Helicobacter Pylori as a Risk Factor for Post Infectious Irritable Bowel Syndrome

Backgrounds: Helicobacter Pylori is a common pathogen leading cause of peptic ulcer disease. Several studies linked Helicobacter Pylori infection and the development of irritable bowel syndrome. Aims: We investigated the effectiveness of standard triple therapy and the association between H.Pylori infection and the development of post infectious irritable bowel syndrome. Materials and methods: Prospective analytical study was conducted and we appointed 200 H.Pylori positive patients, they consented and subjected to structured questionnaire and received standard triple therapy (14 days course of proton pump inhibitor (PPI), clarithromycin and either amoxicillin or metronidazole). After three months all patients re-evaluated regarding their symptoms and tested for eradication. Additionally we evaluated the association between H.Pylori infection and irritable bowel syndrome

Anti-NMDAr Encephalitis and COVID-19 in a Patient With Systemic pANCA-Vasculitis and Recurrent Varicella Zoster Infection

Introduction There is a complex interplay between systemic autoimmunity, immunosuppression, and infections. Any or all of these can result in neurologic manifestations, requiring diligence on the part of neurologists. Case report We herein report a case of a patient on immunosuppressive treatment for a vasculitis that resulted in zoster meningoencephalitis. This was further complicated by the development of anti-NMDAr encephalitis, the etiology of which is undetermined and further discussed in this paper. The patient eventually developed COVID-19 during hospitalization, succumbing to the respiratory infection. Conclusion This case emphasizes that post-infectious autoimmune disorders are becoming increasingly recognized and that they should still be considered in patients who are on immunosuppression. Practitioners should be aware of the complex relationship between autoimmunity and immunosuppression and consider both throughout the disease course.

Encephalitic Arboviruses of Africa: Emergence, Clinical Presentation and Neuropathogenesis

Many mosquito-borne viruses (arboviruses) are endemic in Africa, contributing to systemic and neurological infections in various geographical locations on the continent. While most arboviral infections do not lead to neuroinvasive diseases of the central nervous system, neurologic diseases caused by arboviruses include flaccid paralysis, meningitis, encephalitis, myelitis, encephalomyelitis, neuritis, and post-infectious autoimmune or memory disorders. Here we review endemic members of the Flaviviridae and Togaviridae families that cause neurologic infections, their neuropathogenesis and host neuroimmunological responses in Africa. We also discuss the potential for neuroimmune responses to aide in the development of new diagnostics and therapeutics, and current knowledge gaps to be addressed by arbovirus research.

Post CO VID-19 Encephalopathy Treatment

Aim. To evaluate the severity of encephalopathy and the efficacy of the second stage of rehabilitation in patients with post-infectious encephalopathy. Material and methods. The study included 92 patients with post-infectious encephalopathy, who underwent the second stage of rehabilitation after СOVID-19 infection. All patients were divided into 2 groups: those, who were referred to rehabilitation after the end of the treatment (n=54) and those, who refused to undergo rehabilitation (n=38). In all cases the severity of coronavirus infection, percentage of pulmonary involvement (based on chest CT-findings) and the presence of comorbid pathology were assessed. The severity of the prevailing syndromes was assessed using the International Classification of Functioning, Disability and Health (ICF). Patient status dynamics was assessed using Rehabilitation routing scale (RRS), Rivermead, Holden and Hauser scales. Results and discussion. Post-infectious encephalopathy was mainly accompanied by vestibular ataxia syndrome in 51 (55.4%) patients (in 51.9% and 60.5% patients in groups 1 and 2, respectively) and cerebro-asthenic syndrome in 73 (79.3%) patients (in 72.2% and 89.5% patients in groups 1 and 2, respectively). Comprehensive rehabilitation process is characterized by staging aimed at compensating for all components of pathogenesis that affected during the period of severe course of COVID-19 infection. Rehabilitation was an effective measure for the compensation of neurologic complications of COVID-19 infection. After 2 weeks, cerebro-asthenic syndrome was observed in 24.1% patients in group 1 and 71.0% in group 2 (p <0.05), vestibular ataxia syndrome – in 18.5% and 28.9% (p<0.05) of patients in groups 1 and 2, respectively. The current pandemic is highly likely to be accompanied by a significant increase in the prevalence of encephalopathy affecting the ability to return to daily functioning. Conclusion. The main manifestations of post-covid encephalopathy are cerebro-asthenic (79.3%) and vestibular ataxia (55.4%) syndromes. Therapeutic and rehabilitation measures carried out at the 2nd stage of rehabilitation is an effective measure to compensate for the severity of post-covid encephalopathy.

