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1.
BMC Infect Dis ; 21(1): 341, 2021 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-33845787

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that rapidly spreads worldwide and co-infection of COVID-19 and influenza may occur in some cases. We aimed to describe clinical features and outcomes of severe COVID-19 patients with co-infection of influenza virus. METHODS: Retrospective cohort study was performed and a total of 140 patients with severe COVID-19 were enrolled in designated wards of Sino-French New City Branch of Tongji Hospital between Feb 8th and March 15th in Wuhan city, Hubei province, China. The demographic, clinical features, laboratory indices, treatment and outcomes of these patients were collected. RESULTS: Of 140 severe COVID-19 hospitalized patients, including 73 patients (52.14%) with median age 62 years were influenza virus IgM-positive and 67 patients (47.86%) with median age 66 years were influenza virus IgM-negative. 76 (54.4%) of severe COVID-19 patients were males. Chronic comorbidities consisting mainly of hypertension (45.3%), diabetes (15.8%), chronic respiratory disease (7.2%), cardiovascular disease (5.8%), malignancy (4.3%) and chronic kidney disease (2.2%). Clinical features, including fever (≥38 °C), chill, cough, chest pain, dyspnea, diarrhea and fatigue or myalgia were collected. Fatigue or myalgia was less found in COVID-19 patients with IgM-positive (33.3% vs 50/7%, P = 0.0375). Higher proportion of prolonged activated partial thromboplastin time (APTT) > 42 s was observed in COVID-19 patients with influenza virus IgM-negative (43.8% vs 23.6%, P = 0.0127). Severe COVID-19 Patients with influenza virus IgM positive have a higher cumulative survivor rate than that of patients with influenza virus IgM negative (Log-rank P = 0.0308). Considering age is a potential confounding variable, difference in age was adjusted between different influenza virus IgM status groups, the HR was 0.29 (95% CI, 0.081-1.100). Similarly, difference in gender was adjusted as above, the HR was 0.262 (95% CI, 0.072-0.952) in the COX regression model. CONCLUSIONS: Influenza virus IgM positive may be associated with decreasing in-hospital death.


Asunto(s)
/complicaciones , Mortalidad Hospitalaria , Gripe Humana/complicaciones , Adulto , Anciano , Anticuerpos Antivirales/sangre , China , Coinfección/virología , Comorbilidad , Femenino , Humanos , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
2.
Arch. argent. pediatr ; 119(2): e142-e148, abril 2021. tab, ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1152045

RESUMEN

La gripe se asocia al aparato respiratorio, especialmente en invierno, y puede causar complicaciones neurológicas. Se evaluó a pacientes pediátricos con manifestaciones neurológicas graves por gripe desde septiembre de 2018 hasta febrero de 2019 para determinar características clínicas, neuroimagenología, tratamiento y resultados. El objetivo fue evaluar la encefalitis asociada a la gripe y destacar diferentes manifestaciones neurológicas y cambios de neuroimagenología. El estudio incluyó a 13 pacientes. Los síntomas neurológicos ocurrieron tras los síntomas típicos de la gripe. Los cambios de neuroimagenología incluyen alteraciones de señal de la sustancia blanca cortical y subcortical, edema localizado o generalizado y lesiones multifocales simétricas bilaterales en el tálamo y la médula del cerebelo. Las opciones terapéuticas incluyen metilprednisolona en inyección intravenosa, inmunoglobulina intravenosa, plasmaféresis y oseltamivir. Es fundamental considerar la encefalitis asociada a la gripe en pacientes con convulsiones, la encefalopatía con hallazgos radiológicos compatibles, e iniciar el tratamiento lo antes posible


Influenza is mostly associated with the respiratory tract system, especially in the winter season. Various neurological complications could occur due to influenza infection. Pediatric patients who had severe neurological manifestations due to influenza infection from September 2018 to February 2019 were evaluated for clinical characteristics, neuroimaging studies, treatment, and outcome. We aimed to assess Influenza-associated encephalitis in children, emphasize different neurological manifestations and neuroimaging changes. Thirteen patients were included in the study. Neurological symptoms occurred after flu-like symptoms. Neuroimaging changes of influenza-associated encephalitis/encephalopathy include cortical and subcortical white matter signal alterations, localized or generalized edema, and bilateral symmetrical multifocal lesions on the thalamus and cerebellar medulla. Pulse methylprednisolone, intravenous immunoglobulin, plasma exchange, and oseltamivir are the therapy choices. It is essential to consider influenza-associated encephalitis in patients with seizures, encephalopathy with supporting radiological findings, especially during the influenza season and starting treatment as fast as possible for better outcomes.


