Fatal Community-Acquired Bloodstream Infection Caused By Klebsiella Variicola: A Case Report

2021 ◽  
Author(s):  
Dali Long ◽  
Yuhui Wang ◽  
Jinlong Wang ◽  
Sijie Mu ◽  
Li Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Parasitic Infection ◽  
Drug Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gene Detection ◽  
Case Presentation ◽  
First Case ◽  
Short Period ◽  
Genetic Detection

Abstract Background Klebsiella pneumoniae infection leads to significant concerns because of its varied manifestation and resultant mortality. While recent genetic structure analysis reveals that the higher virulence and mortality could be from its subspecies rather than Klebsiella pneumoniae. However, which is often misdiagnosed and underestimated in clinic because it’s difficult to distinguish Klebsiella pneumoniae from its subspecies using classic clinical examinations. This case study is the first in clinic to report the fast and fatal effect of Klebsiella subspecies, and serve as reference for doctors diagnosing similar diseases. Case presentation A 52-years male patient was admitted to hospital due to unknown high fever. All examinations excluded the viruses, fungi, mycoplasma/chlamydia and parasitic infection. Classic bacterial culture revealed the klebsiella pneumonia, however sensitive antibacterial adheres to drug susceptibility results failed to improve patient’s symptoms. His condition worsened and rapidly entered sepsis and subsequent sepsis shock, died within 72 hours of symptom onset. The PMseq-DNA Pro High throughput gene detection was acquired on second day after death revealing the mixed infection of klebsiella variicola and klebsiella pneumoniae. Clinic evidences suggested that Klebsiella variicola rather than klebsiella pneumoniae contributed to patient’s poor prognosis. Conclusions: This is the first case reported that patient died from klebsiella subspecies infection within short period of time. Which suggests that we should be alert to the clinical hazards and fatal effect of klebsiella subspecies. Classic method is limited in guiding the anti-infection therapy for complex cases, early genetic detection should be recommended in the diagnosis and management of complex infection.

scholarly journals A case of death within 72 hours after community-acquired bloodstream infection caused by klebsiella variicola

2021 ◽  
Author(s):  
Dali Long ◽  
Yuhui Wang ◽  
Jinlong Wang ◽  
Sijie Mu ◽  
Li Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Rare Case ◽  
Bacterial Culture ◽  
Drug Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gene Detection ◽  
Laboratory Methods ◽  
Short Period ◽  
Genetic Detection ◽  
Illness Progression

Abstract Klebsiella subspecies infection is widely misdiagnosed and underestimated in clinic. We report a patient who was admitted to hospital due to unknown high fever. Bacterial culture only revealed the klebsiella pneumonia. Broad-spectrum antibiotics failed to improve patient's symptoms, although these antibiotics are sensitive to klebsiella pneumonia according to the drug susceptibility results. Patient rapidly entered sepsis and subsequent sepsis shock, and died within 72 hours. The delayed PMseq-DNA Pro high throughput gene detection revealed the mixed infection of klebsiella pneumoniae and klebsiella variicola. This is a very rare case that patient suffered so rapid deterioration and died from bacterial infection within short period of time. Klebsiella variicola could contribute to rapid illness progression, while it was revealed by gene detection rather than classic laboratory methods. Which suggests that early genetic detection should be recommended in cases of complex infection.

scholarly journals Comorbid early esophageal cancer and Gongylonema pulchrum infection: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaozhi Zhou ◽  
Yongqiu Wei ◽  
Huihong Zhai ◽  
Shaogang Li ◽  
Rui Xu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Parasitic Infection ◽  
Early Esophageal Cancer ◽  
Case Presentation ◽  
High Risk Factors ◽  
First Case ◽  
Zoonotic Parasite ◽  
The Relationship ◽  
New Hypothesis ◽  
Gongylonema Pulchrum

Abstract Background Gongylonema pulchrum is a zoonotic parasite rarely found in humans. To date, there have been no reports on the carcinogenic properties of G. pulchrum, and there are few reports overall on the relationship between esophageal cancer and parasites. Case presentation This report describes the first case of esophageal gongylonemiasis coexisting with early esophageal cancer. The patient had no high-risk factors for esophageal cancer, such as smoking, flushing after drinking, or tumor history. We speculate the existence of unknown links between esophageal cancer and parasitic infection in this patient. Discussion and conclusions We report the first case of a human presenting both esophageal G. pulchrum infection and esophageal squamous cell carcinoma with the hope that it may provide evidence for a new hypothesis of tumorigenesis.

