RESUMO
The coronavirus disease 2019 (COVID-19) infection has led to accelerated development and utilization of vaccines to prevent its implications on health. One of these vaccines is a vector-based, Oxford-AstraZeneca Vaccine (AZD1222). Frequently reported side effects are related to host-immune response. While dermatologic manifestation is peculiar in nature and denotes a serious eruption that might defer future vaccination. Herein, we present a case of a medically free 37-year-old female who developed clinical and histological evidence of pityriasis rosea (PR) after administration of a second-dose vaccination of AZD1222. The first dose of vaccination was administered as Pfizer BioNTech COVID-19 mRNA (BNT162b2) vaccine. This case is unique in nature as this patient developed AZD1222-induced PR, while some reports in the literature have linked PR to the BNT162b2 vaccine. This patient continued to receive a booster vaccination with BNT162b2 with no reportable side effects.
RESUMO
COVID-19 is inflicted by SARS-CoV-2 and resulted in a global health crisis that necessitated the urgency of vaccine development to prevent its spreading among the public. Pfizer-BioNTech COVID-19 is one of the emergency use authorized (EUA) vaccines. This vaccine is efficacious against the SARS-CoV-2 virus; nonetheless, recipients have frequently reported side effects. Recipients of this vaccine experienced miscellaneous side effects like fatigue and headache. However, cutaneous eruptions of varying degrees of severity and involvements have been manifesting post-vaccination. Dermatological eruptions following vaccination against COVID-19 disease are poorly recognized. Dermatological manifestations triggered post-vaccination differ in the clinical context and patient's demographic features. The only constant factor is various clinical and histopathological relations to establish the diagnosis of cutaneous eruption post-vaccination. Herein, we report a case of an 18-year-old male with T-cell acute lymphocytic lymphoma (ALL) in remission since August 2018 and other comorbidities. After the administration of the first dose of the Pfizer-BioNTech COVID-19 vaccine, the patient developed pruritic eczematous eruption presenting as grouped erythematous-violaceous papulovesicular lesions with fine scales over his upper and lower extremities. These eruptions started two days after the administration of the vaccine. This eruption became generalized 21 days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. Clinical suspicion of the drug-induced vesicular eruption was suspected; thus, a biopsy was obtained and showed erosions and mixed inflammatory cell infiltrate. From a clinical and histopathological correlation, vesicular eruption following vaccination with Pfizer-BioNTech COVID-19 was confirmed. Nevertheless, other diagnoses cannot be ruled out, but from the clinical-histopathological association, the vaccine-inflicted eruption is the likely culprit. Reports are crucial to understanding the nature of such dermatological manifestation after emerging diseases and counteractions like vaccinations. The dermatological manifestations are vaguely recognized; thus, by reporting on the cases similar to the case in this report, more data will be available to understand the nature and underlying cause of such eruptions.
RESUMO
Background Urinary tract infection (UTI) is one of the most common clinical presentations that exhaust the patients and confuse physicians. Some of the risk factors that contribute to UTIs are age, female gender, and diabetes. Urinalysis is used to detect abnormalities in the urine, such as the presence of leukocytes, blood, and nitrite. However, urinalysis accuracy depends on the patient and the analyzer. On the other hand, urine culture is considered gold standard for diagnosing UTI. For that, the aim of this study is to determine the sensitivity of white blood cells (WBC) and nitrite in dipstick urinalysis in detecting UTI. Methods A cross-sectional study was conducted at King Abdulaziz Medical City on adult patients aged 19-65 years who underwent dipstick urinalysis and culture at the same visit from October 2016 to October 2019. The data were collected from the medical records from all the departments by using a data collection sheet through Best Care system. The sample was selected conveniently, and it was determined to be 359 patients with a confidence interval of 95%. Data were analyzed using IBM SPSS version 20 (IBM Corp., Armonk, NY, USA). Chi-square test was used to analyze the association between the outcome and the results of the dipstick urinalysis and urine culture. P-value lower than 0.05 was considered significant. Results Three hundred and fifty-nine patients were included into the study with a majority of females (81.1%) with a mean age of 47.5 years. Two hundred and fifty-two patients were culture positive, WBC sensitivity and specificity were 62.7% and 100%, and nitrite sensitivity and specificity were 20.6% and 93.5%, respectively. Ninety-nine diabetic patients were culture positive; for diabetic patients, WBC sensitivity and specificity were 65.7% and 100% and nitrite sensitivity and specificity were 18.2% and 97.6%, respectively, while for non-diabetic patients, WBC sensitivity and specificity were 60.85% and 100% and nitrite sensitivity and specificity were 22.2% and 90.8%, respectively. Conclusion Our study showed that results of WBC are more sensitive and specific than those of nitrite in comparison to the gold standard (urine culture). Diabetics and non-diabetics have slightly different results. According to our results it is difficult to depend on the dipstick urinalysis without culture. More studies are recommended in this field.