COVID-19: No Guaranteed Protection from Future Infection after the Initial Diagnosis.

The world of microbiology is vast in nature, and viruses continue to be a subset containing a lot of unknowns. Initial infection with certain viruses, such as varicella zoster virus and measles, allows for development of lifelong immunity; on the other hand, the influenza virus requires yearly vaccination, which may not provide adequate immunity. This can be attributed to antigenic shift and drift, rendering previously made antibodies ineffective against new strains of influenza. This article describes six cases of patients who presented with mild acute respiratory symptoms and tested positive for COVID-19 virus. After recovering from initial illness and being asymptomatic for several months, they developed recurrence of acute respiratory symptoms and, again, tested positive for COVID-19 virus, in more severe form than initial presentation. In the current state of the world, COVID-19 has created a lot of unknowns in the medical community, including patient presentation and treatment. COVID-19 research is evolving daily, but many questions remained unanswered. "Will a sufficient antibody response be created by the human body in those infected with COVID-19 and how long will that immunity last?" "Will antigenic drift occur quickly allowing the virus to evade previously made antibodies?" During initial surveillance of the COVID-19 virus, we were expecting development of an immune response comparable to SARS-CoV-1 and MERS-CoV, given the viral similarities. Unfortunately, based on our observations, this may not necessarily be true and will be further discussed in the presented article.

Evaluating and contextualizing the efficacy of portable HEPA filtration units in small exam rooms.

BACKGROUND: Ambulatory clinics attend to COVID-19 patients, often in spaces with less than ideal ventilation. Testing and treatments can often include aerosol-generating procedures. Portable high efficiency particulate air (HEPA) filtration units have been used to remove airborne contaminants in these areas. METHODS: A particle counter was used to evaluate the effectiveness of portable HEPA filtration units when a proxy airborne contaminant (powder) was actuated into the air. The Center for Disease Control and Prevention's (CDC) Airborne Contaminant Removal table served as a basis for initial particle readings at 6 minutes. RESULTS: Percent decrease was calculated post powder actuation at the 6-minute and 12-minute mark. There was a statistically significant decrease in smaller particles at the 6-minute and 12-minute mark when the HEPA filtration units were used. CONCLUSION: As an adjunct infection control intervention, portable HEPA filtration units can make outpatient exam rooms safer for patients and staff by decreasing cumulative airborne particles.

Mycobacterium tuberculosis osteomyelitis in a patient with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): a case report.

The incidence of tuberculosis is increasing in the United States. Extra-pulmonary involvement is more common in patients with HIV/AIDS. The diagnosis of Tuberculosis osteomyelitis requires a high degree of suspicion for accurate and timely diagnosis.We present a case of a 49 year old Caucasian male with HIV/AIDS who presented with a four-month history of soft tissue swelling in the left proximal thigh unresponsive to various broad spectrum antibiotics who was eventually diagnosed with Mycobacterium tuberculosis osteomyelitis of the left proximal femur.