febrile episodes
Recently Published Documents


TOTAL DOCUMENTS

300
(FIVE YEARS 48)

H-INDEX

37
(FIVE YEARS 1)

2022 ◽  
pp. 107815522210740
Author(s):  
Dr. Arul Janani ◽  
Dr. Anandkumar Shruthilaya ◽  
Dr. Jayaraman Dhaarani ◽  
Dr. Scott X Julius

Introduction: Febrile episodes in oncology is common are mostly of infectious etiology requiring repeated investigations and escalation of antibiotics. But, drug induced fever occur more often than we think in oncological set-up. Case Report: A 5 year old male child with rhabdomyosarcoma, developed high grade fever spikes following Vincristine monotherapy. Infective etiology work up was negative and the fever responded to corticosteroids. Management and Outcome: He was treated with corticosteroids as premedication considering vincristine induced fever. The further courses of VCR- monotherapy were uneventful with steroids as premedication. Discussion: We present the case of vincristine induced fever in a child with embryonal rhabdomyosarcoma. Clinician’s should consider drug induced fever at appropriate conditions, to avoid leading to antibiotic resistance.


2021 ◽  
Vol 12 ◽  
Author(s):  
Raffaella Pisapia ◽  
Nicolina Capoluongo ◽  
Giulia Palmiero ◽  
Carlo Tascini ◽  
Carolina Rescigno

Mutations in the ATP1A3 gene encoding the α3 subunit of Na+/K+-ATPase are associated with different neurological manifestations that may be elicited by febrile episodes. A recently described phenotype, linked to the p.Arg756Cys mutation, is clinically characterized by Relapsing Encephalopathy with Cerebellar Ataxia (RECA). In our case, a diagnosis of RECA has been established, and despite an alternative, reasonable cause had been already identified.We describe the case of a child with two recurrent episodes, 2 years apart, of hypotonia and ataxia. In both episodes, a laboratory-confirmed influenza virus infection suggested the diagnosis of influenza-associated encephalopathy. After the second episode, a search for genetic mutations was performed, and ATP1A3 mutation associated to RECA was found. After both episodes, the child was discharged after partial improvement of neurological conditions.The diagnosis of encephalopathy in children is often challenging. A genetic predisposition to neurological decompensation should be suspected in case of recurrent episodes, even if an alternative diagnosis has been established. Indeed, febrile infections may only represent the trigger of neurological involvement. In these patients, the knowledge of a genetic predisposing factors may help in the prevention of neurological episodes by the prompt use of anti-pyrectics and preventive measures as appropriate vaccination.


Author(s):  
Sandeep Suresh Sattur ◽  
Indu Sandeep Sattur

AbstractWith a practice dedicated to hair restoration and hair loss management, the authors have seen a large number of patients presenting with increased hair fall in the last 18 months. Hair fall after a stressfull event such as infections with febrile episodes is known. However, the latent period between the infective episode and hair fall has been shorter after COVID-19 infection than before. This review attempts to look at various pathways responsible for hair fall and if this differs from the conventional hair fall seen after any infection. It also tries to understand if the infection with the SARS-CoV-2 virus has a direct impact on the hair follicle leading to hair fall.


2021 ◽  
Vol 9 ◽  
Author(s):  
Qingyun Kang ◽  
Liming Yang ◽  
Hongmei Liao ◽  
Sai Yang ◽  
Haiyang Yang ◽  
...  

Background:SLC13A3 gene encodes the Na+/dicarboxylate cotransporter 3 (NaDC3), which locates on the plasma membrane and is mainly expressed in kidney, astrocytes and the choroid plexus. It imports four to six carbon dicarboxylates together with three Na+ ions into the cytosol. Nowadays, pathogenic variants of SLC13A3 gene were found to cause acute reversible leukoencephalopathy and α-ketoglutarate accumulation (ARLIAK) in patients. Here, we report two novel SLC13A3 variants c.185C>T (p.T62M) and c.331C>T (p.R111*) identified in a Chinese patient with ARLIAK.Case Presentation: The patient was a Chinese girl aged 13 years and 7 months old, who had acute, recurrent neurological deterioration during two febrile episodes. She presented with reversible leukoencephalopathy and increased urinary excretion of α-ketoglutarate. Genetic studies revealed compound heterozygous variants (c.185C>T, p.T62M, and c.331C>T, p.R111*) in SLC13A3, which had not been reported previously.Conclusions: These findings expand the variant spectrum of SLC13A3, providing the basis for the further study of this rare disease.


Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 190-195
Author(s):  
Niketa Shah ◽  
Lakshmanan Krishnamurti

Abstract In case 1, a 14-month-old male child with sickle cell disease (SCD) was referred for evaluation for an allogeneic hematopoietic stem cell transplant (HCT). The patient had a history of dactylitis 3 times in his first year of life and febrile episodes twice at the consult. His 4-year-old sister was found to be human leukocyte antigen (HLA) identical. The patient was started on hydroxyurea (HU) at 2.5 years of age. His parents again sought consultation when he was 5 years old because of concerns about his medical condition. At the time, the patient had experienced 2 vaso-occlusive pain episodes (VOEs) requiring hospitalization during the previous 2 years. He had also experienced intermittent pain crises requiring rest at home for 2 to 3 days. The child has not attended school in person due to the COVID-19 pandemic. The family is considering HCT but is ambivalent about it because of potential toxicity. In case 2, an 8-year-old female child is 3 years out from HCT for SCD from her HLA-identical sibling. Before HCT, despite receiving HU, she had experienced >5 VOEs requiring hospitalization and 2 episodes of acute chest syndromes in the previous 3 years. She had also been missing almost 50 days of school days each year. After HCT, she is now attending school regularly and participating in all normal age-appropriate activities. The parents believe that HCT has been transformative in their child's life.


Author(s):  
Nicoletta Abram ◽  
Valentina Baretta ◽  
Federico Mercolini ◽  
Massimiliano De Bortoli ◽  
Matteo Chinello ◽  
...  

Abstract Objective Preparations with high-titer immunoglobulin-M (HT-IgM) have been used to treat neonatal and adult sepsis as adjuvant to antibiotics. Limited data are available of this use in pediatric oncohematological patients. We retrospectively assessed the characteristics and outcome of febrile episodes treated with broad-spectrum antibiotics and HT-IgM. Methods The study included febrile episodes diagnosed after chemotherapy or hematopoietic stem cell transplantation (HSCT) treated with antibiotics and HT-IgM. Study period was from January 2011 to March 2019. Results Seventy febrile episodes in 63 patients were eligible. In 40% of episodes (n = 28), blood cultures identified a causative organism: Gram-negative (n = 15), Gram-positive (n = 8), polybacterial (n = 4), fungi (n = 1). Twenty-six percent of Gram-negatives were extend spectrum β-lactamase (ESBL)-producers. In 44% of episodes, a deep-organ localization was present, mostly pulmonary. Severe or profound neutropenia, hypotension, and hypoxemia were present in 89, 26, and 21% of episodes, respectively; 20% of episodes required intensive care and 20% of episodes required the use of inotropes. Overall, 90-day mortality was 13% and infection-attributable mortality resulted 8.6%. More than half of the patients received HT-IgM within 24 hours from fever onset. HT-IgM-related allergic reactions occurred in three episodes. Risk factors for 90-day mortality were as follows: hypotension and hypoxemia at fever presentation, admission to intensive care unit (ICU), use of inotropes, presence of deep-organ infection, and escalation of antibiotic therapy within 5 days. Conclusion The combination of broad-spectrum antibiotics and HT-IgM was feasible, tolerated, and promising, being associated with a limited infectious mortality. Further prospective controlled studies are needed to assess the efficacy of this combination over a standard antibiotic approach.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alejandro Garcia-Ruiz de Morales ◽  
Covadonga Morcate ◽  
Elena Isaba-Ares ◽  
Ramon Perez-Tanoira ◽  
Jose A. Perez-Molina

Abstract Background The study aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain. Methods Observational retrospective study that consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR). Results Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by Plasmodium falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs. 65%), were older (34 vs. 24 years), sought medical attention earlier (17d vs. 32d), had a greater number of previous malaria episodes (74% vs. 60%), lower levels of platelets (110,500µL vs. 250,000µL), and higher of bilirubin (0.6 mg/dL vs. 0.5 mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusions Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitic infection. Prompt diagnosis is crucial to avoid severe cases and deaths.


Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1086
Author(s):  
Federica Cennamo ◽  
Riccardo Masetti ◽  
Prisca Largo ◽  
Alberto Argentiero ◽  
Andrea Pession ◽  
...  

Febrile neutropenia (FN) is a common complication of chemotherapy in oncological children and one of the most important causes of morbidity and mortality in these patients. The early detection of a bacteremia and the rapid therapeutic intervention are crucial to improve the outcome. We analyzed the literature in order to clarify the epidemiology of FN in children undergoing chemotherapy, the specific factors associated with a negative outcome, the most common etiology, and the value of biological markers as a tool to make an early diagnosis or to monitor the evolution of the infection. Several studies have tried to identify specific factors that could help the clinician in the detection of an infection and in its microbiological identification. However, due to the heterogenicity of the available studies, sufficient evidence is lacking to establish the role of these risk factors in clinical practice and future research on this topic appear mandatory. Determinations of risk factors, etiology, and markers of febrile episodes in these patients are complicated by the characteristics of the underlying illness and the effects of treatments received. Although some studies have tried to develop an evidence-based guideline for the empiric management of FN in pediatrics, validated predictive scores and algorithms are still lacking and urgently needed.


2021 ◽  
Vol 47 (4) ◽  
pp. 1338-1351
Author(s):  
David O. Nyakundi ◽  
Aileen Boshoff

Malaria remains a global health burden accounting for many deaths and illnesses in sub-Saharan Africa notwithstanding many decades of research on the disease. P. falciparum, the causative agent of the most fatal form of malaria, expresses a repertoire of heat shock proteins (Hsp) that cushion the parasite against heat shocks as it shuttles between extreme temperatures in human and mosquito vector hosts. By so doing, such proteins promote parasite’s cytoprotection, survival and pathogenesis. Heat shock proteins are named according to their molecular weights and there are six P. falciparum Hsp70 (PfHsp70) found in various cell compartments with mitochondrial putative PfHsp70-3. Using indirect immunofluorescence, this study established mitochondrial localization of PfHsp70-3 though some more confirmatory studies would be needed in the future. PfHsp70-3 was found to be heat inducible and expressed during all stages of the intra-erythrocytic cycle of parasite development. This could be an indication of PfHsp70-3’s involvement in the infectivity process of P. falciparum by helping the parasite to resist heat shocks during malaria febrile episodes. Generally, the data obtained in this study will enhance the existing knowledge on the biology of P. falciparum mitochondrial heat shock protein functions and open possible avenues for targeting the specificity between PfHsp70-3 and its co-chaperones for drug development. Keywords: Malaria, P. falciparum, Heat shock proteins, PfHsp70-3, pathogenesis


2021 ◽  
pp. 20-22
Author(s):  
M. M. Kaabak ◽  
N. N. Rappoport ◽  
Yu. N. Vyunkova ◽  
Yu. B. Shepetun ◽  
A. G. Trofimova ◽  
...  

Current COVID-19 pandemic demands improvements in antiviral prophylaxis. Tyloron, as biological interferon activator, has been synthesized in the 70th of previous century. We used Tyloron in 60 patients – relatives and partners living together with solid organ transplant recipients – in autumn 2020, during second wave of the SARS-CoV‑2 pandemic. Results were compared with 60 patients used other means of antiviral prophylaxis. In patients taking Tyloron the number of febrile episodes was significantly lower (р < 0.02).


Sign in / Sign up

Export Citation Format

Share Document