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Encefalopatías/diagnóstico por imagen , Encefalitis/diagnóstico por imagen , Gripe Humana/complicaciones , Turquia/epidemiología , Encefalopatías/terapia , Encefalitis/terapia , Neuroimagen , Manifestaciones Neurológicas
3.
Dtsch Med Wochenschr ; 146(7): 455-460, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33780991

RESUMEN

Invasive fungal infections are gaining increasing importance in intensive care medicine. The aim of this article is to present an update on recent developments in the field of invasive fungal infection in critically ill patients. Particular emphasis is placed on the recently described invasive mold infections in patients with acute respiratory distress syndrome due to influenza or COVID-19. Detecting high-risk patients and the optimal diagnostic and therapeutic strategies play a decisive role to improve outcome.


Asunto(s)
/complicaciones , Gripe Humana/complicaciones , Infecciones Fúngicas Invasoras/epidemiología , /complicaciones , Biomarcadores , Candidiasis Invasiva/diagnóstico , Candidiasis Invasiva/epidemiología , Candidiasis Invasiva/terapia , Humanos , Incidencia , Gripe Humana/epidemiología , Unidades de Cuidados Intensivos , Infecciones Fúngicas Invasoras/diagnóstico , Infecciones Fúngicas Invasoras/terapia , Aspergilosis Pulmonar Invasiva/complicaciones , Aspergilosis Pulmonar Invasiva/diagnóstico , Aspergilosis Pulmonar Invasiva/epidemiología , Aspergilosis Pulmonar Invasiva/terapia , /etiología
5.
PLoS One ; 16(2): e0247605, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33635872

RESUMEN

Neutrophils participate in the early phase of the innate response to uncomplicated influenza A virus (IAV) infection but also are a major component in later stages of severe IAV or COVID 19 infection where neutrophil extracellular traps (NETs) and associated cell free histones are highly pro-inflammatory. It is likely that IAV interacts with histones during infection. We show that histone H4 binds to IAV and aggregates viral particles. In addition, histone H4 markedly potentiates IAV induced neutrophil respiratory burst responses. Prior studies have shown reactive oxidants to be detrimental during severe IAV infection. C reactive protein (CRP) and surfactant protein D (SP-D) rise during IAV infection. We now show that both of these innate immune proteins bind to histone H4 and significantly down regulate respiratory burst and other responses to histone H4. Isolated constructs composed only of the neck and carbohydrate recognition domain of SP-D also bind to histone H4 and partially limit neutrophil responses to it. These studies indicate that complexes formed of histones and IAV are a potent neutrophil activating stimulus. This finding could account for excess inflammation during IAV or other severe viral infections. The ability of CRP and SP-D to bind to histone H4 may be part of a protective response against excessive inflammation in vivo.


Asunto(s)
Proteína C-Reactiva/inmunología , Histonas/inmunología , Virus de la Influenza A/inmunología , Gripe Humana/inmunología , Neutrófilos/inmunología , Proteína D Asociada a Surfactante Pulmonar/inmunología , Células Cultivadas , Humanos , Inmunidad Innata , Inflamación/etiología , Inflamación/inmunología , Subtipo H1N1 del Virus de la Influenza A/inmunología , Subtipo H3N2 del Virus de la Influenza A/inmunología , Gripe Humana/complicaciones
6.
JCI Insight ; 6(6)2021 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-33600379

