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1.
J Med Case Rep ; 15(1): 394, 2021 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-34364400

RESUMO

BACKGROUND: Herpes virus remains dormant in human cells and could reactivate under immunosuppressed conditions, such as prolonged critical illnesses. The phenomenon of viral replication during intensive care is well known, even in patients without a history of immunosuppression, but it usually does not have a clinical impact. Systemic reactivation leads to viral DNA in blood. It remains unclear whether this replication is a marker of morbimortality or a true pathogenic process. Therefore, it is unclear what medical treatment is most appropriate for simple replication. In organ damage suspected to be induced by herpes virus, there is no consensus on the most appropriate treatment duration. Here, we report a rarely described case of multiorgan failure implicating herpes simplex virus and discuss its treatment. CASE REPORT: A 53-year-old Caucasian immunosuppressed woman was admitted to the intensive care unit for septic shock. She presented pneumonia due to Klebsiella pneumoniae. Two weeks after admission, she showed multiorgan failure with acute respiratory distress syndrome and circulation failure. She had digestive and cutaneous lesions typical of herpes simplex virus 1. Blood and respiratory polymerase chain reaction was strongly herpes simplex virus-1 positive. No other bacteria, fungi, or viruses were found. The evolution was rapidly favorable after the initiation of antiviral treatment. Treatment was stopped after 3 weeks of well-conducted antiviral therapy. Curative-dose treatment was interrupted despite continuous strongly positive blood polymerase chain reaction results. In this context, prophylactic treatment was continued. CONCLUSION: We report an exceptional presentation of multiorgan failure in the intensive care unit due to herpes simplex virus-1. The diagnosis was made based on typical herpes simplex virus-1 visceral lesions and the absence of other responsible microorganisms. Intense viral replication is a key diagnostic element. There is no consensus regarding the most appropriate treatment duration, but such decisions should not be based on blood polymerase chain reaction.


Assuntos
Herpes Simples , Herpesvirus Humano 1 , Pneumonia , Choque Séptico , Antivirais/uso terapêutico , Feminino , Herpes Simples/complicações , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Pneumonia/tratamento farmacológico , Choque Séptico/tratamento farmacológico
3.
Vet Clin Pathol ; 43(4): 567-72, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25088328

RESUMO

BACKGROUND: Blood L-lactate concentration (LAC) can be used for various diagnostic purposes in cattle. As multiple handheld analyzers for LAC exist, it is important to validate their use in cattle in comparison with reference laboratory blood analyzers. OBJECTIVES: The objectives of this study were to validate the handheld Lactate Pro meter (LacP) including reproducibility, and compare the measurements with the StatProfile (StatP) as a gold standard. In addition, diagnostic sensitivity and specificity, and the impact of HCT on LAC measured by both analyzers were assessed. METHODS: A cohort of 64 cattle with acute medical and surgical conditions was studied. Whole blood samples in heparin lithium tubes were analyzed upon arrival with both StatP and LacP. Twenty-three samples were immediately retested to assess intra-assay coefficient of variation (CV). The HCT values were also recorded. RESULTS: The LAC using LacP was highly correlated with the StatP (r = 0.9736 [95% confidence interval [CI]: 0.9562-0.9841]). The LacP underestimated LAC (mean difference:-0.9 mmol/L, 95% CI:-3.1 mmol/L to 1.3 mmol/L). The intra-assay CV was excellent (4.77%). No significant correlation was observed between LacP or StatP and HCT (P = .39 and .09, respectively). Sensitivity and specificity for LacP were 91.7% (95% CI: 76.4-97.8%) and 100% (83.4-100%, cutoff of 4 mmol/L), and 78.6% (58.5-90.9%) and 100% (87.0-100%, cutoff of 6 mmol/L). CONCLUSIONS: The LacP handheld lactate meter can be used safely and reliably cow-side, although it underestimates LAC value when compared with a standard laboratory analyzer especially for LAC ≥ 10.0 mmol/L. The LAC value was not influenced by HCT in this study.


Assuntos
Bovinos/sangue , Ácido Láctico/sangue , Sistemas Automatizados de Assistência Junto ao Leito , Animais , Doenças dos Bovinos/sangue , Doenças dos Bovinos/diagnóstico , Feminino , Hematócrito/veterinária , Sistemas Automatizados de Assistência Junto ao Leito/normas , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Can Vet J ; 52(6): 663-6, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22131585

RESUMO

Maintaining a good quality of life for cows with cardiac manifestation of lymphoma may be valuable, especially in high-producing cows. This report describes the medical management of cardiac lymphoma in a cow by means of repeated pericardiocentesis. The cow survived for 34 days and was productive.


Assuntos
Tamponamento Cardíaco/veterinária , Doenças dos Bovinos/terapia , Neoplasias Cardíacas/veterinária , Linfoma/veterinária , Pericardiocentese/veterinária , Animais , Tamponamento Cardíaco/terapia , Bovinos , Feminino , Neoplasias Cardíacas/terapia , Linfoma/terapia , Cuidados Paliativos
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