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Author(s):  
Nida Siddiqui ◽  
Brett Stephen Mansfield ◽  
Nine-Paula Olmesdahl ◽  
Peter Swart ◽  
Jeremy Nel

Paradoxical immune reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)-positive patients initiating antiretroviral treatment (ART) is caused by restored immunity to specific antigens, resulting in worsening of a pre-existing infection. Molluscum contagiosum (MC) is commonly noted in HIV-positive individuals but ART alone is usually sufficient to bring about resolution. We present a rare case of severe MC-IRIS that worsened despite immune reconstitution.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Wei Hu ◽  
Xiao-hong Yu ◽  
Wei-qin Wei ◽  
Xuan Xiang

Abstract Background Talaromyces Marneffei (Penicillium marneffei, T.marneffei) has been frequently reported in patients with adult acquired immunodeficiency syndrome. Still, cases of children with HIV combined with T.marneffei infection are very rare. This report describes the case of a HIV-child who is a girl from China. Her special clinical manifestations and laboratory diagnosis results can provide clinicians with the basis for diagnosis and treatment of T.marneffei related rare diseases. Case presntation We reported a single case of 7-year-old Chinese female patient who presented with fever, abdominal pain, multiple lymphadenopathy, hepatosplenomegaly, left lower extremity ecchymosis, and bloody stool. The patient received anti-inflammatory therapy; however, her symptoms did not improve. Consequently, she was diagnosed with T.marneffei and HIV infection; it was also confirmed that her mother did not undergo HIV blocking therapy during pregnancy. Yet, the child’s family refused all treatment, after which the child was discharged from the hospital. The patient died a few days later. Conclusion This case suggested that children with AIDS suffering from fever, lymphadenopathy and coagulation dysfunction, penicilliosis should be suspected. Clinicians should diagnose the disease early through laboratory and imaging results, which can help reduce the mortality, prolong the survival time and improve the quality of life of children.


Author(s):  
Alice Delerue Matos ◽  
Andreia Fonseca de Paiva ◽  
Cláudia Cunha ◽  
Gina Voss

AbstractStudies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19-related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50 + with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE-COVID19 questionnaire on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Spain and Italy and lower in Denmark, Finland and Sweden. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours.


2022 ◽  
pp. 253-287

This chapter discusses noninfectious corneal disorders, caused by an immune inflammation such as phlyctenular keratoconjunctivitis, marginal staphylococcal keratitis, peripheral ulcerative keratitis, Mooren's ulcer, interstitial keratitis, rosacea keratitis, etc. Mooren's ulcer, which is considered one of the most severe diseases, is presented with serial photos of follow-ups within 3 years with different complications, management of the condition, and results. A severe case of rosacea keratitis associated with anterior uveitis is included in this chapter too. Thygeson's superficial punctate keratitis case is shown as well, but the disease is very rare in Middle Eastern populations. The material in this chapter also includes filamentary, neurotrophic, and exposure keratitis. A rare disorder like anesthetic abuse keratopathy, caused by topical excess use of anesthetic drops, is presented with before and after treatment photos to illustrate that the condition, if treated appropriately, can leave minimal scarring.


2021 ◽  
Vol 18 (4) ◽  
pp. 938-945
Author(s):  
D. Yu. Maychuk ◽  
A. O. Loshkareva ◽  
A. A. Tarkhanova

Currently the ophthalmologists meet with corneal-conjunctival xerosis more often in their daily practice. The objective of this research is identifying a new alternative method of treatment of the dry eye syndrome of different severity. In this work there will be a demonstration and the results of usage of BAA Delphanto® in treatment of different cases of the dry eye syndrome. The data collected from a dynamic research of groups of patients reveals the effectiveness of the comprehensive therapy with the use of BAA Delphanto®. Consequently, the research results demonstrate an improvement of the initial data from the biomicroscopy, OSDI index, Schirmer-1 test and the tear break up time. The statistically significant results were received reveal the effectiveness of the use of BAA Delphanto® with a significant improvement of the quality of life. It can be used widely by ophthalmologists for the treatment of corneal-conjunctival xerosis of different severity.