RESUMEN

Regulatory T (Treg) cells orchestrate resolution and repair of acute lung inflammation and injury after viral pneumonia. Compared with younger patients, older individuals experience impaired recovery and worse clinical outcomes after severe viral infections, including influenza and SARS coronavirus 2 (SARS-CoV-2). Whether age is a key determinant of Treg cell prorepair function after lung injury remains unknown. Here, we showed that aging results in a cell-autonomous impairment of reparative Treg cell function after experimental influenza pneumonia. Transcriptional and DNA methylation profiling of sorted Treg cells provided insight into the mechanisms underlying their age-related dysfunction, with Treg cells from aged mice demonstrating both loss of reparative programs and gain of maladaptive programs. Strategies to restore youthful Treg cell functional programs could be leveraged as therapies to improve outcomes among older individuals with severe viral pneumonia.


Asunto(s)
Envejecimiento/fisiología , Virus de la Influenza A , Gripe Humana/patología , Pulmón/patología , Neumonía Viral/patología , Linfocitos T Reguladores/patología , Factores de Edad , Envejecimiento/metabolismo , Animales , /metabolismo , /virología , Humanos , Gripe Humana/complicaciones , Gripe Humana/metabolismo , Gripe Humana/virología , Pulmón/metabolismo , Ratones Endogámicos C57BL , Neumonía Viral/etiología , Neumonía Viral/metabolismo , Neumonía Viral/virología , Linfocitos T Reguladores/metabolismo
7.
Med Hypotheses ; 147: 110483, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33444904

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing the current pandemic of coronavirus disease 2019 (COVID-19) that have killed over one million people worldwide so far. To date, over forty million people have officially been identified to be infected with this virus with less than 3% death rate. Since many more people are expected to have been infected with this virus without the official diagnosis, the number of people who have recovered from the SARS-CoV-2 infection should be substantial. Given the large number of people recovered from either the mild SARS-CoV-2 infection or more severe COVID-19 conditions, it is critical to understand the long-term consequences of the infection by this virus. Our histological evaluations revealed that patients died of COVID-19 exhibited thickened pulmonary vascular walls, one important hallmark of pulmonary arterial hypertension (PAH). By contrast, such pulmonary vascular remodeling lesions were not found in patients died of SARS-CoV-1 during the 2002-2004 SARS outbreak or due to the infection by H1N1 influenza. The advancement in the treatment for the human immunodeficiency virus (HIV) infection has been remarkable that HIV-infected individuals now live for a long time, in turn revealing that these individuals become susceptible to developing PAH, a fatal condition. We herein hypothesize that SARS-CoV-2 is another virus that is capable to triggering the increased susceptibility of infected individuals to developing PAH in the future. Given the large number of people being infected with SARS-CoV-2 during this pandemic and that most people recover from severe, mild or asymptomatic conditions, it is imperative to generate scientific information on how the health of recovered individuals may be affected long-term. PAH is one lethal consequence that should be considered and needs to be monitored. This may also foster the research on developing therapeutic agents to prevent PAH, which has not so far been successful.


Asunto(s)
/complicaciones , Hipertensión Arterial Pulmonar/complicaciones , Animales , /virología , Comorbilidad , Brotes de Enfermedades , Susceptibilidad a Enfermedades , Endotelio Vascular/patología , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Pulmón/virología , Modelos Teóricos , Ucrania/epidemiología
9.
BMJ Case Rep ; 14(1)2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33414112

RESUMEN

Influenza A and B commonly cause benign respiratory disease in humans, but can cause more severe illness in high-risk populations. We report an unusual case of a previously healthy adult patient who presented with myositis and severe rhabdomyolysis secondary to influenza A infection that resulted in atraumatic compartment syndrome of all four extremities, each requiring emergent fasciotomy. The patient was subsequently managed with delayed primary closure and skin grafting in the operating room. Prompt recognition of this rare complication by the team resulted in no limb amputations. On his first follow-up appointment, 1 month after discharge, he had regained full functionality in both his hands and his feet were both close to 50% of baseline and improving with physical therapy.


