A Case Report of Infective Endocarditic Aortic Valve Abscess with Perforation in Infant

Abstract Background: Infective endocarditis (IE) is an uncommon but a potentially life-threatening infectious disease in children. The epidemiology of IE has changed in the past three to four decades and its incidence has been increasing recently. This case with atypical present including culture-negative and no-cardiovascular diseases got cardiovascular structural damage that deteriorate in short time. Case presentation: This case was an infant less than one year old without basic cardiovascular disease,and this case was admitted with Kawasaki disease early. His diagnosis was infective endocarditic aortic valve abscess with perforation. The patient received intravenous injection of cefotaxime for two days and piperacillin sulbactam and cefazolin for six days. On 9 th day, piperacillin sulbactam combining with vancomycin were used. On 10 th day, the patient was sent to cardiac surgery department to receive aortic valve repair. The operation is successful.The abscess cavity of the inferior aortic valve and the vegetations on the aortic valve were completely removed, the left coronary valve was removed, and the left coronary valve was locally widened by autologous pericardial patch. Conclusions: Infective Endocarditis in children may be difficult to diagnosis and manage.and the treatment are becoming a new challenge for conventional antibiotic therapy. Some IE require serial follow-up to determine potential need for subsequent cardiovascular surgery (CVS) intervention despite microbiologic cure with antimicrobial therapy.

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Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

ARS Medica Tomitana ◽

10.2478/arsm-2014-0007 ◽

2014 ◽

Vol 20 (1) ◽

pp. 35-39

Author(s):

Cambrea Simona Claudia ◽

Ilie Maria Margareta ◽

Carp Dalia Sorina ◽

Ionescu C.

Keyword(s):

Necrotizing Fasciitis ◽

Severe Disease ◽

The Body ◽

Group A Streptococci ◽

Threatening Condition ◽

Life Threatening ◽

Group A ◽

The Right ◽

Surgery Department ◽

Short Time

ABSTRACT Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body), high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a favorable outcome.

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Successful treatment of pulmonary mucormycosis caused by Rhizopus microsporus with posaconazole

European Journal of Medical Research ◽

10.1186/s40001-021-00602-x ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

F. Yuan ◽

J. Chen ◽

F. Liu ◽

Y. C. Dang ◽

Q. T. Kong ◽

...

Keyword(s):

Fungal Culture ◽

Rhizopus Microsporus ◽

Pulmonary Tissue ◽

Case Presentation ◽

Common Cause ◽

Pulmonary Mucormycosis ◽

Threatening Condition ◽

Life Threatening ◽

One Year

Abstract Background Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation We report a case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up. Conclusions Pulmonary mucormycosis is a life-threatening condition and posaconazole is an effective treatment for pulmonary mucormycosis caused by Rhizopus microspores.

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Brief Intermittent Neuroleptic Prophylaxis for Selected Schizophrenic Out-patients

The British Journal of Psychiatry ◽

10.1192/s0007125000018237 ◽

1989 ◽

Vol 155 (05) ◽

pp. 702-706 ◽

Cited By ~ 3

Author(s):

H. A. McClelland ◽

G. Harrison ◽

S. D. Soni

Keyword(s):

Psychotic Symptoms ◽

Intermittent Treatment ◽

Double Blind ◽

Prodromal Symptoms ◽

Novel Approach ◽

Depot Neuroleptic ◽

One Year ◽

Depot Injections ◽

To Receive

“A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting the American Psychiatric Association's DSM–III criteria for schizophrenia were randomised double blind to receive brief intermittent treatment with either active or placebo depot neuroleptic injections. Only three patients given placebo injections and two controls were admitted to hospital during one year of follow up. Eight (30%) of the patients given placebo injections and only 2 (7%) of the controls, however, had a recurrence of schizophrenic symptoms. Patients given placebo injections experienced fewer extrapyramidal side effects and showed a trend towards a reduction in tardive dyskinesia. Dysphoric and neurotic symptoms were identified before eight out of 11 relapses, and these symptoms were more frequent in patients given placebo depot injections. These results suggest a viable but not necessarily better alternative to continuous oral or depot treatment for less ill, chronic, stabilised schizophrenics based on the early treatment of putative prodromal symptoms of relapse.”

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Discovery of increased epidermal DNAH10 expression after regeneration of dermis in a randomized with-in person trial — reflections on psoriatic inflammation

Scientific Reports ◽

10.1038/s41598-019-53874-z ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Heli Lagus ◽

Mariliis Klaas ◽

Susanna Juteau ◽

Outi Elomaa ◽

Juha Kere ◽

...

