Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines

Many patients are receiving SARS-CoV-2 vaccinations, which have been associated with a variety of adverse effects. Cutaneous adverse reactions to SARS-CoV-2 vaccinations have been progressively reported, but they have not been reviewed according to their morphological clinical patterns. The objective of this review was to summarize the existing data concerning the cutaneous adverse reactions following SARS-CoV-2 vaccines and group them according to common morphological and pathogenetic patterns. We reviewed the English language literature up to August 15th, 2021, using predefined keywords to identify the relevant studies evaluating cutaneous adverse reactions associated with SARS-CoV-2 vaccines. We search for recurrent morphological patterns sharing clinical signs and symptoms and physio-pathological mechanisms. Timing to onset following the first or booster dose of the vaccine, predisposing conditions, therapeutic management, and outcome were also collected. Among the dermatological manifestations associated with SARS-CoV-2 vaccinations, we distinguished: (1) new onset reactions and (2) flares of preexisting dermatoses. The most common were injection site reactions, affecting 30–70% and generally mild or moderate. Small case series or single case reports included filler reactions, exanthemas, vascular lesions, urticaria, eczematous dermatitis, autoimmune bullous reactions, and severe cutaneous adverse reactions. In addition, the exacerbation of chronic immuno-mediated dermatoses (mainly psoriasis and atopic dermatitis) and reactivations of herpes infection were reported. The cutaneous reactions were generally mild, self-limiting, and resembled common cutaneous drug eruptions and/or COVID-19 skin manifestations.

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Medically important trombiculids: a systematic review of the global distribution and clinical consequences of their bites

Revista Peruana de Investigación en Salud ◽

10.35839/repis.5.2.908 ◽

2021 ◽

Vol 5 (2) ◽

pp. 67-76

Author(s):

Julián F. Porras-Villamil ◽

Mario Javier-Olivera

Keyword(s):

Systematic Review ◽

Human Health ◽

Case Reports ◽

Clinical Signs ◽

Case Series ◽

Clinical Importance ◽

Signs And Symptoms ◽

Publication Date ◽

Rickettsial Infections ◽

Clinical Consequences

Background: Mites are among the smallest arthropods that can be seen without magnification, were the use of dermatoscopy is an invaluable tool. They are a cosmopolitan pest, and at the moment more than 250 species have been shown to produce problems for humans and animals alike. These mites are capable of producing a wide array of clinical signs and symptoms, from local to systemic, from mild to severe, as well as transmitting pathogens. This study aimed to provide an update to the clinical impact on human health, the distribution and species involved in the clinical conditions produced by trombiculids through a systematic review. Background: Mites are among the smallest arthropods that can be seen without magnification, were the use of dermatoscopy is an invaluable tool. They are a cosmopolitan pest, and at the moment more than 250 species have been shown to produce problems for humans and animals alike. These mites are capable of producing a wide array of clinical signs and symptoms, from local to systemic, from mild to severe, as well as transmitting pathogens. This study aimed to provide an update to the clinical impact on human health, the distribution and species involved in the clinical conditions produced by trombiculids through a systematic review. Methods: A systematic literature review was conducted in Medline, Lilacs, Redalyc, Scopus, SciELO and Google Scholar, were we use as a threshold of publication date the year 2008. We limited the search strategy to articles published in Portuguese, French, English and Spanish. Eligible studies were case reports and case series that reported outcomes in humans caused by trombiculid bites. Patient-level and study-level information was extracted. Results: The literature search yielded 832 studies; 13 were case reports, 4 case series and 2 descriptive studies reporting a total of 49 cases. Most patients were male, and the median age was 33.7±6.4 years old. The most frequently reported symptoms were local erythema, pruritus and papules. No deaths were documented. Trombiculids from the genera Trombicula, Eutrombicula and Leptotrombidium appear to be the most commonly reported. Discussion: Trombiculiasis is an infestation caused by the larval stage of various types of mites, known as chiggers, they belong to the class Arachnida and the family Trombiculidae. This systematic review provides an overview of the trombiculids of clinical importance, their distribution and effects of the bite on human health. Our results show that there are different species of mites that can have important consequences for human health. No fatal cases owere registered.Even so, the transmission of scrub typhus is important and remains one of the most life-threatening rickettsial infections in some regions of Asia. Conclusions: The bite of different species of trombiculids around the world can cause a wide array of clinical consequences to human health. Even as mortality appear to be nonexistent, trombiculid bites must be adequately diagnosed and treated properly: A systematic literature review was conducted in Medline, Lilacs, Redalyc, Scopus, SciELO and Google Scholar, were we use as a threshold of publication date the year 2008. We limited the search strategy to articles published in Portuguese, French, English and Spanish. Eligible studies were case reports and case series that reported outcomes in humans caused by trombiculid bites. Patient-level and study-level information was extracted. Results: The literature search yielded 832 studies; 13 were case reports, 4 case series and 2 descriptive studies reporting a total of 49 cases. Most patients were male, and the median age was 33.7±6.4 years old. The most frequently reported symptoms were local erythema, pruritus and papules. No deaths were documented. Trombiculids from the genera Trombicula, Eutrombicula and Leptotrombidium appear to be the most commonly reported. Discussion: Trombiculiasis is an infestation caused by the larval stage of various types of mites, known as chiggers, they belong to the class Arachnida and the family Trombiculidae. This systematic review provides an overview of the trombiculids of clinical importance, their distribution and effects of the bite on human health. Our results show that there are different species of mites that can have important consequences for human health. No fatal cases owere registered.Even so, the transmission of scrub typhus is important and remains one of the most life-threatening rickettsial infections in some regions of Asia. Conclusions: The bite of different species of trombiculids around the world can cause a wide array of clinical consequences to human health. Even as mortality appear to be nonexistent, trombiculid bites must be adequately diagnosed and treated properly.