Asunto(s)
Extremidades/patología , Gripe Humana/complicaciones , Miositis/complicaciones , Rabdomiólisis/complicaciones , Síndromes Compartimentales/etiología , Síndromes Compartimentales/cirugía , Extremidades/cirugía , Humanos , Virus de la Influenza A , Masculino , Persona de Mediana Edad , Miositis/virología , Rabdomiólisis/virología , Trasplante de Piel
10.
Adv Exp Med Biol ; 1324: 29-34, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33346902

RESUMEN

This paper presents a case of coinfection of influenza A virus (H1N1) and respiratory syncytial virus (RSV) in a male newborn. On the first day of life, the newborn required passive oxygen therapy, followed by respiratory support with nasal continuous positive airway pressure (nCPAP) due to respiratory insufficiency. As the newborn's respiratory effort was intensifying, he was intubated. In the second day of life, a nasopharyngeal swab was taken yielding the presence of H1N1 and RSV in the RT-PCR test. The child was isolated and given oseltamivir and empirical antibiotic therapy, which improved his condition. Other newborns who initially stayed with the sick child in the post-delivery room did not obtain oseltamivir prophylactically as their nasopharyngeal swabs were negative. The child's parents denied the occurrence of influenza-like symptoms within 14 days of delivery, which suggests a transplacental transmission of the child's infection or asymptomatic course of infection in the parents. In conclusion, this report confirms the possibility of viral coinfections in newborns, which points attention to considering a panel of respiratory viruses in the diagnostics. Symptoms of influenza in newborns may be atypical, including a fever-free course. Oseltamivir treatment in newborns with influenza seems an effective therapeutic measure.


Asunto(s)
Coinfección , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana , Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Infecciones del Sistema Respiratorio , Coinfección/diagnóstico , Coinfección/tratamiento farmacológico , Humanos , Lactante , Recién Nacido , Subtipo H1N1 del Virus de la Influenza A/genética , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/tratamiento farmacológico , Masculino , Infecciones por Virus Sincitial Respiratorio/complicaciones , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico
11.
J Med Virol ; 93(4): 2446-2452, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33368427

RESUMEN

We have evaluated flu vaccine coverage and variables associated with the lack of vaccination in cirrhotic subjects with particular attention to the cirrhosis etiology. Cirrhotic subjects consecutively referring to eight Italian centers were prospectively enrolled for a 6-month period in 2019. Subjects were asked if they had received a flu vaccine in the last 12 months. Multiple logistic regression analysis was performed to identify independent predictors of lack of vaccination. A total of 818 cases were recruited. The overall vaccine coverage was 39.6% (26.9% in those younger than 65 years and 51.9% in those older than 64 years; p < 0.001). Age < 65 years (odds ratio [OR] = 2.38; 95% confidence interval [CI] = 1.68-3.36), alcoholic etiology (OR = 2.40; 95% CI = 1.49-3.85), birth abroad (OR = 2.7; 95% CI = 1.10-6.61), and residence in South/Sardinia island (OR = 1.66; 95% CI = 1.14-2.42) all resulted independent predictors of the likelihood of lack of vaccination. The lack of information regarding the vaccine as the reason for no vaccination was reported by 71.4% of foreigners and by 34.7% of natives (p < 0.001). In conclusion, much work still should be done to improve coverage among groups at higher risk of lack of vaccination identified in this survey. The ongoing SARS-CoV-2 pandemic may represent one more alert for improving seasonal flu vaccine coverage to avoid further stress to the National Health System.


Asunto(s)
/epidemiología , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/complicaciones , Cirrosis Hepática/epidemiología , Cobertura de Vacunación/estadística & datos numéricos , Anciano , Femenino , Humanos , Gripe Humana/epidemiología , Cirrosis Hepática/etiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , Estaciones del Año , Vacunación/estadística & datos numéricos
12.
Trends Cardiovasc Med ; 31(3): 163-169, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33383171

RESUMEN

Myocarditis is common during viral infection with cases described as early as the influenza pandemic of 1917, and the current COVID-19 pandemic is no exception. The hallmark is elevated troponin, which occurs in 36% of COVID patients, with electrocardiogram, echocardiogram, and cardiac magnetic resonance being valuable tools to assist in diagnosis. Cardiac inflammation may occur secondary to direct cardiac invasion with the virus, or to intense cytokine storm, often encountered during the course of the disease. Angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and judicious use of beta-blockers are beneficial in management of myocarditis. Corticosteroids may be avoided during the very early phase of viral replication, but can be of clear benefit in hospitalized, critically ill patients. Statins are beneficial to shorten the course of the disease and may decrease mortality.