Author(s):  
Isha Chandrakar ◽  
Shruti Sanghavi

Dry eye disease (DED) is a multifactorial disease in which the tear film’s homeostasis is lost, along with other ocular symptoms such as tear film instability and high osmolarity, neurosensory abnormalities, and ocular surface inflammation and damage. DED is a condition of lacrimal apparatus which is responsible for tear production. The tear film is a mixture of mucin, aqueous (water and solutes like NacI, sugar, urea, proteins,), lipids secreted by goblet cells, lacrimal glands, and meibomian glands, respectively. It keeps the eye moist, provides oxygen to the cornea, and has antibacterial properties. The lipid layer prevents the evaporation of the aqueous. DED is categorized into (i)Aqueous-tear deficiency, characterized by a deficiency of lacrimal glands to secrete tears, (ii)Evaporative DED, associated with increased tear loss by evaporation because there is a deficiency of the meibomian glands. The mechanism of DED might be loss of tear through evaporation or insufficient aqueous production or a combination of the two. DED is a widespread eye problem, which is often left untreated. It causes irritation, itching, dryness, foreign body sensation, and discomfort; severe case causes conjunctival congestion, keratinization, erosion of the corneal epithelium, and plaque formation. If left Univision- threatening vision-threatening, leading to complications like corneal ulceration and perforation. Various clinical tests are used to diose DED, including tear breakup time, tear osmolarity, Schirmer test, Rose Bengal staining, and expression of inflammatory markers. There is no cure for DED at present. The following modalities are used for its treatment: use of punctual and canalicular plugs, artificial tear products like polyethylene glycol/propylene glycol with guar HP, consuming food rich in omega-three fatty acids, antioxidants zeaxanthin, and lutein, Use of anti-inflammatory drugs, mucolytics, secretagogues. Reducing or avoiding mild risk factors like prolonged reading, prolonged use of contact lenses, excessive screen time, etc. Treatment of causative disease.  Appropriate management and establishing reasonable patient expectations are necessary to ensure patient satisfaction and adherence to the treatment.


Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1526
Author(s):  
Andreaserena Recchia ◽  
Marco Cascella ◽  
Sabrina Altamura ◽  
Felice Borrelli ◽  
Nazario De Nittis ◽  
...  

A 20-year-old man was admitted to the intensive care unit for septic shock due to Lemierre’s syndrome. It is a rare syndrome that manifests as an upper respiratory infection, although systemic involvement, severe coagulopathy, and multi-organ failure can dangerously complicate the clinical picture. In this syndrome, sepsis-related neuroendocrine dysregulation and microcirculation impairment can have a rapid deleterious progression. Consequently, proper diagnosis, early source control, and appropriate antibiotics administration are mandatory to improve the prognosis. The intensive treatment is aimed at limiting organ damage through hemodynamic optimization. Remarkably, in septic shock due to Lemierre’s syndrome, hemodynamic optimization can be achieved through the synergic effect of norepinephrine, argipressin, and hydrocortisone.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jingyue Wang ◽  
Botao Shen ◽  
Xiaoxing Feng ◽  
Zhiyu Zhang ◽  
Junqian Liu ◽  
...  

Objective: Cardiogenic shock seriously affects the survival rate of patients. However, few prognostic models are concerned with the score of cardiogenic shock, and few clinical studies have validated it. In order to optimize the diagnosis and treatment of myocardial infarction complicated with cardiogenic shock and facilitate the classification of clinical trials, the prognosis score model is urgently needed.Methods: Cardiogenic shock, severe case, prognosis score, myocardial infarction and external verification were used as the search terms to search PubMed, Embase, Web of Science, Cochrane, EBSCO (Medline), Scopus, BMC, NCBI, Oxford Academy, Science Direct, and other databases for pertinent studies published up until 1 August 2021. There are no restrictions on publication status and start date. Filter headlines and abstracts to find articles that may be relevant. The list of references for major studies was reviewed to obtain more references.Results and Conclusions: The existing related models are in urgent need of more external clinical verifications. In the meanwhile, with the development of molecular omics and the clinical need for optimal treatment of CS, it is urgent to establish a prognosis model with higher differentiation and coincidence rates.


2021 ◽  
pp. 103153
Author(s):  
Mohamed Fajri ◽  
Meryem Essafti ◽  
Rachid Aloua ◽  
Youssef Mouaffak
Keyword(s):  

2021 ◽  
Vol 14 (12) ◽  
pp. e245594
Author(s):  
Rachael Collins ◽  
George Lafford ◽  
Laura Parry

We report a case of a generally fit and well 54-year-old man who presented with a 2-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and fever on the background of a 7-week history of otitis externa (OE). His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately, he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life threatening condition. It emphasises the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multidisciplinary team approach when managing complex complications of OE.


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