Chapter 7: TBE in special situations

2020 ◽  
Keyword(s):  
Clinical Manifestation ◽  
Environmental Conditions ◽  
Clinical Course ◽  
Milk Products ◽  
Related Disease ◽  
Transplant Patients ◽  
Imported Cases ◽  
Fatal Course ◽  
Transplacental Infection ◽  
In Pregnancy

TBE often takes a severe clinical course in immuno-suppressed patients. In transplant patients TBE usually takes a fatal course. TBE vaccination in immuno-suppressed patients can be non-effective TBE in pregnancy has rarely been reported; from recent cases there is no evidence of transplacental infection of the offspring. The alimentary route of infection of TBE is still common in some European countries resulting in a high clinical manifestation index. TBEV can be infectious in milk and milk products for up to 14 days under optimal environmental conditions. TBE is an important travel-related disease. Increasing numbers of non-endemic countries report imported cases. Imported TBE cases in non-endemic areas pose challenges regarding the diagnosis of TBE.

Chapter 7: TBE in special situations

2021 ◽  
Author(s):  
Gerhard Dobler ◽  
Igor Stoma
Keyword(s):  
Clinical Manifestation ◽  
Environmental Conditions ◽  
Clinical Course ◽  
Milk Products ◽  
Related Disease ◽  
Transplant Patients ◽  
Imported Cases ◽  
Fatal Course ◽  
Transplacental Infection ◽  
In Pregnancy

TBE often takes a severe clinical course in immuno-suppressed patients. In transplant patients TBE usually takes a fatal course. TBE vaccination in immuno-suppressed patients can be non-effective TBE in pregnancy has rarely been reported; from recent cases there is no evidence of transplacental infection of the offspring. The alimentary route of infection of TBE is still common in some European countries resulting in a high clinical manifestation index. TBEV can be infectious in milk and milk products for up to 14 days under optimal environmental conditions. TBE is an important travel-related disease. Increasing numbers of non-endemic countries report imported cases. Imported TBE cases in non-endemic areas pose challenges regarding the diagnosis of TBE.

Chapter 7: TBE in special situations

2019 ◽  
Author(s):  
Gerhard Dobler
Keyword(s):  
Clinical Manifestation ◽  
Environmental Conditions ◽  
Clinical Course ◽  
Milk Products ◽  
Related Disease ◽  
Transplant Patients ◽  
Imported Cases ◽  
Fatal Course ◽  
Transplacental Infection ◽  
In Pregnancy

• TBE often takes a severe clinical course in immuno-supressed patients. • In transplant patients TBE usually takes a fatal course. • TBE vaccination in immuno-suppressed patients can be non-effective • TBE in pregnancy has been rarely reported; from recent cases there is no evidence of transplacental infection of the offspring. • The alimentary route of infection of TBE is still common in some European countries resulting in a high clinical manifestation index. • TBEV can be infectious in milk and milk products for up to 14 days under optimal environmental conditions. • TBE is an important travel-related disease. Increasing numbers of non-endemic countries report imported cases. • Imported TBE cases in non-endemic areas pose challenges regarding the diagnosis of TBE.

scholarly journals 530. COVID-19 in kidney transplant recipients: Single-center experience and case-control study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S332-S332
Author(s):  
Anna Hardesty ◽  
Aakriti Pandita ◽  
Yiyun Shi ◽  
Kendra Vieira ◽  
Ralph Rogers ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Case Control Study ◽  
Clinical Course ◽  
Case Series ◽  
Case Fatality ◽  
Case Control ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transplant Patients ◽  
Control Study