Asunto(s)
/complicaciones , Gripe Humana/complicaciones , Miocarditis/virología , Pandemias , /diagnóstico , Humanos , Virus de la Influenza A , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Miocarditis/diagnóstico , Miocarditis/terapia
13.
Klin Mikrobiol Infekc Lek ; 26(1): 25-29, 2020 Mar.
Artículo en Checo | MEDLINE | ID: mdl-33326592

RESUMEN

AIMS: To describe the symptoms and complications of influenza A in seniors in the 2018-2019 influenza season. MATERIAL AND METHODS: A retrospective analysis of data on 84 seniors with laboratory confirmed influenza A between 1 October 2018 and 30 April 2019 who were tested for this infectious disease in the University Hospital Pilsen. RESULTS: Influenza A was diagnosed in 84 seniors during the period under review. The most common symptoms were fever (69 cases; 82.14 %) and cough (60 cases; 71.43 %). These two symptoms combined occurred in more than half of patients over 65 years of age (51 cases; 60.71 %). Other common symptoms included general weakness (58 cases; 69.05 %) and fatigue (57 cases; 67.86 %). The other symptoms occurred in less than half of cases. The most common complication was pneumonia (36 cases; 42.86 %). Bacterial etiology was confirmed in 13 cases and the most commonly occurring pathogens were Klebsiella pneumoniae and Streptococcus pneumoniae. Another common complication of influenza was acute respiratory insufficiency in pneumonia, heart failure or exacerbation of chronic respiratory disease. The mortality rate of seniors in our sample was 17.86 % (15 cases). CONCLUSION: In the senior population, the most common symptoms of influenza are a rapid onset of fever and dry cough. The study has confirmed that the most common complication is pneumonia. Furthermore, exacerbations of various chronic diseases of the cardiovascular and respiratory systems, worsening of chronic renal insufficiency and urinary tract infections were common. The most effective prevention of the development of influenza and its complications is the available quadrivalent vaccine.


Asunto(s)
Gripe Humana , Neumonía Bacteriana/complicaciones , Anciano , República Checa , Fiebre , Humanos , Gripe Humana/complicaciones , Gripe Humana/epidemiología , Estudios Retrospectivos
15.
BMC Med ; 18(1): 403, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33334360

RESUMEN

BACKGROUND: Due to the overlapping clinical features of coronavirus disease 2019 (COVID-19) and influenza, parallels are often drawn between the two diseases. Patients with pre-existing cardiovascular diseases (CVD) are at a higher risk for severe manifestations of both illnesses. Considering the high transmission rate of COVID-19 and with the seasonal influenza approaching in late 2020, the dual epidemics of COVID-19 and influenza pose serious cardiovascular implications. This review highlights the similarities and differences between influenza and COVID-19 and the potential risks associated with coincident pandemics. MAIN BODY: COVID-19 has a higher mortality compared to influenza with case fatality rate almost 15 times more than that of influenza. Additionally, a significantly increased risk of adverse outcomes has been noted in patients with CVD, with ~ 15 to 70% of COVID-19 related deaths having an underlying CVD. The critical care need have ranged from 5 to 79% of patients hospitalized due to COVID-19, a proportion substantially higher than with influenza. Similarly, the frequency of vascular thrombosis including deep venous thrombosis and pulmonary embolism is markedly higher in COVID-19 patients compared with influenza in which vascular complications are rarely seen. Unexpectedly, while peak influenza season is associated with increased cardiovascular hospitalizations, a decrease of ~ 50% in cardiovascular hospitalizations has been observed since the first diagnosed case of COVID-19, owing in part to deferred care. CONCLUSION: In the coming months, increasing efforts towards evaluating new interventions will be vital to curb COVID-19, especially as peak influenza season approaches. Currently, not enough data exist regarding co-infection of COVID-19 with influenza or how it would progress clinically, though it may cause a significant burden on an already struggling health care system. Until an effective COVID-19 vaccination is available, high coverage of influenza vaccination should be of utmost priority.


