Atypical Bacterial Infections Explained by a Concomitant Virus Infection

Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.

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A case of pneumonia and sepsis in cirrhosis as paradigm of the problems in the management of bacterial infections in cirrhosis and of the limitations of current knowledge

Italian Journal of Medicine ◽

10.4081/itjm.2013.209 ◽

2013 ◽

pp. 209-214

Author(s):

Manuel Tufoni ◽

Alessandra Tovoli ◽

Caterina Maggioli ◽

Lucia Napoli ◽

Carmen Serena Ricci ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatic Encephalopathy ◽

Hepatitis C ◽

Antibiotic Therapy ◽

Bacterial Infection ◽

Bacterial Infections ◽

Clinical Presentation ◽

Current Knowledge ◽

Empirical Antibiotic Therapy ◽

Increased Risk

Bacterial infections are a major problem in the management of liver cirrhosis. They represent the first precipitating cause of death since patients with cirrhosis carry an increased risk of sepsis, sepsis-induced organ failure and death. Although the clinical presentation is often misleading, the presence of bacterial infection should always be actively searched and ruled out with certainty whenever a cirrhotic patient is admitted to the hospital with an acute clinical deterioration. Major changes in the epidemiology of bacterial infections have also occurred in the last decade making the choice of empirical antibiotic therapy a challenge. We report a paradigmatic case of a 54-year old man with hepatitis C-related cirrhosis admitted to the hospital for worsening of his ascites and onset of hepatic encephalopathy, an excellent example for the difficulties of management of sepsis in cirrhosis and the limits of current knowledge.

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Fever without a focus in children 0-36 months of age

Medicinski pregled ◽

10.2298/mpns0604187k ◽

2006 ◽

Vol 59 (3-4) ◽

pp. 187-191 ◽

Cited By ~ 2

Author(s):

Svetlana Kuzmanovic ◽

Nevenka Roncevic ◽

Aleksandra Stojadinovic

Keyword(s):

Antibiotic Therapy ◽

Bacterial Infection ◽

Medical Care ◽

Bacterial Infections ◽

Clinical Presentation ◽

Febrile Illness ◽

Empirical Antibiotic Therapy ◽

Focus Of Infection ◽

Serious Bacterial Infections ◽

Yale Observation Scale

Introduction. About 20% of fevers in childhood have no apparent cause. A small, but significant number of these children may have a seroius bacterial infection. Fever without a focus of infection is an acute febrile illness with rectal temperature of 38?C or higher in children younger than 36 months, without localizing signs or symptoms. Practice Guidelines for Medical Care. In this article, practical recommendations for medical care of febrile children 0-36 months of age are given, bearing in mind children's age, clinical presentation (toxic manifestations) and risk for serious bacterial infection (sepsis, meningitis, pneumonia, urinary tract infection...). Toxic appearance is a clinical presentation characterized by lethargy, poor perfusion, marked hypo/hyperventilation and cyanosis. All febrile children under 36 months of age, who are appearing toxic, require hospitalization, evaluation for sepsis and administration of empirical antibiotic therapy. All febrile neonates, however, must be hospitalized: cultures of blood, urine and spinal fluid should be taken and empirical antibiotic therapy administered immediately. Febrile infants, 28 to 90 days of age, need to be evaluated in order to determine whether they are in the low-risk group for serious bacterial infections (Rochester Criteria). Yale Observation Scale is recommended to assess febrile children aged 3-36 months, and the risk of occult bacteriemia. Febrile children, 3-36 months of age who appear well, with temperature of less than 39?C without focus, should be closely followed up without laboratory tests and antibiotics and 2-3 days later reexamined. In febrile children, 3-36 months old, with temperature of 39?C and above, without toxic manifestations, blood culture should be taken and ceftriaxone 50 mg/kg/in a single dose should be given, if leukocyte count is 15000/mm? or absolute neutrophil count is over 10.000/mm? .