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Presentation and management of N-acetylglutamate synthase deficiency: a review of the literature

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-020-01560-z ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Aileen Kenneson ◽

Rani H. Singh

Keyword(s):

Current Knowledge ◽

Case Reports ◽

Management Strategies ◽

Clinical Signs ◽

Case Series ◽

Signs And Symptoms ◽

Protein Restriction ◽

Therapeutic Trials ◽

Acetylglutamate Synthase ◽

Clinical Signs And Symptoms

Abstract Background N-Acetylglutamate synthase (NAGS) deficiency is an extremely rare autosomal recessive metabolic disorder affecting the urea cycle, leading to episodes of hyperammonemia which can cause significant morbidity and mortality. Since its recognition in 1981, NAGS deficiency has been treated with carbamylglutamate with or without other measures (nutritional, ammonia scavengers, dialytic, etc.). We conducted a systematic literature review of NAGS deficiency to summarize current knowledge around presentation and management. Methods Case reports and case series were identified using the Medline database, as well as references from other articles and a general internet search. Clinical data related to presentation and management were abstracted by two reviewers. Results In total, 98 cases of NAGS deficiency from 79 families, in 48 articles or abstracts were identified. Of these, 1 was diagnosed prenatally, 57 were neonatal cases, 34 were post-neonatal, and 6 did not specify age at presentation or were asymptomatic at diagnosis. Twenty-one cases had relevant family history. We summarize triggers of hyperammonemic episodes, diagnosis, clinical signs and symptoms, and management strategies. DNA testing is the preferred method of diagnosis, although therapeutic trials to assess response of ammonia levels to carbamylglutamate may also be helpful. Management usually consists of treatment with carbamylglutamate, although the reported maintenance dose varied across case reports. Protein restriction was sometimes used in conjunction with carbamylglutamate. Supplementation with citrulline, arginine, and sodium benzoate also were reported. Conclusions Presentation of NAGS deficiency varies by age and symptoms. In addition, both diagnosis and management have evolved over time and vary across clinics. Prompt recognition and appropriate treatment of NAGS deficiency with carbamylglutamate may improve outcomes of affected individuals. Further research is needed to assess the roles of protein restriction and supplements in the treatment of NAGS deficiency, especially during times of illness or lack of access to carbamylglutamate.

