scholarly journals The key factors contributing to the risk, diagnosis and treatment of non-tuberculous mycobacterial opportunistic infections

2021 ◽  
Vol 75 (1) ◽  
pp. 696-710
Author(s):  
Anna Grzegorzewicz ◽  
Mariola Paściak
Keyword(s):  
Opportunistic Infections ◽  
Wide Spectrum ◽  
Natural Resistance ◽  
Diagnostic Tools ◽  
Species Determination ◽  
Treatment Methods ◽  
Drug Regimens ◽  
Antibiotic Susceptibility Patterns ◽  
One Year ◽  
Active Exploration

Abstract The incidence and prevalence of diseases caused by non-tuberculous mycobacteria (NTM) have been steadily increasing worldwide. NTM are environmental saprophytic organisms; however, a few strains are known to produce diseases in humans affecting pulmonary and extra-pulmonary sites. Although the environment is a major source of NTM infection, recent studies have shown that person-to-person dissemination could be an important transmission route for these microorganisms. Structural and functional lung defects and immunodeficiency are major risk factors for acquiring NTM infections. Diagnosis of NTM diseases is very complex owing to the necessity of distinguishing between a true pathogen and an environmental contaminant. Identification at the species level is critical due to differences in the antibiotic susceptibility patterns of various NTM strains. Such identification is mainly achieved by molecular methods; additionally, mass spectrometry (e.g., MALDI-TOF) is useful for NTM species determination. Natural resistance of NTM species to a wide spectrum of antibiotics makes prescribing treatment for NTM diseases very difficult. NTM therapy usually takes more than one year and requires multi-drug regimens, yet the outcome often remains poor. Therefore, alternatives to antibiotic therapy treatment methods is an area under active exploration. NTM infections are an active global health problem imposing the necessity for better diagnostic tools and more effective treatment methods.

scholarly journals Molecular analysis of the mitochondrial markers COI, 12S rDNA and 16S rDNA for six species of Iranian scorpions

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Parisa Soltan-Alinejad ◽  
Javad Rafinejad ◽  
Farrokh Dabiri ◽  
Piero Onorati ◽  
Olle Terenius ◽  
...  
Keyword(s):  
16S Rdna ◽  
Phylogenetic Analyses ◽  
Coi Gene ◽  
Diagnostic Tools ◽  
Morphological Identification ◽  
Species Determination ◽  
Important Species ◽  
Mitochondrial Markers ◽  
12S Rdna ◽  
Rdna Sequences

Abstract Objectives Annually, 1.2 million humans are stung by scorpions and severely affected by their venom. Some of the scorpion species of medical importance have a similar morphology to species with low toxicity. To establish diagnostic tools for surveying scorpions, the current study was conducted to generate three mitochondrial markers, Cytochrome Oxidase I (COI gene), 12S rDNA and 16S rDNA for six species of medically important Iranian scorpions: Androctonus crassicauda, Hottentotta saulcyi, Mesobuthus caucasicus, M. eupeus, Odontobuthus doriae, and Scorpio maurus. Results Phylogenetic analyses of the obtained sequences corroborated the morphological identification. For the first time, 12S rDNA sequences are reported from Androctonus crassicauda, Hottentotta saulcyi, Mesobuthus caucasicus and M. eupeus and also the 16S rDNA sequence from Hottentotta saulcyi. We conclude that the mitochondrial markers are useful for species determination among these medically important species of scorpions.

scholarly journals Hematological abnormalities in HIV infected individuals in correlation to CD4 counts and ART status

2016 ◽  
Vol 7 (4) ◽  
pp. 14-18 ◽  
Author(s):  
R Raman Thulasi ◽  
D Manimaran ◽  
G Hemanathan ◽  
Tameem Afroz ◽  
Radha Sagar
Keyword(s):  
Opportunistic Infections ◽  
Hematological Parameters ◽  
Cd4 Count ◽  
Health Concern ◽  
Medical Sciences ◽  
Cd4 Counts ◽  
Medical Centers ◽  
Hematological Abnormalities ◽  
Set Up ◽  
One Year

