- Prospective evaluation of accuracy and clinical utility of the Dual Path Platform (DPP) assay for the point-of-care diagnosis of leptospirosis in hospitalized patients. [Journal Article]
- PNPLoS Negl Trop Dis 2018 Feb 20; 12(2):e0006285
- Early detection of leptospirosis with field-ready diagnostics may improve clinical management and mitigate outbreaks. We previously validated the point-of-care Dual Path Platform (DPP) for leptospiro...
Early detection of leptospirosis with field-ready diagnostics may improve clinical management and mitigate outbreaks. We previously validated the point-of-care Dual Path Platform (DPP) for leptospirosis with sera in the laboratory. This prospective study compares the diagnostic accuracy and clinical utility of the DPP using finger stick blood (FSB) against the serum DPP, venous whole blood (VWB) DPP, IgM-ELISA, and clinical impression. We sequentially enrolled 98 patients hospitalized for acute febrile illnesses, of which we confirmed 32 by leptospirosis reference tests. Among syndromes consistent with classic leptospirosis, the FSB DPP showed similar sensitivity and specificity (Se 93% and Sp 80%), and positive and negative predictive values (PPV 74% and NPV 95%), to VWB DPP (Se 96%, Sp 75%, PPV 68%, and NPV 97%), serum DPP (Se 85%, Sp 87%, PPV 79%, and NPV 91%) and IgM-ELISA (Se 81%, Sp 100%, PPV 100%, and NPV 90%). The FSB DPP provided a favorable likelihood ratio profile (positive LR 4.73, negative LR 0.09) in comparison to other assays and clinical impression alone. Additionally, we identified four of five leptospirosis-associated meningitis patients by whole blood DPP, none of which clinicians suspected. This demonstrates potential for the DPP in routine detection of this less common syndrome. The FSB DPP demonstrated similar discrimination for severe human leptospirosis compared with serum assays, and it is a simpler option for diagnosing leptospirosis. Its performance in other epidemiological settings and geographic regions, and for detecting atypical presentations, demands further evaluation.
- Group A Streptococcal Brain Abscess in The Pediatric Population - Case Series and Review of The Literature. [Journal Article]
- PIPediatr Infect Dis J 2018 Feb 16
- Group A Streptococcus (GAS) is a rare cause of central nervous system infections. We describe 3 new cases of GAS brain abscess in previously healthy children treated by us between 2015-2016 and revie...
Group A Streptococcus (GAS) is a rare cause of central nervous system infections. We describe 3 new cases of GAS brain abscess in previously healthy children treated by us between 2015-2016 and review the 5 cases reported in the literature since 1988. All 8 children received early empiric antibiotic therapy and surgical intervention, and 5 made a full recovery. GAS brain abscess is a rare infection; however its incidence may be rising. We suggest that if patients show symptoms such as fever, vomiting, and lethargy, with contiguous infection such as otitis media, mastoiditis, sinusitis, or meningitis, GAS brain abscess should be suspected. Prognosis is expected to be good with early implementation of appropriate treatment.
- Utility of the Performance of Lumbar Puncture for Febrile Children with Status Epilepticus in the Bacterial Conjugate Vaccine Era. [Journal Article]
- PIPediatr Infect Dis J 2018 Feb 15
- CONCLUSIONS: Routine lumbar puncture for the differentiation of severe CNS infection cannot be recommended in children with FSE.
- ['Masks' of acute neuroinfections and markers of differencial diagnosis]. [Journal Article]
- ZNZh Nevrol Psikhiatr Im S S Korsakova 2018; 118(1):82-91
- CONCLUSIONS: The misdiagnosis can be explained by the overestimation of such symptoms as the acute (in most cases) onset of the disease with increased body temperature to febrile levels, presence of meningeal syndrome, disorders of consciousness and focal symptoms of varying severity. The authors showed the errors and difficulties in the diagnosis, the role and importance of an integrated, interdisciplinary approach taking into account history, clinical data, results of CSF study, conventional and special methods of laboratory and instrumental examination of patients.
- Advances in measuring influenza burden of disease. [Editorial]
- IOInfluenza Other Respir Viruses 2018; 12(1):3-9
- The Glutaredoxin Gene,grxB, Affects Acid Tolerance, Surface Hydrophobicity, Auto-Aggregation, and Biofilm Formation inCronobacter sakazakii. [Journal Article]
- FMFront Microbiol 2018; 9:133
- Cronobacterspecies are foodborne pathogens that can cause neonatal meningitis, necrotizing enterocolitis, and sepsis; they have unusual abilities to survive in environmental stres...