Asunto(s)
/epidemiología , Enfermedades Cardiovasculares/epidemiología , Coinfección/epidemiología , Gripe Humana/epidemiología , Adulto , Enfermedades Cardiovasculares/complicaciones , Femenino , Humanos , Gripe Humana/complicaciones , Masculino , Persona de Mediana Edad
16.
Environ Health Perspect ; 128(12): 127004, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33325772

RESUMEN

BACKGROUND: Environmental cadmium exposure is widespread. In humans, cadmium is poorly excreted, triggers pulmonary inflammation, reduces pulmonary function, and enhances lung injury by respiratory syncytial virus. OBJECTIVES: We examined the association of cadmium burden with mortality related to influenza or pneumonia. METHODS: This prospective analysis of the National Health and Nutrition Examination Survey (NHANES) included 7,173 and 8,678 participants ≥45 years of age enrolled in NHANES-III and NHANES 1999-2006, respectively. Associations were evaluated between cadmium and mortality from influenza or pneumonia during a median follow-up of 17.3 y (NHANES-III, based on creatinine-corrected urine cadmium) and 11.4 y (NHANES 1999-2006, based on blood cadmium). Survey-weighted Cox proportional hazard models were used to compute hazard ratios (HRs) comparing the mortality of individuals at the 80th vs. the 20th percentile of cadmium concentrations. RESULTS: In NHANES-III, after adjustment for sex, race/ethnicity, education, body mass index, serum cholesterol, hypertension, and NHANES phase (or cycle), the HR comparing influenza or pneumonia mortality among participants with creatinine-corrected urinary cadmium in the 80th vs. 20th percentile was 1.15 (95% CI: 1.05, 1.26; p=0.002) in the population as a whole and 1.27 (95% CI: 1.12, 1.43; p=0.002) among never smokers. In NHANES 1999-2006, adjusted HRs for the 80th vs. 20th percentile of blood cadmium were 1.14 (95% CI: 0.96, 1.36; p=0.15) for the overall population and 1.71 (95% CI: 0.95, 3.09; p=0.07) in never smokers. DISCUSSION: Among middle-aged and older adults in the United States, higher cadmium burdens are associated with higher mortality from influenza or pneumonia. This raises the possibility that cadmium may worsen outcomes from COVID-19 infections. https://doi.org/10.1289/EHP7598.


Asunto(s)
/mortalidad , Cadmio/sangre , Contaminantes Ambientales/sangre , Gripe Humana/mortalidad , Neumonía/mortalidad , Anciano , Anciano de 80 o más Años , /complicaciones , Exposición a Riesgos Ambientales , Femenino , Humanos , Gripe Humana/sangre , Gripe Humana/complicaciones , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Neumonía/sangre , Neumonía/complicaciones , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Estados Unidos/epidemiología
17.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33370941

RESUMEN

A 9-year-old girl was admitted to the paediatric intensive care unit with acute respiratory failure due to influenza. Nine months earlier, she presented with unexplained lymphoedema of the lower extremities and monocytopenia. She had a history of occasional finger warts and onychomycoses. During hospitalisation, the patient was diagnosed with Emberger syndrome caused by GATA2 deficiency. The admission was complicated by thromboses in the right hand, leading to amputation of multiple fingers. From then on, the patient has been in good recovery, the function of her right hand was improving and an allogeneic haematopoietic cell transplantation has now been successfully performed.