scholarly journals Towards kilometer-scale ocean–atmosphere–wave coupled forecast: a case study on a Mediterranean heavy precipitation event

2021 ◽  
Vol 21 (15) ◽  
pp. 11857-11887
Author(s):  
César Sauvage ◽  
Cindy Lebeaupin Brossier ◽  
Marie-Noëlle Bouin
Keyword(s):  
Weather Prediction ◽  
Heavy Precipitation ◽  
Western Mediterranean ◽  
Precipitation Event ◽  
Coupled Modeling ◽  
Low Level ◽  
First Case ◽  
Short Period ◽  
Ocean Atmosphere

Abstract. The western Mediterranean Sea area is frequently affected in autumn by heavy precipitation events (HPEs). These severe meteorological episodes, characterized by strong offshore low-level winds and heavy rain in a short period of time, can lead to severe flooding and wave-submersion events. This study aims to progress towards an integrated short-range forecast system via coupled modeling for a better representation of the processes at the air–sea interface. In order to identify and quantify the coupling impacts, coupled ocean–atmosphere–wave simulations were performed for a HPE that occurred between 12 and 14 October 2016 in the south of France. The experiment using the coupled AROME-NEMO-WaveWatchIII system was notably compared to atmosphere-only, coupled atmosphere–wave and ocean–atmosphere simulations. The results showed that the HPE fine-scale forecast is sensitive to both couplings: the interactive coupling with the ocean leads to significant changes in the heat and moisture supply of the HPE that intensify the convective systems, while coupling with a wave model mainly leads to changes in the low-level dynamics, affecting the location of the convergence that triggers convection over the sea. Result analysis of this first case study with the AROME-NEMO-WaveWatchIII system does not clearly show major changes in the forecasts with coupling and highlights some attention points to follow (ocean initialization notably). Nonetheless, it illustrates the higher realism and potential benefits of kilometer-scale coupled numerical weather prediction systems, in particular in the case of severe weather events over the sea and/or in coastal areas, and shows their affordability to confidently progress towards operational coupled forecasts.

scholarly journals Spontaneous Intracerebral Hemorrhage and Delayed Cerebral Vasospasm in a Patient with COVID-19 Infection

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Björn Sommer ◽  
Christoph Maurer ◽  
Ansgar Berlis ◽  
Ehab Shiban
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Vasospasm ◽  
Neurological Impairment ◽  
Clonic Seizure ◽  
Transluminal Angioplasty ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Case Presentation ◽  
Delayed Cerebral Vasospasm ◽  
First Case ◽  
Short Period

Introduction: The SARS-CoV-2 may cause vasculitis and thromboembolic events. We report on an unusual case of spontaneous intracerebral hemorrhage and delayed cerebral vasospasms in a patient with COVID-19. Case Presentation: A 65-year-old male was transferred to the emergency department due to a short period of unconsciousness. Twenty-two hours prior to presentation, the patient had a 39.5°C fever with breathing difficulties. Initial COVID-19 PCR was positive. While conscious and without any neurological impairment, a large right frontal intracerebral hemorrhage (ICH) was detected. A preoperative angiogram showed no pathological blood vessels or vasospasm. The patients had a generalized tonic-clonic seizure due to ICH progression, which led to an immediate microsurgical ICH removal. Thirteen days thereafter, the patient became unconscious again. Angiography revealed severe cerebral vasospasm (CV) that required repetitive percutaneous transluminal angioplasty (PTA) and intra-arterial nimodipine treatment. Conclusions: We present the first case of ICH and delayed vasospasm associated with COVID-19. In these patients, combined maximum surgical and endovascular therapy is needed.

scholarly journals Canine ovarian gonadoblastoma with dysgerminoma overgrowth: a case study and literature review

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Ana R. Flores ◽  
João Lobo ◽  
Francisco Nunes ◽  
Alexandra Rêma ◽  
Paula Lopes ◽  
...  
Keyword(s):  
Germ Cell ◽  
Y Chromosome ◽  
Epithelial Membrane Antigen ◽  
Histopathological Examination ◽  
Stromal Tumour ◽  
Pcr Analysis ◽  
Case Presentation ◽  
First Case