Cronobacterspecies are foodborne pathogens that can cause neonatal meningitis, necrotizing enterocolitis, and sepsis; they have unusual abilities to survive in environmental stresses such as acid stress. However, the factors involved in acid stress responses and biofilm formation inCronobacterspecies are poorly understood. In this study, we investigated the role ofgrxBon cellular morphology, acid tolerance, surface hydrophobicity, auto-aggregation (AAg), motility, and biofilm formation inCronobacter sakazakii. The deletion ofgrxBdecreased resistance to acid stresses, and notably led to weaker surface hydrophobicity, AAg, and biofilm formation under normal and acid stress conditions, compared with those of the wild type strain; however, motility was unaffected. Therefore,grxBappears to contribute to the survival ofC. sakazakiiin acid stresses and biofilm formation. This is the first report to provide valuable evidence for the role ofgrxBin acid stress responses and biofilm formation inC. sakazakii.
- Does Toxoplasma gondii infection impact liver transplantation outcomes? A systematic review. [Journal Article]
- JMJ Med Microbiol 2018 Feb 12
- CONCLUSIONS: Although we review Toxoplasma infection and liver transplantation cases, problems associated with the parasite may be greater than identified. Hence, follow-up studies on Toxoplasma infection in liver transplantation patients are recommended.
- Association between TLR2 + 2477G/A polymorphism and bacterial meningitis: a meta-analysis. [Journal Article]
- EIEpidemiol Infect 2018 Feb 19; :1-6
- Toll-like receptor 2 (TLR2) is a key member of TLRs, which is crucial in the initial inflammatory response against bacteria. TLR2, is also the initial barrier against bacterial infection and plays an...
Toll-like receptor 2 (TLR2) is a key member of TLRs, which is crucial in the initial inflammatory response against bacteria. TLR2, is also the initial barrier against bacterial infection and plays an important role in recognising a variety of bacterial lipoproteins. Several studies have been performed to investigate the TLR2 + 2477G/A polymorphism and bacterial meningitis susceptibility. Unfortunately, the results of previous studies were controversial. Therefore, we performed a meta-analysis to derive a more precise estimation of the association. The association between the TLR2 + 2477G/A polymorphism and bacterial meningitis susceptibility was assessed by odds ratios together with their 95% confidence intervals (CI). Six studies were enrolled in the present meta-analysis. Overall, no significant association between TLR2 + 2477G/A polymorphism and bacterial meningitis risk were found under allele contrast (A vs. G: OR = 1.15, 95% CI = 0.93-1.43, P = 0.202), recessive genetic model (AA vs.
- Progressive Depigmentation in a Patient with Panuveitis and Meningitis. [Journal Article]
- SASkin Appendage Disord 2018; 4(1):12-14
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- Endoscopic Endo-Nasal Trans-Sphenoidal Excision of Pituitary Tumors: An Institutional Experience. [Journal Article]
- IJIndian J Otolaryngol Head Neck Surg 2018; 70(1):98-101
- To analyze the clinical presentation, management and outcomes of patients with pituitary adenoma treated by Endoscopic Endo-nasal Trans-sphenoidal (EETS) excision. Study was conducted on the basis of...
To analyze the clinical presentation, management and outcomes of patients with pituitary adenoma treated by Endoscopic Endo-nasal Trans-sphenoidal (EETS) excision. Study was conducted on the basis of medical records of 14 patients who had undergone EETS excision of pituitary adenomas. The data obtained was assessed for demographic and clinical characteristics, radiographic features and post-operative outcomes. Study included 10 males and 4 females. Mean age of patients was 46.43 years (range 16-70 Years). Most common presentation was diminished vision reported in 79% patients. Features of acromegaly encountered in 21% cases. Location of majority of tumors was sellar with supra-sellar extension (71%) followed by sellar (14%), sellar with para-sellar extension (7%) and sellar with supra-sellar and para-sellar extensions (7%). Total tumor resection was achieved in 64% cases and sub-total resection in 36% cases. One of the lesions on biopsy revealed granulomatous pathology. No post-operative complication was seen in 71% patients. Transient Diabetes Insipidus was observed in 21% cases that resolved within 3-4 days. One patient expired due to meningitis and septicemia. One patient had CSF leak that was effectively managed by placing lumbar drain. There was significant improvement in visual symptoms and hormonal levels. Average hospital stay was 13.54 days and mean follow up period was 13 months. EETS approach is safe, minimally invasive and effective surgical technique for resection of pituitary adenomas with low post-operative morbidity, reduced hospital stay and better remission of symptoms.