ABSTRACT
A 13-year-old boy presented with hypoxia, microscopic hematuria, and elevated blood pressures. Persistent microscopic hematuria and hypertension led to investigation of glomerular and non-glomerular causes of hematuria. After reviewing his clinical course, family history, and laboratory testing, an additional test was sent, revealing the diagnosis.
ABSTRACT
A 12-Year-Old Girl with Weight LossThis report examines a case of chronic weight loss, anxiety, abdominal pain, and nausea in an adolescent girl. With directed questioning, physical examination, and testing, an illness script for the presentation emerges; the differential is refined until a final diagnosis is made.
Subject(s)
Abdominal Pain , Weight Loss , Female , Adolescent , Humans , Child , Abdominal Pain/diagnosis , NauseaSubject(s)
Acute Kidney Injury , Contrast Media , Diagnostic Imaging , Kidney , Humans , Acute Kidney Injury/chemically induced , Acute Kidney Injury/prevention & control , Contrast Media/adverse effects , Diagnostic Imaging/adverse effects , Diagnostic Imaging/methods , Kidney/diagnostic imaging , Kidney/drug effects , Risk FactorsSubject(s)
Arthritis , Connective Tissue Diseases , Hearing Loss, Sensorineural , Retinal Detachment , Child , Humans , Arthritis/diagnosisSubject(s)
Atrial Fibrillation , Mass Screening , Aged , Asymptomatic Diseases , Atrial Fibrillation/diagnosis , Electrocardiography , Humans , Risk FactorsABSTRACT
Co-infections with different variants of SARS-CoV-2 are a key precursor to recombination events that are likely to drive SARS-CoV-2 evolution. Rapid identification of such co-infections is required to determine their frequency in the community, particularly in populations at-risk of severe COVID-19, which have already been identified as incubators for punctuated evolutionary events. However, limited data and tools are currently available to detect and characterise the SARS-CoV-2 co-infections associated with recognised variants of concern. Here we describe co-infection with the SARS-CoV-2 variants of concern Omicron and Delta in two epidemiologically unrelated adult patients with chronic kidney disease requiring maintenance haemodialysis. Both variants were co-circulating in the community at the time of detection. Genomic surveillance based on amplicon- and probe-based sequencing using short- and long-read technologies identified and quantified subpopulations of Delta and Omicron viruses in respiratory samples. These findings highlight the importance of integrated genomic surveillance in vulnerable populations and provide diagnostic pathways to recognise SARS-CoV-2 co-infection using genomic data.