ro13-9904 and Pneumonia--Viral

Macrophage activation syndrome (MAS) is a rare life-threatening condition characterized by cytokine-mediated tissue injury and multiorgan dysfunction.. We describe the unique case of young man who developed MAS as the sole manifestation of an otherwise paucisymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.. Clinical and biological criteria led to the diagnosis of MAS; cytokine profile was highly suggestive reverse transcription polymerase chain reaction for SARS-CoV-2 in nasopharyngeal swabs was negative, but serum anti-SARS-CoV-2 immunoglobulin A and immunoglobulin G resulted positive leading to the diagnosis of SARS-CoV-2 infection.. The patient was treated with empiric antibiotic and hydroxychloroquine.. Clinical improvement ensued. At follow-up, the patient is well.. SARS-CoV-2 infection may trigger develop life-threatening complications, like MAS. This can be independent from coronavirus disease 2019 gravity.

Topics: Adolescent; Blood Chemical Analysis; Ceftriaxone; China; Clinical Laboratory Techniques; Coronavirus Infections; COVID-19; COVID-19 Testing; Diagnosis, Differential; Disease Progression; DNA, Viral; Drug Therapy, Combination; Electrocardiography; Follow-Up Studies; Hospitalization; Humans; Hydroxychloroquine; Macrophage Activation Syndrome; Male; Pandemics; Patient Discharge; Pneumonia, Viral; Radiography, Thoracic; Real-Time Polymerase Chain Reaction; Risk Assessment; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome

Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After its first occurrence in Wuhan of China from December 2019, COVID-19 rapidly spread around the world. According to the World Health Organization statement on 13 March 2020, there had been over 132 500 confirmed cases globally. Nevertheless, the case reports of children are rare, which results in the lack of evidence for preventing and controlling of children's infection. Here, we report three cases of SARS-CoV-2 infected children diagnosed from 3 February to 17 February 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after the treatment, with the nucleic acid of throat swab turning negative within 14, 11, and 7 days after diagnosis, respectively. However, after been discharged, all three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases.

Topics: Ascorbic Acid; Betacoronavirus; Biomarkers; Ceftriaxone; Child; China; Clinical Laboratory Techniques; Convalescence; Coronavirus Infections; COVID-19; COVID-19 Testing; Drugs, Chinese Herbal; Feces; Humans; Interferons; Male; Pandemics; Patient Discharge; Pharynx; Pneumonia, Viral; Reverse Transcriptase Polymerase Chain Reaction; Ribavirin; RNA, Viral; SARS-CoV-2; Tomography, X-Ray Computed

The clinical manifestation of COVID-19 can vary from an asymptomatic course to ARDS requiring invasive mechanical ventilation and extracorporeal membrane oxygenation. A kidney transplanted patient infected with SARS CoV-2 infection showed a mild disease despite immune suppression. It is possible that Immunosuppression can "be protective" as the cytokine storm is an important factor in the disease story. Despite the good outcome reported in the present case report, is remains of vital importance the solid organ transplant patients use precautions in order to avoid the infection.

Topics: Betacoronavirus; Ceftriaxone; Coronavirus Infections; COVID-19; Cytokines; Glomerulonephritis, IGA; Humans; Immunosuppression Therapy; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Mycophenolic Acid; Pandemics; Pneumonia, Viral; SARS-CoV-2; Tacrolimus; Treatment Outcome

The early shortage of novel coronavirus disease (COVID-19) tests in the United States led many hospitals to first screen for common respiratory pathogens, and only if this screen was negative to proceed with COVID-19 testing. We report a case of a 56-year-old woman with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) coinfection with group A

Topics: Antibodies, Monoclonal, Humanized; Azithromycin; Betacoronavirus; Ceftriaxone; Chicago; Chronic Pain; Coinfection; Coronavirus Infections; COVID-19; Extracorporeal Membrane Oxygenation; Female; Humans; Hydroxychloroquine; Hypertension; Lung; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2; Streptococcal Infections; Streptococcus pyogenes; Tomography, X-Ray Computed; Treatment Outcome

Topics: Age Factors; Aged; Aged, 80 and over; Antiviral Agents; Azithromycin; Betacoronavirus; Ceftriaxone; Cobicistat; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Darunavir; Drug Therapy, Combination; Female; HIV Protease Inhibitors; Humans; Hydroxychloroquine; Italy; Lopinavir; Male; Methylprednisolone; Middle Aged; Neoplasms; Pandemics; Pneumonia, Viral; Ritonavir; SARS-CoV-2

Topics: Aged; Anti-Bacterial Agents; Anticoagulants; Antimalarials; Azithromycin; Betacoronavirus; Ceftriaxone; Cerebral Infarction; Coronavirus Infections; COVID-19; Humans; Hydroxychloroquine; Male; Pandemics; Pneumonia, Viral; SARS-CoV-2