Background: HIV is pandemic and remains as a public health concern for many decades. This infection though associated with many opportunistic infections and neoplasms, it is further complicated with marked hematological abnormalities. The aim of this study is to determine the magnitude & severity of hematological abnormalities in HIV infected individuals and also to analyze these abnormalities in correlation with the CD4 counts. We also compared these hematological abnormalities in patients on ART and those not on ART.Materials and Methods: The study was conducted for a period of one year, on 120 HIV positive cases including both patients on ART & not on ART. Controls with similar age and sex distribution was set up. The blood samples were collected and processed in an automated cell counter. The parameters were tabulated and analyzed with respect to CD4 count & ART status.Results: Among the total of 120 HIV cases, 77% had anemia, 21% had leucopenia and 5% had thrombocytopenia. The magnitude and severity of anemia, leucopenia, thrombocytopenia and other parameters was found to be more in patients not on ART, when compared to patients on ART. Similarly, the magnitude and severity of most of hematological abnormalities were inversely proportional to the CD4 count in non-ART cases but not with cases on ART.Conclusion: The basic hematological parameters can be used as a prospective screening test to assess the severity and progression of HIV infection when CD4 count is not available. These parameters can also be used to assess the response to anti-retroviral treatment. Therefore, these basic hematological investigations readily available at all medical centers are of great use while treating HIV infected patients.Asian Journal of Medical Sciences Vol.7(4) 2016 14-18 

scholarly journals Management of Bandhyatava (Infertility) by Sodhan Followed by Shaman Chikitsa: A Case Report

2021 ◽  
pp. 35-40
Author(s):  
Renu Yadav ◽  
Soni Kapil ◽  
Anil Bhardwaj
Keyword(s):  
Case Report ◽  
Reproductive Health ◽  
Reproductive Tract ◽  
Modern Science ◽  
Causative Factor ◽  
Unprotected Sex ◽  
Treatment Methods ◽  
Female Reproductive Health ◽  
One Year ◽  
Vast Range

As per Ayurveda Vandhyatva occurs due to the vitiation of Vata Dosha which affects basic four constituents of Garbha sthapana. In modern science Infertility is described as an inability to conceive despite unprotected sex for duration of one year or more and PCOS is a major causative factor behind it. PCOS results in deterioration of female reproductive health which leads to infertility. In Ayurveda Samhithas, vast range of treatment methods are described. The basic aim in Ayurveda is to correct Ritu, Kshetra, Ambu and Beeja, the four basic factors for infertility by Shamana and Shodhan Chikitsa. Panchkarma provides best efficacy because it helps in balancing Doshas and Dushyas. Uttarbasti is also indicated for infertility which helps in detoxification of reproductive tract and balancing Vata Dosha, finally helps in retaining Garbha. In this case report importance of Sodhan Chikitsa before Shaman Chikitsa in case of infertility is emphasized.

scholarly journals Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karo Servatyari ◽  
Hero Yazdanpanah ◽  
Chamara Dalugama
Keyword(s):  
Lymph Nodes ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Presentation Of Self ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
One Year ◽  
Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

scholarly journals Opportunist Coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised Patients

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 771
Author(s):  
Ines Joao ◽  
Helena Bujdáková ◽  
Luisa Jordao
Keyword(s):  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
Nontuberculous Mycobacteria ◽  
Wide Spectrum ◽  
Case Reports ◽  
Fungal Species ◽  
Mycobacterium Abscessus ◽  
Accurate Identification ◽  
Patient Prognosis

Nontuberculous mycobacteria (NTM) and many fungal species (spp.) are commonly associated with opportunistic infections (OPIs) in immunocompromised individuals. Moreover, occurrence of concomitant infection by NTM (mainly spp. of Mycobacterium avium complex and Mycobacterium abscessus complex) and fungal spp. (mainly, Aspergillus fumigatus, Histoplasma capsulatum and Cryptococcus neoformans) is very challenging and is associated with poor patient prognosis. The most frequent clinical symptoms for coinfection and infection by single agents (fungi or NTM) are similar. For this reason, the accurate identification of the aetiological agent(s) is crucial to select the best treatment approach. Despite the significance of this topic it has not been sufficiently addressed in the literature. This review aims at summarizing case reports and studies on NTM and fungi coinfection during the last 20 years. In addition, it briefly characterizes OPIs and coinfection, describes key features of opportunistic pathogens (e.g., NTM and fungi) and human host predisposing conditions to OPIs onset and outcome. The review could interest a wide spectrum of audiences, including medical doctors and scientists, to improve awareness of these infections, leading to early identification in clinical settings and increasing research in the field. Improved diagnosis and availability of therapeutic options might contribute to improve the prognosis of patients’ survival.