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Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

East Africa Science ◽

10.24248/easci.v1i1.4 ◽

2019 ◽

Vol 1 (1) ◽

pp. 49-56

Author(s):

Mariam M. Mirambo ◽

Lucas Matemba ◽

Mtebe Majigo ◽

Stephen E. Mshana

Keyword(s):

Virus Infection ◽

Neural Tube ◽

Zika Virus ◽

English Language ◽

Case Reports ◽

Case Series ◽

Epidemiological Studies ◽

Ocular Manifestations ◽

Zika Virus Infection ◽

N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

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Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

East Africa Science ◽

10.24248/easci.v1.iss1.4 ◽

2019 ◽

Vol 1 (1) ◽

pp. 49-56

Author(s):

Mariam M. Mirambo ◽

Lucas Matemba ◽

Mtebe Majigo ◽

Stephen E. Mshana

Keyword(s):

Virus Infection ◽

Neural Tube ◽

Zika Virus ◽

English Language ◽

Case Reports ◽

Case Series ◽

Epidemiological Studies ◽

Ocular Manifestations ◽

Zika Virus Infection ◽

N 93

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Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽

10.3390/life11020167 ◽

2021 ◽

Vol 11 (2) ◽

pp. 167

Author(s):

Pasquale Sansone ◽

Luca Gregorio Giaccari ◽

Caterina Aurilio ◽

Francesco Coppolino ◽

Valentina Esposito ◽

...

Keyword(s):

Single Case ◽

Case Reports ◽

Case Series ◽

Guillain Barre Syndrome ◽

Response To Treatment ◽

Comprehensive Overview ◽

Fisher Syndrome ◽

Immunomodulating Therapy ◽

Guillain Barré Syndrome ◽

Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

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Zolpidem for Insomnia: A Double-Edged Sword. A Systematic Literature Review on Zolpidem-Induced Complex Sleep Behaviors

Indian Journal of Psychological Medicine ◽

10.1177/0253717621992372 ◽

2021 ◽

pp. 025371762199237

Author(s):

Niti Mittal ◽

Rakesh Mittal ◽

M. C. Gupta

Keyword(s):

Adverse Reactions ◽

Case Reports ◽

Case Series ◽

Eligibility Criteria ◽

Study Objective ◽

Spontaneous Reports ◽

Cochrane Database ◽

Sleep Behaviors ◽

Therapeutic Doses ◽

Favorable Side Effect Profile

Background: Being a nonbenzodiazepine, zolpidem is believed to have a favorable side-effect profile and is widely prescribed for insomnia. However, in the past few years, numerous neuropsychiatric adverse reactions, particularly complex sleep behaviors (CSBs), have been reported with zolpidem. Objective: To conduct a systematic review of zolpidem-associated CSBs. Data Sources: An electronic search was conducted using MEDLINE, Embase, PubMed, and Cochrane database of systematic reviews to extract relevant articles till July 2020. Study Eligibility Criteria: Any type of literature article (case report, case series, and observational or interventional study) reporting CSBs associated with zolpidem. Results: In this review, we present aggregate summarized data from 148 patients presenting with zolpidem-induced CSBs (79 patients from 23 case reports and 5 case series; 69 patients out of 1454 taking zolpidem [4.7%] from three observational clinical studies). Various types of CSBs associated with zolpidem were reported, most common being sleepwalking/somnambulism and sleep-related eating disorder. On causality assessment, around 88% of cases were found to have a probable association with zolpidem. Limitations: Extraction of data from observational studies and spontaneous reports, due to nonavailability of any randomized controlled trials relevant to the study objective. Conclusion and Implication of Key Findings: Zolpidem-induced CSBs, although not very common, may develop when the drug is used at therapeutic doses for insomnia. Doctors need to be alert to monitor such adverse effects of zolpidem and exercise caution while prescribing it.

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Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0041-1723810 ◽

2021 ◽

Author(s):

Xuefeng Wei ◽

Xu Zhang ◽

Zimu Song ◽

Feng Wang

Keyword(s):

Literature Review ◽

Single Case ◽

Case Reports ◽

Case Series ◽

Subtotal Resection ◽

Study Cohort ◽

Primitive Neuroectodermal Tumors ◽

Pathologic Features ◽

Neuroectodermal Tumors ◽

The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

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Drug-Induced Restless Legs Syndrome

Annals of Pharmacotherapy ◽

10.1177/1060028018760296 ◽

2018 ◽

Vol 52 (7) ◽

pp. 662-672 ◽

Cited By ~ 9

Author(s):

Edna Patatanian ◽

Melanie K. Claborn

Keyword(s):

