Asunto(s)
Levofloxacino , Infecciones por Pseudomonas , Humanos , Levofloxacino/farmacología , Ciprofloxacina/farmacología , Pseudomonas aeruginosa/genética , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Fluoroquinolonas/farmacología , Infecciones por Pseudomonas/tratamiento farmacológico , Pruebas de Sensibilidad MicrobianaRESUMEN
Se presenta el caso de un paciente varón de 19 años que desarrolla una poliartritis simétrica distal que se diagnosticó como artritis reactiva atípica por infección por SARS-CoV-2 tras descartar otras causas de artritis.(AU)
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.(AU)
Asunto(s)
Humanos , Masculino , Adulto Joven , Artritis Reactiva , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Infecciones por Coronavirus/epidemiología , Betacoronavirus , Pacientes Internos , Examen Físico , Evaluación de Síntomas , Anamnesis , Artritis , Reumatología , Enfermedades Autoinmunes , Enfermedades ReumáticasRESUMEN
BACKGROUND: In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structural heart disease and valve abnormalities. OBJECTIVE: To determine the diagnostic accuracy of POCUS for the detection of signs suggestive of IE, including vegetation, valvular regurgitation, structural heart disease, hepatomegaly, splenomegaly and septic embolisms, in patients with bacteremia or candidemia. DESIGN: Observational, cross-sectional, multicenter study using convenience sampling. SETTING: Six Spanish academic hospitals. PATIENTS: Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. MEASUREMENTS: The reference test, to evaluate vegetation, valvular regurgitation and structural heart disease, was transesophageal echocardiography (TEE). For patients who did not undergo TEE, transthoracic echocardiography (TTE) was considered the reference test. POCUS was performed by internists, while conventional echocardiography procedures were performed by cardiologists. RESULTS: In 258 patients, for the detection of valvular vegetation, POCUS had sensitivity, specificity, and positive and negative predictive values of 77%, 94%, 82% and 92%, respectively. For valvular regurgitation (more than mild), sensitivity was ≥76% and specificity ≥85%. Sensitivity values for the detection of hepatomegaly and splenomegaly were 92% and 92%, respectively, while those for specificity were 96% and 98%. CONCLUSION: POCUS could be a valuable tool, as a complement to physical examination, at the hospital bedside for patients with bacteremia or candidemia, helping to identify signs suggestive of IE.
RESUMEN
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.
Asunto(s)
Artritis Reactiva , COVID-19 , Adulto , Artritis Reactiva/diagnóstico , Artritis Reactiva/etiología , COVID-19/complicaciones , Humanos , Masculino , SARS-CoV-2 , Adulto JovenRESUMEN
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.