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A CONTROLLED TRIAL OF INTRAVENOUS IMMUNE GLOBULIN FOR THE PREVENTION OF SERIOUS BACTERIAL INFECTIONS IN CHILDREN RECEIVING ZIDOVUDINE FOR ADVANCED HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PEDIATRICS ◽

10.1542/peds.96.2.408a ◽

1995 ◽

Vol 96 (2) ◽

pp. 408-408

Author(s):

David Fuentes ◽

William T. Shearer

Keyword(s):

Human Immunodeficiency Virus ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Bacterial Infection ◽

Immune Globulin ◽

Bacterial Infections ◽

Controlled Trial ◽

Immunodeficiency Virus ◽

Aids Related Complex ◽

Serious Bacterial Infections

Children with AIDS or AIDS-related complex receiving zidovudine have a decreased risk of bacterial infection when given IVIG. In this study, the benefit is most apparent in those not receiving trimethoprim- sulfamethoxazole prophylaxis.

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Influenza “Trains” the Host for Enhanced Susceptibility to Secondary Bacterial Infection

mBio ◽

10.1128/mbio.00810-19 ◽

2019 ◽

Vol 10 (3) ◽

Cited By ~ 10

Author(s):

Kari Ann Shirey ◽

Darren J. Perkins ◽

Wendy Lai ◽

Wei Zhang ◽

Lurds R. Fernando ◽

...

Keyword(s):

Influenza Virus ◽

Virus Infection ◽

Bacterial Infection ◽

Bacterial Infections ◽

Influenza Virus Infection ◽

Health Concern ◽

Type I ◽

Lung Pathology ◽

Chemokine Production ◽

Content Type

ABSTRACT We previously reported that the Toll-like receptor 4 (TLR4) antagonist Eritoran blocks acute lung injury (ALI) therapeutically in mouse and cotton rat models of influenza. However, secondary (2°) bacterial infection following influenza virus infection is associated with excess morbidity and mortality. Wild-type (WT) mice infected with mouse-adapted influenza A/Puerto Rico/8/34 virus (PR8) and, 7 days later, with Streptococcus pneumoniae serotype 3 (Sp3) exhibited significantly enhanced lung pathology and lethality that was reversed by Eritoran therapy after PR8 infection but before Sp3 infection. Cotton rats infected with nonadapted pH1N1 influenza virus and then superinfected with methicillin-resistant Staphylococcus aureus also exhibited increased lung pathology and serum high-mobility-group box 1 (HMGB1) levels, both of which were blunted by Eritoran therapy. In mice, PR8 infection suppressed Sp3-induced CXCL1 and CXCL2 mRNA, reducing neutrophil infiltration and increasing the bacterial burden, all of which were reversed by Eritoran treatment. While beta interferon (IFN-β)-deficient (IFN-β−/−) mice are highly susceptible to PR8, they exhibited delayed death upon Sp3 superinfection, indicating that while IFN-β was protective against influenza, it negatively impacted the host response to Sp3. IFN-β-treated WT macrophages selectively suppressed Sp3-induced CXCL1/CXCL2 transcriptionally, as evidenced by reduced recruitment of RNA polymerase II to the CXCL1 promoter. Thus, influenza establishes a “trained” state of immunosuppression toward 2° bacterial infection, in part through the potent induction of IFN-β and its downstream transcriptional regulation of chemokines, an effect reversed by Eritoran. IMPORTANCE Enhanced susceptibility to 2° bacterial infections following infection with influenza virus is a global health concern that accounts for many hospitalizations and deaths, particularly during pandemics. The complexity of the impaired host immune response during 2° bacterial infection has been widely studied. Both type I IFN and neutrophil dysfunction through decreased chemokine production have been implicated as mechanisms underlying enhanced susceptibility to 2° bacterial infections. Our findings support the conclusion that selective suppression of CXCL1/CXCL2 represents an IFN-β-mediated “training” of the macrophage transcriptional response to TLR2 agonists and that blocking of TLR4 therapeutically with Eritoran after influenza virus infection reverses this suppression by blunting influenza-induced IFN-β.