Restless Legs Syndrome ◽

English Language ◽

Case Reports ◽

Data Extraction ◽

Case Series ◽

Predisposing Factors ◽

Drug Induced ◽

Restless Legs ◽

Drug Classes ◽

Study Selection

Objective: To review the literature on drug-induced restless legs syndrome (DI-RLS). Data Sources: The review included a search for English-language literature from 1966 to December 2017 in the MEDLINE, PubMed, and Ovid databases using the following search terms: restless legs syndrome (RLS), periodic limb movement, adverse effects, and drug-induced. In addition, background articles on the pathophysiology, etiology, and epidemiology of RLS were retrieved. Bibliographies of relevant articles were reviewed for additional citations. Study Selection and Data Extraction: All case reports, case series, and review articles of DI-RLS were identified and analyzed. There were only a small number of controlled clinical trials, and most data were from case reports and case series. Results: Several drugs and drug classes have been implicated in DI-RLS, with antidepressants, antipsychotics, and antiepileptics having the most evidence. In addition, RLS may be linked with a number of disorders or underlying predisposing factors as well. Conclusions: The prevalence of RLS is variable and ranges from 3% to 19% in the general population. There are many predisposing factors to RLS, but an emerging body of evidence suggests that there is an association between numerous drugs and RLS.

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Bacillus cereus Typhlitis in a Patient with Acute Myelogenous Leukemia: A Case Report and Review of the Literature

Case Reports in Infectious Diseases ◽

10.1155/2018/7510715 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

James D. Denham ◽

Sowmya Nanjappa ◽

John N. Greene

Keyword(s):

Bacillus Cereus ◽

Acute Myelogenous Leukemia ◽

English Language ◽

Neutropenic Patient ◽

Hematologic Malignancy ◽

Case Reports ◽

Clinical Manifestations ◽

Case Series ◽

Myelogenous Leukemia ◽

Acute Myelogenous

Bacillus cereus is a Gram-positive rod that is now recognized as a rare cause of frank disease in the neutropenic hematologic malignancy patient. Because this pathogen is rarely isolated in clinical specimens, no large studies exist to guide the management of these acutely ill patients. Individual case reports and case series exist in the literature describing various clinical manifestations of B. cereus in the neutropenic patient including bacteremia/septicemia, pneumonia, meningitis/encephalitis, hepatic abscesses, and gastritis. In this report, we describe a case of typhlitis caused by B. cereus in a 74-year-old female with recently diagnosed acute myelogenous leukemia (AML), and we summarize the available English language literature to draw tentative conclusions regarding the clinical manifestations of this organism.

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The Need for Routine Bleomycin Test Dosing in the 21st Century

Annals of Pharmacotherapy ◽

10.1345/aph.1g235 ◽

2005 ◽

Vol 39 (11) ◽

pp. 1897-1902 ◽

Cited By ~ 10

Author(s):

Masha SH Lam

Keyword(s):

Clinical Trials ◽

English Language ◽

Case Reports ◽

Mail Survey ◽

Signs And Symptoms ◽

Test Dose ◽

Host Cells ◽

High Grade Fever ◽

Search Terms ◽

E Mail

OBJECTIVE To review the clinical evidence for routine use of bleomycin test dosing. DATA SOURCES English-language review articles, references from retrieved articles, case reports, and clinical trials were identified from a MEDLINE literature search (1966–July 2005). Key search terms included bleomycin, test dose, anaphylactic reactions, and hypersensitivity. Information from an unpublished E-mail survey, the manufacturer, and the Internet was also used. DATA SYNTHESIS Early clinical trials and isolated case reports suggest that bleomycin-induced acute hypersensitivity reactions occur in 1% of patients with lymphoma and <0.5% of those with solid tumors. The reactions are mainly characterized by high-grade fever, chills, hypotension, and in a few cases, cardiovascular collapse, which can lead to death. The exact mechanism of these reactions is unclear, but is thought to be related to the release of endogenous pyrogens from the host cells. Evidence does not suggest any correlation between doses and the onset or severity of the reactions. Supportive care, including hydration, steroids, antipyretics, and antihistamines, may resolve the symptoms. However, it may not completely prevent recurrences. CONCLUSIONS The incidence of acute hypersensitivity or hyperpyrexic reactions associated with bleomycin is very low, but the reaction is potentially fatal. Clinicians should monitor their patients for any signs and symptoms of acute hyperpyrexic reactions during bleomycin administration. Since the onset of the reactions can occur with any dose of bleomycin and at any time, routine test dosing does not seem to predict when drug reactions may occur.

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