[First case of COVID-19 treated with tocilizumab in Iceland]. / Fyrsta meðferð með tocilizumab við COVID-19 hérlendis - sjúkratilfelli

A gentleman in his early fifties became ill with flu-like symptoms after vacationing abroad and was diagnosed with COVID-19 after returning to Iceland. A few days later he was admitted to the University Hospital, Landspitali, due to worsening respiratory symptoms and severe fatigue. A computed tomography scan of lthe lungs showed diffuse bilateral consolidations and ground glass changes. He developed respiratory failure and was transferred to the intensive care unit where he received further treatment, including tocilizumab (IL-6 receptor inhibitor). He subsequently showed clinical improvement and did not require endotracheal intubation.

[Melioidosis, first four cases in Iceland]. / Melioidosis á Íslandi, fyrstu fjögur tilfelli.

We report the first four cases of Melioidosis treated in Iceland and review the literature. Melioidosis is caused by the saprophytic Gram negative bacteria Burkholderia pseudomallei. Most disease occurs in residents of Southeast-Asia and North-Australia. The most common presentation of Melioidosis is pneumonia but as these cases demonstrate the infection has protean manifestations and B. pseudomallei can infect nearly every organ. It is important to notify the laboratory of the possibilty of Melioidosis as the bacteria can be difficult to identify and poses an infection risk to laboratory staff. Also, B. pseudomallei is resistant to many of the antibiotics normally used to treat pneumonia and due to its intracellular persistance requires prolonged therapy.