Asunto(s)
Dedos/patología , Deficiencia GATA2/complicaciones , Factor de Transcripción GATA2/deficiencia , Virus de la Influenza A/inmunología , /inmunología , Amputación , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Niño , Codón sin Sentido , Análisis Mutacional de ADN , Quimioterapia Combinada , Femenino , Dedos/cirugía , Deficiencia GATA2/diagnóstico , Deficiencia GATA2/genética , Deficiencia GATA2/inmunología , Factor de Transcripción GATA2/genética , Gangrena/inmunología , Gangrena/cirugía , Glucocorticoides/uso terapéutico , Trasplante de Células Madre Hematopoyéticas , Humanos , Virus de la Influenza A/aislamiento & purificación , Gripe Humana/complicaciones , Gripe Humana/inmunología , Gripe Humana/terapia , Gripe Humana/virología , Pulmón/diagnóstico por imagen , Pulmón/inmunología , Respiración Artificial , /terapia , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
18.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-33318255

RESUMEN

Influenza-associated encephalopathy/encephalitis (IAE) can result in serious neurological complications. We report a 4-year-old healthy female child with the diagnosis of IAE. Her clinical course was complicated by temporary visual impairment and significant motor deficits. Her unique ophthalmological findings have little precedent in previous literature.


Asunto(s)
Encefalopatías/diagnóstico , Encefalopatías/virología , Gripe Humana/complicaciones , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/virología , Encéfalo/patología , Encéfalo/virología , Encefalopatías/fisiopatología , Preescolar , Femenino , Humanos , Virus de la Influenza B , Imagen por Resonancia Magnética , Trastornos de la Visión/fisiopatología
19.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-33372021

RESUMEN

Bilateral adrenal haemorrhage is a rare and often fatal condition that most commonly occurs under conditions of severe physiological stress. We describe a 33-year-old male patient with ulcerative colitis who presented with acute worsening epigastric pain, vomiting and raised inflammatory markers. Initial differentials included gastritis and peptic ulceration. Gastroscopy revealed no abnormalities. By day 3, he had developed sepsis with a sequential organ failure assessment score of 2 as well as coagulopathy. A subsequent CT scan diagnosed bilateral adrenal haemorrhage. A short Synacthen Test confirmed adrenal insufficiency and he was treated with replacement steroids and antibiotics for a possible urinary tract infection or pyelonephritis and he recovered well. Several days later he developed fever, dyspnoea and a productive cough. Subsequently, he became hypotensive (Blood Pressure (BP) 95/65 mm Hg) and unresponsive with a Glasgow Coma Scale of 7 and was hyponatraemic and hyperkalaemic. He was intubated and transferred to a tertiary hospital for intensive care unit management where investigations confirmed the patient to be influenza A positive.


Asunto(s)
Insuficiencia Suprarrenal/etiología , Infecciones Bacterianas/complicaciones , Trastornos de la Coagulación Sanguínea/complicaciones , Colitis Ulcerosa/complicaciones , Hemorragia/etiología , Gripe Humana/complicaciones , Sepsis/complicaciones , Insuficiencia Suprarrenal/tratamiento farmacológico , Adulto , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Coinfección , Diagnóstico Diferencial , Hemorragia/complicaciones , Humanos , Hidrocortisona/uso terapéutico , Virus de la Influenza A , Masculino , Sepsis/tratamiento farmacológico , Tomografía Computarizada por Rayos X
20.
Cephalalgia ; 40(13): 1406-1409, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33146034

RESUMEN

New daily persistent headache was first documented in the medical literature in the 1980s. The leading trigger is a viral illness. As we navigate our way thru the current SARS-CoV-2 pandemic, looking back at past viral epidemics may help guide us for what to expect in the near future in regard to headaches as a persistent manifestation of the SARS-CoV-2 infection. The 1890 viral pandemic known as the "Russian or Asiatic flu", has extensive documentation about the neurologic sequelae that presented months to years after the pandemic ended. One of the complications was daily persistent headache. There are actually many similarities between the viral presentation of the 1890 pandemic and the current SARS-CoV-2 pandemic, which may then suggest that not only will NDPH be part of the neurological sequelae but a possible key consequence of the SARS-CoV-2 infection.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Cefalea/epidemiología , Cefalea/virología , Gripe Humana/complicaciones , Gripe Humana/historia , Neumonía Viral/complicaciones , Betacoronavirus , Historia del Siglo XIX , Humanos , Pandemias , Federación de Rusia
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