scholarly journals Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Nives Jonjić ◽  
Andrea Dekanić ◽  
Nedeljka Glavan ◽  
Larisa Prpić-Massari ◽  
Blaženka Grahovac
Keyword(s):  
Clinical Information ◽  
Braf V600e ◽  
Diagnostic Tools ◽  
Blue Nevus ◽  
Ki 67 ◽  
Melanocytic Tumor ◽  
Pigmented Lesion ◽  
History Of ◽  
One Year ◽  
Cellular Blue Nevus

A case of a 41-year-old woman with a history of nodular melanoma (NM), associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN); however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67) and molecular (BRAF V600E mutation) analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.

scholarly journals Epidemiology and genotyping of Anaplasma marginale and co-infection with piroplasms and other Anaplasmataceae in cattle and buffaloes from Egypt

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Amira AL-Hosary ◽  
Cristian Răileanu ◽  
Oliver Tauchmann ◽  
Susanne Fischer ◽  
Ard M. Nijhof ◽  
...  
Keyword(s):  
Blood Smear ◽  
Anaplasma Marginale ◽  
Carrier State ◽  
Babesia Bovis ◽  
Diagnostic Tools ◽  
Enzyme Linked Immunosorbent Assay ◽  
Babesia Bigemina ◽  
Infection Level ◽  
Significant Difference ◽  
One Year

Abstract Background Anaplasma marginale is an obligate intracellular bacterium and the main cause of bovine anaplasmosis in tropical and subtropical regions. In Egypt, data regarding the prevalence of A. marginale in ruminant hosts and of the circulating genotypes is lacking. This study therefore aimed to (i) investigate the presence, epidemiology and genotypes of A. marginale in cattle and buffaloes in Egypt, (ii) to evaluate suitable diagnostic tools and (iii) to identify co-infections of A. marginale with other selected tick-borne pathogens. Methods Blood samples were collected from 394 animals (309 cattle and 85 buffaloes) from three different areas in Egypt. For the detection of A. marginale infection, several tests were compared for their sensitivity and specificity: blood smear analysis, enzyme-linked immunosorbent assay (ELISA), PCR, real-time PCR and reverse line blot (RLB) assay. Co-infections with A. marginale, piroplasms and other Anaplasmataceae were surveyed by RLB while A. marginale genotypes were identified by amplifying and sequencing the partial msp1α gene. Results Anaplasma marginale DNA was amplified by qPCR in 68.3% of cattle and 29.4% of buffaloes. RLB showed infection with A. marginale in 50.2% of cattle and 42.5% of buffaloes. Blood smear analysis detected this agent in 16.2% of cattle and 2.4% of buffaloes. ELISA showed specific antibodies against A. marginale in 54.9% of cattle. Anaplasma marginale was associated, in cattle and buffaloes, with several tick-borne pathogens (Theileria annulata, Babesia bovis, Babesia bigemina, Babesia occultans and Anaplasma platys). A significant difference of A. marginale infection level was noticed in cattle, where animals between 3–5-years-old had a higher prevalence (79.2%) compared to those older than 5 years (36.4%) and younger than 3 years (59.7%) and one year (64.5%), respectively (P = 0.002281). Microsatellite analysis identified 15 different genotypes. Conclusions The epidemiological findings revealed high prevalence of A. marginale in cattle and buffaloes in all the investigated areas. The circulation of diverse genotypes was observed, most of these A. marginale genotypes being specific for Egypt. The qPCR assay was confirmed to be the most sensitive tool for detection of A. marginale in cattle and buffaloes even in the carrier state, highlighting the importance of using suitable diagnostic tests.

scholarly journals EPIDEMIOLOGY, CLINICAL ASPECTES,LABORATORY DIAGNOSIS AND TREATMENT OF RICKESIAL DISEASES IN THE MEDITERRANEAN AREA DURIN COVID-19 PANDEMIC:A REVIEW OF THE LITERATURE

2020 ◽  
Vol 12 (1) ◽  
pp. e2020056
Author(s):  
Andrea De Vito ◽  
Nicholas Geremia ◽  
Maria Sabrina Mameli ◽  
Pier Andrea Serra ◽  
Vito Fiore ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Mediterranean Area ◽  
Laboratory Diagnosis ◽  
Diagnostic Tools ◽  
Nucleotide Sequencing ◽  
Human Pathogens ◽  
Rickettsia Species ◽  
Rickettsial Infections ◽  
The Mediterranean ◽  
Correct Understanding