Topics: Antibodies, Monoclonal, Humanized; Betacoronavirus; Brugada Syndrome; Ceftriaxone; Clinical Laboratory Techniques; Continuous Positive Airway Pressure; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; COVID-19 Testing; Humans; Hydroxychloroquine; Lung Diseases, Interstitial; Male; Middle Aged; Nasopharynx; Pandemics; Pneumonia, Viral; Psoriasis; SARS-CoV-2; Treatment Outcome

The presence of rhabdomyolysis secondary to multiple infections has been reported, predominantly viral, but also bacterial and fungal. It is well known that COVID-19 can present a wide variety of complications during the course of infection; however, the presence of rhabdomyolysis as an initial condition has not been reported so far. We report a case of rhabdomyolysis as an initial presentation in a patient diagnosed with SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection.

Topics: Aged; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Anticoagulants; Azithromycin; Betacoronavirus; Bicarbonates; Ceftriaxone; Coronavirus Infections; COVID-19; Cytochrome P-450 CYP3A Inhibitors; Enoxaparin; Enzyme Inhibitors; Fluid Therapy; Humans; Hydroxychloroquine; Lopinavir; Lung; Male; Pandemics; Pneumonia, Viral; Respiration, Artificial; Rhabdomyolysis; Ritonavir; SARS-CoV-2; Tomography, X-Ray Computed; Treatment Outcome

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Betacoronavirus; Ceftriaxone; Coronavirus Infections; COVID-19; Diagnosis, Differential; Erythema Multiforme; Humans; Inflammation; Male; Pandemics; Pneumonia, Viral; SARS-CoV-2; Tomography, X-Ray Computed; Treatment Outcome

BACKGROUND Parainfluenza viruses (PIV) are known to cause mild respiratory tract infections in immunocompetent patients but can cause severe infections in immune-compromised patients such as transplant recipients and children with HIV. PIV infection in HIV-infected adults has rarely been reported. We report a case of PIV pneumonia in an adult with AIDS who was successfully treated with oral ribavirin. CASE REPORT A 64-year-old man with history of acquired immune deficiency syndrome (AIDS) was admitted to the hospital with shortness of breath that began 3 days before. He was in respiratory distress and required mechanical ventilation on arrival. A bronchoalveolar lavage (BAL) culture was positive for Hemophilus influenzae and a respiratory viral panel was positive for Parainfluenza virus. The patient was initially started on Cefepime and Trimethoprim- Sulfamethoxazole and later changed to Ceftriaxone based on culture results. As the patient's condition did not improve after 48 h, oral ribavirin was added to treat PIV. The patient subsequently improved and was extubated after 72 h. CONCLUSIONS Oral ribavirin can have a beneficial effect in AIDS patients who have PIV-associated pneumonia. Further investigation of the benefit of oral ribavirin in similar cases is warranted.

Topics: Acquired Immunodeficiency Syndrome; Anti-Bacterial Agents; Antiviral Agents; Ceftriaxone; Coinfection; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Middle Aged; Paramyxoviridae Infections; Pneumonia, Viral; Respiration, Artificial; Respiratory Distress Syndrome; Ribavirin

The clinical implications of COVID-19 in pregnancy remain unknown. While preliminary reports demonstrate that pregnant patients have a similar symptomatic presentation to the general population, the appropriate management and timing of delivery in these patients is still unclear, as pregnancy may impose additional risk factors and impede recovery in gravid patients. In this brief report, we present a case of COVID-19 in a pregnant patient with severe respiratory compromise, whose clinical status significantly improved after caesarean delivery. We also address the potential benefits of experimental therapy, including tocilizumab, a monoclonal antibody that targets interleukin-6 receptors.

Topics: Adult; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Azithromycin; Betacoronavirus; Ceftriaxone; Cesarean Section; Coronavirus Infections; COVID-19; Disease Progression; Enzyme Inhibitors; Female; Humans; Hydroxychloroquine; Pandemics; Pneumonia, Viral; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious; SARS-CoV-2; Treatment Outcome

The evolving pandemic of Coronavirus Disease 2019 has posed a substantial health risk worldwide. However, there is a paucity of data regarding the clinical course and the therapeutic management of patients with chronic kidney disease and COVID-19 infection. To date, most evidence has come from renal transplantation, with about 45 patients reported thus far, and the current data from the ERA-EDTA (ERACODA) registry for transplanted patients and patients on Renal Replacement Therapy (RRT); as for those with glomerular diseases, data are lacking. Herein, we report the case of a 62-year-old patient with severe membranoproliferative glomerulonephritis who had been receiving a high burden of immunosuppression until four months before the COVID-19 infection. He developed severe disease with acute respiratory failure requiring mechanical ventilation. After treatment with hydroxychloroquine and azithromycin, despite his low chances, he gradually recovered and survived. To the best of our knowledge, this is one of the few reported patients with glomerulonephritis who had COVID-19 Besides our single case with glomerulonephritis early during the disease outbreak, the very low prevalence of COVID-19 infection in the country's transplant recipients (0.038%) and dialysis patients (0.24%) reflects the impact of the rapid implementation of social distancing rules as well as of preventive measures for disease control in the hospitals and dialysis units in our country.