Abstract Background Organ transplant recipients (OTR) are considered high-risk for morbidity and mortality from COVID-19. Case-fatality rates (CFR) vary significantly in different case series, and some patients were still hospitalized at the time of analyses. To our knowledge, no case-control study of COVID-19 in OTR has been published to-date. Methods We captured kidney transplant recipients (KTR) diagnosed with COVID-19 between 3/1 and 5/18/2020. After exclusion of KTR on hemodialysis and off immunosuppression (IS), we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by sex and age (controls). All patients were discharged from the hospital or died. Results 16 KTR had COVID-19. All 3 KTR off IS, who were excluded from further analyses, survived. Median age was 54 (range: 34–65) years; 5/13 KTR (38.4%) were men. Median time from transplant was 41 (range: 1–203) months. Two KTR, both transplanted >10 years ago, were managed as outpatients. IS was reduced in 12/13 (92.3%), most often by discontinuation of the antimetabolite. IL6 levels were >1,000 (normal: < 5) pg/mL in 3 KTR. Tacrolimus or sirolimus levels were >10 ng/mL in 6/9 KTR (67%) (Table 1). Eleven KTR were hospitalized (84.6%) and matched with 44 controls. One KTR, the only one treated with hydroxychloroquine, died (CFR 5.8%; 7.6% in KTR on IS; 9% in hospitalized KTR on IS). Four controls died (CFR: 9%; state CFR: 5.2%; inpatient CFR: 16.6%). There were no significant differences in length of stay or worst oxygenation status between hospitalized KTR and controls. Four KTR (30.7%), received remdesivir, 4 convalescent plasma, 3 (23%) tocilizumab. KTR received more often broad-spectrum antibiotics, convalescent plasma or tocilizumab, compared to controls (Table 2). Table 1 Table 2 Conclusion Unlike early reports from the pandemic epicenters, the clinical course and outcomes of KTR with COVID-19 in our small case series were comparable to those of non-transplant patients. Calcineurin or mTOR inhibitor levels were high, likely due to diarrhea and COVID-19-related hepatic dysfunction. Extremely high IL6 levels were common. The role of IS and potential benefits from investigational treatments remain to be elucidated. A larger multi-institutional study is underway. Disclosures All Authors: No reported disclosures

Fatal Complication from an Alkaline Battery Foreign Body in the Esophagus

1977 ◽  
Vol 86 (5) ◽  
pp. 611-615 ◽  
Author(s):  
Donald S. Blatnik ◽  
Robert J. Toohill ◽  
Roger H. Lehman
Keyword(s):  
Foreign Body ◽  
Steroid Therapy ◽  
Potassium Hydroxide ◽  
Foreign Bodies ◽  
Clinical Course ◽  
Fatal Complication ◽  
Alkaline Battery ◽  
Fatal Course

Foreign bodies and alkali burns in the trachea and esophagus are potentially fatal. Some camera batteries contain 45% potassium hydroxide electrolyte which can leak and cause liquification necrosis upon tissue contact. This report describes a case of an alkali battery foreign body in the esophagus with a subsequent fatal course which was masked by steroid therapy. A discussion of corrosive burns of the esophagus, their etiology, clinical course and pathology is presented.

scholarly journals Management of myasthenia gravis during pregnancy: A report of eight cases

2018 ◽  
Vol 13 (1) ◽  
pp. 28-33
Author(s):  
Beibei Shi ◽  
Linchai Zeng
Keyword(s):  
Birth Weight ◽  
Adverse Effects ◽  
Myasthenia Gravis ◽  
Potential Risk ◽  
Congenital Abnormalities ◽  
Clinical Course ◽  
The Other ◽  
Term Pregnancy ◽  
Lower Birth Weight ◽  
In Pregnancy

AbstractBackgroundThe clinical course of myasthenia gravis (MG) during pregnancy is highly variable and unpredictable. The management of MG in pregnancy has not been standardized.MethodsEight cases of MG in pregnancy, who were treated and gave birth in our hospital between 2004 and 2012, were retrospectively reviewed.ResultsIn three patients, MG deteriorated during pregnancy. Three patients discontinued their medication for MG during their pregnancy, and the other five patients continued on corticosteroid or pyridostigmine. None of the infants showed any congenital abnormalities. Interestingly, there was a trend towards lower birth weight in infants born to women who had an exacerbation of MG during pregnancy. One patient who had unstable MG before pregnancy and voluntarily discontinued the medication for MG at the beginning of pregnancy, experienced MG exacerbation at the 30th week of pregnancy and gave birth prematurely to an infant with transient neonatal MG at the 34th week. The other seven patients had uneventful full-term pregnancy.ConclusionWomen with unstable MG should postpone pregnancy to avoid potential risk of MG exacerbation and adverse effects on the fetus. Medication for MG should not be stopped abruptly during pregnancy, particularly for women with unstable MG. MG during pregnancy should be closely monitored and properly controlled.

Sign in / Sign up

Export Citation Format

Share Document