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Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

Asian Pacific Journal of Environment and Cancer ◽

10.31557/apjec.2019.2.1.1-3 ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-3

Author(s):

Attabak Toofani Milani ◽

Mahshid Mohammadian ◽

Sadegh Rostaminasab ◽

Roghayeh Paribananaem ◽

Zohre Ahmadi ◽

...

Keyword(s):

Antibiotic Therapy ◽

Bacterial Infection ◽

Diagnostic Test ◽

Bacterial Infections ◽

Intervention Studies ◽

Antibiotic Use ◽

Clinical Suspicion ◽

Diagnostic Biomarker ◽

Clinical Routine ◽

Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

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Faculty Opinions recommendation of Evidence of a causal role of winter virus infection during infancy in early childhood asthma.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1134836.590923 ◽

2008 ◽

Author(s):

Peter Openshaw

Keyword(s):

Early Childhood ◽

Virus Infection ◽

Childhood Asthma ◽

Causal Role

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Crystalline ruthenium polypyridyl nanoparticles: a targeted treatment of bacterial infection with multifunctional antibacterial, adhesion and surface-anchoring photosensitizer properties

Journal of Materials Chemistry B ◽

10.1039/d1tb00103e ◽

2021 ◽

Author(s):

Chenyang Yin ◽

Zekun Wang ◽

Xiaoyuan Ding ◽

Xiaoqing Chen ◽

Jingyuan Wang ◽

...

Keyword(s):

Bacterial Infection ◽

Antibacterial Therapy ◽

Bacterial Infections ◽

Targeted Treatment ◽

Ruthenium Polypyridyl ◽

Surface Anchoring ◽

Antibacterial Materials

Photodynamic antibacterial therapy employs nanocomposites as an alternative to traditional antibiotics for the treatment of bacterial infections. However, many of these antibacterial materials are less effective towards bacteria than traditional...

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Risk factors and disposition in development of the nervous system infections

Medicinski pregled ◽

10.2298/mpns0910461n ◽

2009 ◽

Vol 62 (9-10) ◽

pp. 461-467

Author(s):

Ljiljana Nesic ◽

Predrag Canovic ◽

Zeljko Mijailovic ◽

Jelena Djokovic

Keyword(s):

Risk Factors ◽

Nervous System ◽

Virus Infection ◽

Lupus Erythematosus ◽

Bacterial Infections ◽

Heart Diseases ◽

Final Diagnosis ◽

Medical Documentation ◽

Virus Infections ◽

Number Of Patients

Introduction. Although well protected, brain is not resistant to infection agents. Acute infections of our nervous system appear more often in children and in persons who have medical history data about previous disorders, especially disorders of the nervous system. It is difficult to list possible risk factors which can be responsible for the appearance of infections of CNS and the resulting conditions. It is often difficult or impossible to determine what previous neural damage was (trauma, anoxic damages etc.) from those appearing during infections of CNS. All-inclusive anamnestic research reduces the possibility of approximate judgments. Material and methods. The research was based on the retrospective analysis of medical documentation of 275 patients. All patients were divided into three groups according to the final diagnosis. The first group consisted of 125 patients who were treated for acute virus encephalitis, the second group consisted of 125 patients who were treated for acute bacterial meningoencephalitis and the third group consisted of 25 patients who were treated for cerebritis. Discussion. In our studies sample, the youngest patient was 3 years old and the oldest was 87 years old. The highest number of patients with virus infection of the CNS was in the group under 25 years of age (45.6%). The highest number of patients with bacterial infections of the CNS and cerebritis was in the group of patients over 45 years of age (64%, 37%). Conclusion. Risk factors were more present in bacterial infections of the nervous system and cerebrit thanin virus infection of CNS. In virus infections of the CNS, 28% of patients had some risk factor, most often-chronic ethylism, diabetes mellitus and acquired heart diseases. In bacterial infections of the CNS, 64% of patients had some predisposed factor. The most frequent factor of risk in these patients were chronic otitis (21.6%) and craniotrauma (14.4%). In cerebritis, risk factors were present in 76% of patients and they were: sepsis (20%), chronic otitis (12%) and systemic lupus erythematosus (8%).

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