Topics: Anti-Bacterial Agents; Azithromycin; Betacoronavirus; Ceftriaxone; Coronavirus Infections; COVID-19; Creatinine; Cryoglobulinemia; Cyclophosphamide; Enzyme Inhibitors; Glomerulonephritis, Membranoproliferative; Glucocorticoids; Greece; Humans; Hydroxychloroquine; Immunocompromised Host; Immunologic Factors; Kidney Failure, Chronic; Kidney Transplantation; Leukemia, Lymphocytic, Chronic, B-Cell; Lung; Male; Methylprednisolone; Middle Aged; Pandemics; Pneumonia, Viral; Renal Dialysis; Respiration, Artificial; Respiratory Insufficiency; Reverse Transcriptase Polymerase Chain Reaction; Rituximab; SARS-CoV-2; Tomography, X-Ray Computed

Bacterial co-infection in the ongoing pandemic of COVID-19 is associated with poor outcomes but remains little understood. A 22-year-old woman presented with a 3-week history of fever, headache, neck stiffness, rigours and confusion. She was noted to have a purpuric rash over her hands and feet. Cerebrospinal fluid bacterial PCR was positive for

Topics: Anti-Bacterial Agents; Betacoronavirus; Ceftriaxone; Coinfection; Coronavirus Infections; COVID-19; Female; Humans; Meningitis, Meningococcal; Pandemics; Pneumonia, Viral; Risk Factors; SARS-CoV-2; Young Adult

Adenovirus is a common cause of acute upper respiratory tract infection and rarely causes respiratory failure or septic shock in immunocompetent patients. Severe disease is confined to immunocompromised patients. Human bocavirus (HBoV) is known as the fourth most common virus in respiratory samples from healthy subjects. In patients with respiratory complaints, it can be found alone or, more often, in combination with other viruses known to cause respiratory complaints. A well-documented fatal case of HBoV and adenovirus pneumonia with myocarditis in an immunocompetent child is described.

Topics: Adenovirus Infections, Human; Adenoviruses, Human; Antiviral Agents; Ceftriaxone; Child, Preschool; Fatal Outcome; Human bocavirus; Humans; Male; Parvoviridae Infections; Pneumonia, Viral; Vancomycin

Topics: Adult; Aged; Ambulatory Care; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftriaxone; Female; Humans; Male; Middle Aged; Patient Admission; Pneumonia, Bacterial; Pneumonia, Pneumococcal; Pneumonia, Viral; Risk Factors; Systemic Inflammatory Response Syndrome

Available data on the etiology of community-acquired pneumonia (CAP) in Australia are very limited. Local treatment guidelines promote the use of combination therapy with agents such as penicillin or amoxycillin combined with either doxycycline or a macrolide.. The Australian CAP Study (ACAPS) was a prospective, multicenter study of 885 episodes of CAP in which all patients underwent detailed assessment for bacterial and viral pathogens (cultures, urinary antigen testing, serological methods, and polymerase chain reaction). Antibiotic agents and relevant clinical outcomes were recorded.. The etiology was identified in 404 (45.6%) of 885 episodes, with the most frequent causes being Streptococcus pneumoniae (14%), Mycoplasma pneumoniae (9%), and respiratory viruses (15%; influenza, picornavirus, respiratory syncytial virus, parainfluenza virus, and adenovirus). Antibiotic-resistant pathogens were rare: only 5.4% of patients had an infection for which therapy with penicillin plus doxycycline would potentially fail. Concordance with local antibiotic recommendations was high (82.4%), with the most commonly prescribed regimens being a penicillin plus either doxycycline or a macrolide (55.8%) or ceftriaxone plus either doxycycline or a macrolide (36.8%). The 30-day mortality rate was 5.6% (50 of 885 episodes), and mechanical ventilation or vasopressor support were required in 94 episodes (10.6%). Outcomes were not compromised by receipt of narrower-spectrum beta-lactams, and they did not differ on the basis of whether a pathogen was identified.. The vast majority of patients with CAP can be treated successfully with narrow-spectrum beta-lactam treatment, such as penicillin combined with doxycycline or a macrolide. Greater use of such therapy could potentially reduce the emergence of antibiotic resistance among common bacterial pathogens.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Australia; Bacteria; Ceftriaxone; Community-Acquired Infections; Doxycycline; Female; Guideline Adherence; Humans; Macrolides; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Pneumonia, Bacterial; Pneumonia, Viral; Prospective Studies; Treatment Outcome; Viruses