RESUMEN
OBJECTIVE: To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital. METHODS: Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test. RESULTS: We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis. CONCLUSIONS: CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.
Asunto(s)
COVID-19 , Infecciones por Citomegalovirus , Humanos , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/epidemiología , Citomegalovirus/genética , Prevalencia , COVID-19/epidemiología , Hospitales GeneralesRESUMEN
Os autores apresentam dois casos de blastomicose sul-americana com localizacao ossea isolada. Num caso, a lesao era no colo do femur e, no outro, localizada no terco proximal e diafise de 2o. metatarsiano.Foram estuados historia clinica, diagnostico diagnostico diferencial e tratamento em todos os seus aspectos. Os resultados obtidos com o tratamento cirurgico e medicamentoso foram bons, igualando-se aos ja citados na literatura atual