Keyword(s):

Protein Expression ◽

Psoriatic Skin ◽

Dermal Matrix ◽

Thickness Skin ◽

Dermal Regeneration ◽

Unaffected Skin ◽

One Year ◽

To Receive

AbstractBecause molecular memories of past inflammatory events can persist in epidermal cells, we evaluated the long-term epidermal protein expression landscapes after dermal regeneration and in psoriatic inflammation. We first characterized the effects of two dermal regeneration strategies on transplants of indicator split-thickness skin grafts (STSGs) in ten adult patients with deep burns covering more than 20% of their body surface area. After fascial excision, three adjacent areas within the wound were randomized to receive a permanent dermal matrix, a temporary granulation-tissue-inducing dressing or no dermal component as control. Control areas were covered with STSG immediately, and treated areas after two-weeks of dermis formation. Epidermis-dermis-targeted proteomics of one-year-follow-up samples were performed for protein expression profiling. Epidermal expression of axonemal dynein heavy chain 10 (DNAH10) was increased 20-fold in samples having had regenerating dermis vs control. Given the dermal inflammatory component found in our dermal regeneration samples as well as in early psoriatic lesions, we hypothesized that DNAH10 protein expression also would be affected in psoriatic skin samples. We discovered increased DNAH10 expression in inflammatory lesions when compared to unaffected skin. Our results associate DNAH10 expression with cell proliferation and inflammation as well as with the epidermal memory resulting from the previous regenerative signals of dermis. This study (ISRCTN14499986) was funded by the Finnish Ministry of Defense and by government subsidies for medical research.

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Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120926979 ◽

2020 ◽

Vol 11 (5) ◽

pp. 611-618

Author(s):

Maria Rodriguez ◽

Anahita Malvea ◽

Dayre McNally ◽

Vid Bijelic ◽

Ming Guo ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Small Sample Size ◽

Case Series ◽

Small Sample ◽

Aortic Root Surgery ◽

Valve Sparing ◽

One Year

Background: Pediatric aortic root dilatation is a life-threatening condition that lacks guidelines for surgical management. We aimed to analyze the data on aortic valve interventions during root surgery to guide decision-making. Methods: A search was performed of MEDLINE, Embase, CENTRAL, ClinicalTrials.gov , and WHO ICTRP. Citations were screened in duplicate and independently to identify randomized controlled trials, cohorts, and case series involving populations aged 0 to 18 years, who received valve-sparing and valve-replacing aortic root surgeries between 1999 and 2019. Outcomes considered included mortality (perioperative, one year, five year), reintervention rates. Results: After duplicate removal, 689 citations were screened through abstract and full text review, identifying five eligible studies. All five were observational studies evaluating valve-sparing procedures. There were 81 patients with a mean study age range of 9.9 to 13.9 years. Both reimplantation (74%) and remodeling (26%) subtypes were done. Range of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality reported until the one-year follow-up period. The long-term mortality rate was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13). Conclusions: There is limited experience on aortic valve intervention during aortic root surgery in children. Single-arm studies on valve-sparing surgeries show excellent survival up to one year. Mortality and reintervention rates increase in the longer term. The small sample size and lack of controlled studies do not allow for direct comparisons between procedure types.

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Does Teacher Training Actually Work? Evidence from a Large-Scale Randomized Evaluation of a National Teacher Training Program

American Economic Journal Applied Economics ◽

10.1257/app.20170226 ◽

2019 ◽

Vol 11 (3) ◽

pp. 128-154 ◽

Cited By ~ 3

Author(s):

Prashant Loyalka ◽

Anna Popova ◽

Guirong Li ◽

Zhaolei Shi

Keyword(s):

Teacher Training ◽

Teacher Professional Development ◽

Student Outcomes ◽

Large Scale ◽

Causal Chain ◽

Randomized Evaluation ◽

Teacher Professional ◽

One Year ◽

To Receive

Despite massive investments in teacher professional development (PD) programs in developing countries, there is little evidence on their effectiveness. We present results of a large-scale, randomized evaluation of a national PD program in China in which teachers were randomized to receive PD; PD plus follow-up; PD plus evaluation of the command of PD content; or no PD. Precise estimates indicate PD and associated interventions failed to improve teacher and student outcomes after one year. A detailed analysis of the causal chain shows teachers find PD content to be overly theoretical, and PD delivery too rote and passive, to be useful. (JEL I21, I28, J24, J45, O15, P36)

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Reconstruction of a Previously Repaired Aortic Valve Destroyed by Infective Endocarditis: Case Report

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116636571 ◽

2016 ◽

Vol 8 (3) ◽

pp. 408-410

Author(s):

Tomas Chalela ◽

Viktor Hraska

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Case Report ◽

Infective Endocarditis ◽

Aortic Valve ◽

Congenital Heart ◽

Congenital Aortic Stenosis ◽

Life Threatening ◽

History Of ◽

Uncommon Condition

Infective endocarditis (IE) is an uncommon condition among patients with congenital heart disease, however it can be life threatening. The usual management includes replacement of the affected valve, especially in patients with aortic valve compromise, and is even more common in previously repaired valves. In this case report, we describe the successful reconstruction of an aortic root destroyed by IE, in a patient with history of ballooning of a congenital aortic stenosis.

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