Chlamydia pneumoniae-associated pleuropericarditis: a case report and systematic review of the literature.

BACKGROUND: Chlamydia pneumoniae is a common cause of atypical community acquired pneumonia (CAP). The diagnostic approach of chlamydial infections remains a challenge. Diagnosis of delayed chlamydial-associated complications, involving complex autoimmune pathophysiological mechanisms, is still more challenging. C. pneumoniae-related cardiac complications have been rarely reported, including cases of endocarditis, myocarditis and pericarditis. CASE PRESENTATION: A 40-year old female was hospitalized for pleuropericarditis following lower respiratory tract infection. The patient had been hospitalized for CAP (fever, dyspnea, chest X-ray positive for consolidation on the left upper lobe) 5 weeks ago and had received ceftriaxone and moxifloxacin. Four weeks after her discharge, the patient presented with fever, shortness of breath and pleuritic chest pain and was readmitted because of pericardial and bilateral pleural effusions (mainly left). The patient did not improve on antibiotics and sequential introduction of colchicine and methylprednisolone was performed. The patient presented impressive clinical and laboratory response. Several laboratory and clinical assessments failed to demonstrate any etiological factor for serositis. Chlamydial IgM and IgG antibodies were positive and serial measurements showed increasing kinetics for IgG. Gold standard polymerase chain reaction of respiratory tract samples was not feasible but possibly would not have provided any additional information since CAP occurred 5 weeks ago. The patient was discharged under colchicine and tapered methylprednisolone course. During regular clinic visits, she remained in good clinical condition without pericardial and pleural effusions relapse. CONCLUSIONS: C. pneumoniae should be considered as possible pathogen in case of pleuritis and/or pericarditis during or after a lower respiratory tract infection. In a systematic review of the literature only five cases of C. pneumoniae associated pericarditis were identified. Exact mechanisms of cardiovascular damage have not yet been defined, yet autoimmune pathways might be implicated.

Measurement of job satisfaction among healthcare workers during the COVID­19 pandemic: A cross­sectional study.

Job satisfaction is one of the most frequently studied subjects for numerous researchers, aiming to investigate the behavior of employees in the workplace. Moreover, it is an important predictor of well-being in the workplace, having a direct association with the productivity of employees and the quality of services provided by each organization. In the field of health, the high level of job satisfaction of healthcare workers translates into a high level of patient care. Therefore, during the period of the coronavirus disease 2019 (COVID-19) pandemic, efforts to evaluate the level of job satisfaction of healthcare workers represents a cornerstone in the effort to maintain high-level health services. The aim of the present study was to evaluate job satisfaction among healthcare workers in a COVID-19 emergency department during the pandemic and its potential association with the demographic characteristics of the participants. For the present cross-sectional study, which included 89 frontline healthcare workers, the 36-item Job Satisfaction Survey questionnaire was used. The findings concluded that the majority of the participants were not satisfied with their work (120±25.58). Among the nine job satisfaction factors examined, only the co-worker factor received a high job satisfaction score in the entire sample (16.08±4.14). By contrast, the other motivating factors were classified as unsatisfactory, namely pay (10.10±4.63), promotion (11.22±4.38), fringe benefits (10.63±4.09), contingent rewards (11.39±4.13) and communications (14.15±4.21). The control of the association between the socio-demographic data of the participants and the motivating factors of job satisfaction revealed that the age group of 45-55 years and the paramedical staff were more satisfied with the communication factor than the other categories of colleagues. In addition, it appears that the average value of satisfaction with the pay factor was significantly lower in the participating physicians (mean=8.59, P<0.05) compared to the other employee categories. On the whole, the present study demonstrates that the measurement and evaluation of job satisfaction in the workplace of a hospital environment is a cornerstone in the efforts to create a healthy and safe work environment for healthcare staff during the period of the COVID-19 pandemic. Ensuring a high level of job satisfaction for healthcare workers will provide a high level of services to health service users.