Abstract Background Gonadoblastoma (GB) is a rare mixed germ cell-sex cord-stromal tumour, first described in humans, commonly found in dysgenetic gonads of intersex patients that have a Y chromosome. However, this entity in not recognized in the WHO classification of tumours of genital system of domestic animals. Herein, we describe a case of ovarian gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour components, in a phenotypically and cytogenetically normal bitch. Case presentation A 17-year-old cross-breed bitch had a firm, grey-white multinodular mass in the left ovary. The tumour was submitted to histopathological examination and Y chromosome detected through karyotype analysis and PCR studies. Microscopically, the ovary was almost replaced by an irregular neoplasm composed of three distinct, intermixed elements: dysgerminoma, mixed germ cell-sex cord-stromal tumour resembling human GB and a proliferative sex cord-stromal tumour component. The germ cells of gonadoblastoma and dysgerminoma components were immunoreactive for c-KIT. Sex cord-stromal cells of gonadoblastoma were immunoreactive for α-inhibin. The sex cord-stromal tumour was immunoreactive for AE1/AE3, occasionally for α-inhibin and negative for epithelial membrane antigen (EMA). The karyotype was 78, XX and PCR analysis confirmed the absence of the Y chromosome. Conclusion Based on these findings, a diagnosis of gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour was made. This is the first case of ovarian gonadoblastoma in a female dog.

scholarly journals Towards kilometer-scale ocean-atmosphere-wave coupled forecast: a case study on a Mediterranean heavy precipitation event

2021 ◽  
Author(s):  
César Sauvage ◽  
Cindy Lebeaupin Brossier ◽  
Marie-Noëlle Bouin
Keyword(s):  
Weather Prediction ◽  
Heavy Precipitation ◽  
Western Mediterranean ◽  
Precipitation Event ◽  
Coupled Modelling ◽  
Low Level ◽  
First Case ◽  
Short Period ◽  
Ocean Atmosphere

Abstract. The Western Mediterranean Sea area is frequently affected in autumn by heavy precipitation events (HPEs). These severe meteorological episodes, characterized by strong offshore low-level winds and heavy rain in a short period of time, can lead to severe flooding and wave-submersion events. This study aims to progress towards integrated short-range forecast system via coupled modelling for a better representation of the processes at the air–sea interface. In order to identify and quantify the coupling impacts, coupled ocean–atmosphere–wave simulations were performed for a HPE that occurred between October 12 and 14, 2016 in the South of France, using the coupled AROME-NEMO-WaveWatchIII system and notably compared to atmosphere only, coupled atmosphere–wave and ocean–atmosphere simulations. The results showed that the HPE fine-scale forecast is sensitive to both couplings: The interactive coupling with the ocean leads to significant changes in the heat and moisture supply of the HPE that intensify the convective systems, while coupling with a wave model mainly leads to changes in the low-level dynamics, affecting the location of the convergence that triggers convection over sea. Even if this first case study with the AROME-NEMO-WaveWatchIII system does not clearly show major changes in the forecasts with coupling and highlights some attention points to follow (ocean initialisation notably), it illustrates the higher realism and potential benefits of kilometer-scale coupled numerical weather prediction systems, in particular in case of severe weather events over sea and/or in coastal areas, and shows their affordability to confidently progress towards operational coupled forecasts.

scholarly journals Concomitant carriage of KPC-producing and non-KPC-producing Klebsiella pneumoniae ST512 within a single patient

2020 ◽  
Author(s):  
Agnès B Jousset ◽  
Rémy A Bonnin ◽  
Julie Takissian ◽  
Delphine Girlich ◽  
Liliana Mihaila ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
Single Patient ◽  
Susceptible Population ◽  
First Case ◽  
Short Period

