RESUMO
Dengue can cause neurologic complications in addition to the more common manifestations of plasma leakage and coagulopathy. Posterior reversible encephalopathy syndrome has rarely been described in dengue, although the pathophysiology of endothelial dysfunction likely underlies both. We describe a case of dengue-associated posterior reversible encephalopathy syndrome and discuss diagnosis and management.
Assuntos
Dengue/complicações , Síndrome da Leucoencefalopatia Posterior/etiologia , Feminino , Humanos , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico , Vietnã/epidemiologiaRESUMO
Japanese encephalitis virus was detected by deep sequencing for the first time in urine of a 16-year-old boy with encephalitis. Seroconversion and polymerase chain reaction analysis confirmed the metagenomics finding. Urine is useful for diagnosis of flaviviral encephalitis, whereas deep sequencing can be a panpathogen assay for the diagnosis of life-threatening infectious diseases.
Assuntos
Amebíase/etiologia , Infecções Protozoárias do Sistema Nervoso Central/etiologia , Mergulho/efeitos adversos , Naegleria fowleri , Adulto , Amebíase/diagnóstico , Infecções Protozoárias do Sistema Nervoso Central/diagnóstico , Evolução Fatal , Humanos , Lagos/parasitologia , Masculino , VietnãRESUMO
OBJECTIVES: To determine the effectiveness of hand hygiene in a developing healthcare setting in reducing nosocomial infections (NIs). METHOD: Prospective study measuring NI rates in a urology ward in Ho Chi Minh City, Vietnam, before and after implementation of a hand hygiene programme with an alcohol-based decontaminant, and compliance rates of medical staff and carers with hand hygiene using standardised observation sheets. RESULTS: Incidence of NIs fell by 84%, from 13.1% to 2.1%, after implementation of the hand hygiene programme. Extended-spectrum beta-lactamase production was detected in 38.2%-50% of Enterobacteriaceae isolated from clinical samples. Length of patient stay and cost to the patient for antibiotics were reduced after implementation of the hand hygiene programme. CONCLUSION: The hand hygiene programme was effective in reducing incidence of NIs, leading to shorter inpatient stays and reduced treatment costs. Such programmes with measurable outcomes can be implemented at minimal cost in developing health contexts and should be promoted in all healthcare settings.