The purpose of the present review is to give an update regarding the classification, the epidemiology, the clinical manifestation, the diagnoses, and the treatment of the Rickettsiae species present in the Mediterranean area. We performed a comprehensive search, through electronic databases (Pubmed – MEDLINE) and search engines (Google Scholar), of peer-reviewed publications (articles, reviews, and books). The availability of new diagnostic tools, including Polymerase Chain Reaction and nucleotide sequencing has significantly modified the classification of intracellular bacteria, including the order Rickettsiales with more and more new Rickettsia species recognized as human pathogens. Furthermore, emerging Rickettsia species have been found in several countries and are often associated with unique clinical pictures that may challenge the physician in the early detection of the diseases. Rickettsial infections include a wide spectrum of clinical presentations ranging from a benign to a potentially life treating disease that requires prompt recognition and proper management. Recently, due to the spread of SARS-CoV-2 infection, the differential diagnosis with COVID-19 is of crucial importance. The correct understanding of the clinical features, diagnostic tools, and proper treatment can assist clinicians in the management of Rickettsioses in the Mediterranean area.

Prevention ofStreptococcus pneumoniae(pneumococcal) infections in adults

2014 ◽  
Vol 155 (50) ◽  
pp. 1996-2004 ◽  
Author(s):  
Endre Ludwig ◽  
Zsófia Mészner
Keyword(s):  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Infection ◽  
Polysaccharide Vaccine ◽  
Diagnostic Tools ◽  
Renal Diseases ◽  
Pneumococcal Polysaccharide Vaccine ◽  
Pneumococcal Infections ◽  
Incidence And Mortality ◽  
One Year

Infections caused by Streptococcus pneumoniae (pneumococcus) are still meaning a serious health problem, about 40% of community acquired pneumonia (CAP) is due to pneumococcal bacteria in adults requiring hospitalization. The incidence and mortality rate of pneumococcal infections is increasing in the population above 50 years of age. Certain congenital and acquired immunocompromised conditions make the individual susceptible for pneumococcal infection and other chronic comorbidities should be considered as a risk factor as well, such as liver and renal diseases, COPD, diabetes mellitus. Lethality of severe pneumococcal infections with bacteraemia still remains about 12% despite adequate antimicrobial therapy in the past 60 years. Underestimation of pneumococcal infections is mainly due to the low sensitivity of diagnostic tools and underuse of bacteriological laboratory confirmation methods. 13-valent pneumococcal conjugate vaccine (PCV-13) became available recently beyond the 23-valent polysacharide vaccine (PPV-23) which has been using for a long time.The indication and proper administration of the two vaccines are based on international recommendations and vaccination guideline published by National Centre for Epidemiology (NCE):Pneumococcal vaccination is recommended for: Every person above 50 years of age. Patients of all ages with chronic diseases who are susceptible for severe pneumococcal infections: respiratory (COPD), heart, renal, liver disease, diabetes, or patients under immunsuppressive treatment. Smokers regardless of age and comorbidities. Cochlear implants, cranial-injured patients. Patients with asplenia.Recommendation for administration of the two different vaccines:Adults who have not been immunized previously against pneumococcal disease must be vaccinated with a dose of 13-valent pneumococcal conjugate vaccine first. This protection could be extended with administration of 23-valent pneumococcal polysaccharide vaccine at least two month later. Adults who have been immunized previously, but above 65 years of age, with a 23-valent polysaccharide vaccine are recommended to get one dose of conjugate vaccine at least one year later. Adults who have been immunized previously, but under 65 years of age, with a 23-valent polysaccharide vaccine are recommended to get one dose of conjugate vaccine at least one year later. After a minimal interval of two months one dose of 23-valent pneumococcal polysaccharide vaccine is recommended if at least 5 years have elapsed since their previous PPSV23 dose. Vaccination of immuncompromised patients (malignancy, transplantation, etc.) and patients with asplenia should be defined by vaccinology specialists. Pneumococcal vaccines may be administered concommitantly or any interval with other vaccines. Orv. Hetil., 2014, 155(50), 1996–2004.

scholarly journals Mycobacteriosis treatment challenges in patients with HIV-infection

2020 ◽  
Vol 12 (3) ◽  
pp. 35-45
Author(s):  
M. A. Savchenko ◽  
A. M. Panteleev
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
The United States ◽  
Steady Increase ◽  
The Past ◽  
Highly Active ◽  
History Of ◽  
One Year

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

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