Post-infectious irritable bowel syndrome: renaissance time?

Postinfectious irritable bowel syndrome (PI–IBS) is a distinct phenotype of the disease. The occurrence of gastrointestinal symptoms in PI–IBS is in direct chronological connection with an episode of acute intestinal infection. Previously the problem was considered as the outcome of parasitic, protozoal or bacterial infection. The global spread of a novel coronavirus infection (COVID-19) and increase in the number of new cases of IBS in the population suggests a renaissance of PI–IBS and makes us look at this problem again. This article summarizes and presents modern information on the possible mechanisms of development of PI–IBS, including in persons who have undergone COVID-19.

Post-malaria neurological syndrome manifesting as new onset psychosis with generalized encephalopathy: an analysis of two cases in children

Post-malaria neurological syndrome(PMNS) is a rare heterogenous syndrome heralded by the appearance of new neurological or psychiatric manifestations emerging in the post-infectious phase after clearance of malaria parasitaemia. Most cases of PMNS have been described in adults. Only seven cases have been reported in children. We describe two further cases of possible PMNS who presented with prominent psychiatric manifestations evolving into generalized encephalopathy after complete recovery from malaria. Both patients were treated with antivirals and antibiotics without clinical improvement. One patient received pulse corticosteroids and had a remarkable and rapid clinical improvement. The other recovered without specific treatment.

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

Children have been described to show neurological symptoms in acute coronavirus disease 2019 (COVID-19) and multisystemic inflammatory syndrome in children (MIS-C). We present a 2-year-old boy's clinical course of unilateral acute sixth nerve palsy in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Onset of the palsy in the otherwise healthy boy occurred seven days after symptoms attributed to acute infection had subsided respectively 3 weeks after onset of respiratory symptoms. SARS-CoV-2 specific IgG was detected in serum as well as in cerebrospinal fluid. The patient showed a prolonged but self-limiting course with a full recovery after three and a half months. This case illustrates in a detailed chronological sequence that sixth cranial nerve involvement may occur as post-infectious, self-limiting complication of pediatric SARS-CoV-2-infection thus expanding the neurological spectrum of symptoms for children with COVID-19. Clinicians should be aware of the possibility of post-infectious sixth nerve palsy related to SARS-CoV-2-infection particularly in view of recent respiratory tract infection or confirmed cases of SARS-CoV-2-infection amongst the patient's close contacts.

Overview on Acute Poststreptococcal Glomerulonephritis in Pediatrics: A Review

Acute poststreptococcal glomerulonephritis (APSGN) is the most common kind of post-infectious glomerulonephritis and is caused by group A streptococcus (Streptococcus pyogenes). Although the prevalence of PSGN has decreased in affluent nations, non-streptococcal species are becoming more common. and it is still the major cause of glomerulonephritis in children. APSGN can manifest itself in epidemic outbreaks or clusters of instances, as well as in single persons. Epidemic outbreaks have previously been documented as a result of upper respiratory or cutaneous streptococcal infections in various parts of the world. In developed nations, APSGN is now mostly a disease of the elderly, who are more likely to have disabling illnesses such as cancer, alcoholism, or diabetes. Children between the ages of 3 and 12 (with a peak incidence between the ages of 5 and 6 years) and seniors over the age of 60 are the most commonly affected. The pathophysiology of APSGN is complicated by inflammation. (APSGN) often occurs one to two weeks after a throat infection and three to five weeks after a skin infection. Hematuria, edoema, azotemia, and hypertension are the most common clinical signs. Loop or thiazide diuretics, are the most effective therapy for hypertension and edoema in PSGN. In this review we’ll be looking at the disease causes, epidemiology, presentation and treatment.