilliosis and oral hairy leukoplakia (p&lt;0.044). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Infectious dermatoses remain as the far most common skin manifestations in HAART naïve patients. Lower the CD4 higher will be the incidence. Rare endemic infections like penicilliosis should be considered in differentials of umbulicated lesions in this part of the country.</span></p>

scholarly journals Case Report on Mucormycotic Osteomyelitis of Maxilla

2021 ◽  
pp. 159-162
Author(s):  
Paras R. Nasare ◽  
Archana Teltumde
Keyword(s):  
Bacterial Infections ◽  
Viral Infections ◽  
Oral Surgery ◽  
Fungal Infections ◽  
Local Level ◽  
Vascular Supply ◽  
Clinical Findings ◽  
Urine Albumin ◽  
Life Threatening Illness ◽  
Fungal Osteomyelitis

Introduction: The upper jaw is formed by the maxilla, one of the basic bones of the face. It is a crucial viscerocranium structure that aids in the creation of the palate, nose, and orbit. The upper teeth are held in place by the alveolar process of the maxilla, which is vital for mastication and speaking. Because of its substantial vascular supply, maxillary necrosis is uncommon compared to mandible necrosis [1]. Maxillary necrosis can be caused by bacterial infections like osteomyelitis, viral infections like herpes zoster, or fungal infections like mucormycosis, as well as trauma, radiation, and other factors [2]. Long-term use of antibiotics or corticosteroids, on the other hand, may result in an opportunistic infection. Mucormycosis is a fungal infection that mostly affects immunocompromised persons. These fungi are widespread in many people, although the symptoms have been linked to a weakened immune system. Mucormycosis is a life-threatening illness that frequently affects immunocompromised individuals due to diabetic ketoacidosis, neutropenia, organ transplantation, and elevated blood iron levels. Clinical Findings: The patient have a complaint of discomfort in the upper left side of the jaw was rapid in start, dull hurting, intermittent in character, and worse on mastication. A radiating headache on the left side is also a complaint. Diagnostic Evaluation: CRP - 12.48 m/ L, Calcium 8.1 mg/dl, KFT-Ser (urea – 29 mg/dl, Creatinine 0.4 mg/dl, Sodium 138 mmol/L, Potassium -4.3 mmol/L, Albumin 2.6 g/dl,) Urine exam routine Pus cells 1-2 cells, urine albumin nil, Crystal 3-4 calcium oxalate Crystal, 2D echo was done on dated 31/5/21, MRI was done,  Cardiac call was done. Therapeutic Intervention: If not recognised and treated early, fungal osteomyelitis is more invasive than bacterial osteomyelitis. Treatment is given to the patient as a follow-up. Debridement of necrotic tissue on a local level. Antibiotics - Tab Augmentine 625 mg, Tab paracetamols 500 mg, Inj T. T 0.5 ml in a single dosage, Antifungal treatment, and Betadine gargle twice a day. Conclusion: On 04/06/2021, a 58-year-old male was hospitalised to AVBR Hospital's Oral Surgery Ward 35 after being diagnosed with Mucormycotic Osteomyelitis of the Maxilla. The patient is being counselled on how to proceed with his treatment.

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