Abstract Background KPC-producing Klebsiella pneumoniae of clonal group 258 are prominent in healthcare settings in many regions of the world. The blaKPC gene is mostly carried by a multireplicon IncFIIk-IncFI plasmid suspected to be highly compatible and stable in this genetic background. Here, we analysed the genetic diversity of an ST512 K. pneumoniae population in a single patient. Methods Twelve K. pneumoniae isolates (n = 5 from urine samples and n = 7 from rectal swabs) were recovered from one patient over a 2 month period. Antimicrobial susceptibility testing, plasmid extraction and WGS were performed on all isolates. The first K. pneumoniae isolate, D1, was used as a reference for phylogenetic analysis. Results Antimicrobial susceptibility testing, plasmid analysis and WGS revealed concomitant carriage of carbapenem-resistant and carbapenem-susceptible K. pneumoniae isolates of ST512, with the absence of the entire blaKPC-carrying plasmid in the susceptible population. Furthermore, 14 other genetic events occurred within the genome, including 3 chromosomal deletions (of 71 kb, 33 kb and 11 bp), 2 different insertions of ISKpn26 and 9 SNPs. Interestingly, most of the events occurred in the same chromosomal region that has been deleted independently several times, probably after homologous recombination involving 259 bp repeated sequences. Conclusions Our study revealed (to the best of our knowledge) the first case of in vivo blaKPC-carrying plasmid curing and a wide within-patient genetic diversity of a single K. pneumoniae ST512 clone over a short period of carriage. This within-patient diversity must be taken into account when characterizing transmission chains using WGS during nosocomial outbreaks.

scholarly journals Meningitis induced by severe acute respiratory syndrome coronavirus 2: A case report

2021 ◽  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Computed Tomography Scan ◽  
Chain Reaction ◽  
Emergency Center ◽  
Case Presentation ◽  
First Case ◽  
Polymerase Chain ◽  
The Brain ◽  
Tomography Scan

Introduction: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and caused a catastrophic pandemic in 2020. Significant manifestations of COVID-19 are related to the respiratory system; however, other organs, such as the brain and heart, can also be involved. Case presentation: A 44-year-old-male was hospitalized in our referral emergency center due to being febrile and confused. He experienced five episodes of convulsion in the hospital. Within a day, the respiratory symptoms developed. The polymerase chain reaction of cerebrospinal fluid (CSF) was positive for COVID-19. The analysis of CSF and findings of chest computed tomography scan revealed that the case was infected with meningitis induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pneumonia. Conclusions: It has been reported that neurological symptoms of COVID-19 can appear earlier than other symptoms. To the best of our knowledge, few articles have represented COVID-induced meningitis. This case study reported the first case of meningitis induced by SARS-CoV-2 in Iran

Scales and Units

2018 ◽  
Author(s):  
Kathryn M. de Luna
Keyword(s):  
Language Change ◽  
Historical Linguistics ◽  
Bantu Languages ◽  
The North ◽  
First Case ◽  
Linguistic Evidence ◽  
River Region ◽  
History Of ◽  
Alternative Approaches

This chapter uses two case studies to explore how historians study language movement and change through comparative historical linguistics. The first case study stands as a short chapter in the larger history of the expansion of Bantu languages across eastern, central, and southern Africa. It focuses on the expansion of proto-Kafue, ca. 950–1250, from a linguistic homeland in the middle Kafue River region to lands beyond the Lukanga swamps to the north and the Zambezi River to the south. This expansion was made possible by a dramatic reconfiguration of ties of kinship. The second case study explores linguistic evidence for ridicule along the Lozi-Botatwe frontier in the mid- to late 19th century. Significantly, the units and scales of language movement and change in precolonial periods rendered visible through comparative historical linguistics bring to our attention alternative approaches to language change and movement in contemporary Africa.

Applications of random graphs

2017 ◽  
Author(s):  
A.C.C. Coolen ◽  
A. Annibale ◽  
E.S. Roberts
Keyword(s):  
Social Networks ◽  
Random Graphs ◽  
Interaction Network ◽  
Power Grids ◽  
Protein Protein Interaction ◽  
Topological Features ◽  
First Case ◽  
The Stability ◽  
Protein Protein Interaction Network

This chapter reviews graph generation techniques in the context of applications. The first case study is power grids, where proposed strategies to prevent blackouts have been tested on tailored random graphs. The second case study is in social networks. Applications of random graphs to social networks are extremely wide ranging – the particular aspect looked at here is modelling the spread of disease on a social network – and how a particular construction based on projecting from a bipartite graph successfully captures some of the clustering observed in real social networks. The third case study is on null models of food webs, discussing the specific constraints relevant to this application, and the topological features which may contribute to the stability of an ecosystem. The final case study is taken from molecular biology, discussing the importance of unbiased graph sampling when considering if motifs are over-represented in a protein–protein interaction network.

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