Guillermo Rodriguez Nava
Postdoctoral Medical Fellow, Infectious Diseases
Fellow in Graduate Medical Education
All Publications
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Syphilis Treatment: Systematic Review and Meta-Analysis Investigating Nonpenicillin Therapeutic Strategies.
Open forum infectious diseases
2024; 11 (4): ofae142
Abstract
Background: Penicillin's long-standing role as the reference standard in syphilis treatment has led to global reliance. However, this dependence presents challenges, prompting the need for alternative strategies. We performed a systematic literature review and meta-analysis to evaluate the efficacy of these alternative treatments against nonneurological syphilis.Methods: We searched MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Scopus, and Web of Science from database inception to 28 August 2023, and we included studies that compared penicillin or amoxicillin monotherapy to other treatments for the management of nonneurological syphilis. Our primary outcome was serological cure rates. Random-effect models were used to obtain pooled mean differences, and heterogeneity was assessed using the I2 test.Results: Of 6478 screened studies, 27 met the inclusion criteria, summing 6710 patients. The studies were considerably homogeneous, and stratified analyses considering each alternative treatment separately revealed that penicillin monotherapy did not outperform ceftriaxone (pooled odds ratio, 1.66 [95% confidence interval, .97-2.84]; I2 = 0%), azithromycin (0.92; [.73-1.18]; I2 = 0%), or doxycycline (0.82 [.61-1.10]; I2 = 1%) monotherapies with respect to serological conversion.Conclusions: Alternative treatment strategies have serological cure rates equivalent to penicillin, potentially reducing global dependence on this antibiotic.
View details for DOI 10.1093/ofid/ofae142
View details for PubMedID 38595955
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Correction: Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus Infection and COVID-19: a retrospective cohort study.
BMC infectious diseases
2024; 24 (1): 84
View details for DOI 10.1186/s12879-023-08782-z
View details for PubMedID 38225539
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COVID-19 AND THE RISK OF INFECTIONS CAUSED BY MULTIDRUG-RESISTANT ORGANISMS: A RETROSPECTIVE COHORT STUDY IN A COMMUNITY HOSPITAL
ELSEVIER. 2023: 798A
View details for DOI 10.1016/j.chest.2023.07.594
View details for Web of Science ID 001085062000486
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Low infectivity among asymptomatic patients with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) admission test at a tertiary care center, 2020-2022.
Infection control and hospital epidemiology
2023: 1-3
Abstract
We used a strand-specific RT-qPCR to evaluate viral replication as a surrogate for infectiousness among 242 asymptomatic inpatients with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) admission test. Only 21 patients (9%) had detectable SARS-CoV-2 minus-strand RNA. Because most patients were found to be noninfectious, our findings support the suspension of asymptomatic admission testing.
View details for DOI 10.1017/ice.2023.210
View details for PubMedID 37746805
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Sternal wound infection with Mycoplasma salivarium following bilateral lung transplant.
Transplant infectious disease : an official journal of the Transplantation Society
2023: e14120
View details for DOI 10.1111/tid.14120
View details for PubMedID 37622411
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Use of a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) strand-specific assay to evaluate for prolonged viral replication >20 days from illness onset.
Infection control and hospital epidemiology
2023: 1-3
Abstract
Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (rRT-PCR) strand-specific assay can be used to identify active SARS-CoV-2 viral replication. We describe the characteristics of 337 hospitalized patients with at least 1 minus-strand SARS-CoV-2 assay performed >20 days after illness onset. This test is a novel tool to identify high-risk hospitalized patients with prolonged SARS-CoV-2 replication.
View details for DOI 10.1017/ice.2023.105
View details for PubMedID 37381726
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Reconsidering the routine use of contact precautions in preventing the transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in healthcare settings.
Infection control and hospital epidemiology
2023: 1-2
View details for DOI 10.1017/ice.2023.91
View details for PubMedID 37138546
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Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus infection and COVID-19: a retrospective cohort study
BMC INFECTIOUS DISEASES
2022; 22 (1): 618
Abstract
Unlike SARS-CoV and MERS-C0V, SARS-CoV-2 has the potential to become a recurrent seasonal infection; hence, it is essential to compare the clinical spectrum of COVID-19 to the existent endemic coronaviruses. We conducted a retrospective cohort study of hospitalized patients with seasonal coronavirus (sCoV) infection and COVID-19 to compare their clinical characteristics and outcomes.A total of 190 patients hospitalized with any documented respiratory tract infection and a positive respiratory viral panel for sCoV from January 1, 2011, to March 31, 2020, were included. Those patients were compared with 190 hospitalized adult patients with molecularly confirmed symptomatic COVID-19 admitted from March 1, 2020, to May 25, 2020.Among 190 patients with sCoV infection, the Human Coronavirus-OC93 was the most common coronavirus with 47.4% of the cases. When comparing demographics and baseline characteristics, both groups were of similar age (sCoV: 74 years vs. COVID-19: 69 years) and presented similar proportions of two or more comorbidities (sCoV: 85.8% vs. COVID-19: 81.6%). More patients with COVID-19 presented with severe disease (78.4% vs. 67.9%), sepsis (36.3% vs. 20.5%), and developed ARDS (15.8% vs. 2.6%) compared to patients with sCoV infection. Patients with COVID-19 had an almost fourfold increased risk of in-hospital death than patients with sCoV infection (OR 3.86, CI 1.99-7.49; p < .001).Hospitalized patients with COVID-19 had similar demographics and baseline characteristics to hospitalized patients with sCoV infection; however, patients with COVID-19 presented with higher disease severity, had a higher case-fatality rate, and increased risk of death than patients with sCoV. Clinical findings alone may not help confirm or exclude the diagnosis of COVID-19 during high acute respiratory illness seasons. The respiratory multiplex panel by PCR that includes SARS-CoV-2 in conjunction with local epidemiological data may be a valuable tool to assist clinicians with management decisions.
View details for DOI 10.1186/s12879-022-07555-4
View details for Web of Science ID 000825992700006
View details for PubMedID 35840902
View details for PubMedCentralID PMC9284965
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Clinical characteristics and outcomes of the first two waves of the COVID-19 pandemic in a community hospital: a retrospective cohort study
IJID REGIONS
2022; 3: 1-7
Abstract
To describe the clinical characteristics and outcomes of two waves of the COVID-19 pandemic.A de-identified dataset of patients with COVID-19 admitted to our community hospital in Evanston, Illinois, from March 1, 2020 to February 28, 2021 was retrospectively reviewed. Patients from the first wave were identified as those admitted during the initial peak of admissions observed at our hospital between March 1, 2020 and September 3, 2020. The second wave was defined as those admitted during the second peak of admissions observed between October 1, 2020 and February 28, 2021.In total, 671 patients were included. Of these, 399 (59.46%) were identified as patients from the first wave and 272 (40.54%) as patients from the second wave. Significantly more patients received steroids (86.4% vs 47.9%, p < 0.001), remdesivir (59.6% vs 9.5%, p < 0.001), humidified high-flow nasal cannula (18% vs 6.5%, p < 0.001), and noninvasive ventilation (11.8% vs 3.3%, p < 0.001) during the second wave. Patients from the first wave had a greater hazard for death compared with patients from the second wave (hazard ratio [HR] 1.62, 95% CI 1.08-2.43; p = 0.019).Among patients hospitalized with COVID-19 in our community hospital, there was a decrease in case-fatality rate in the second surge of the COVID-19 pandemic compared with the first wave.
View details for DOI 10.1016/j.ijregi.2022.02.001
View details for Web of Science ID 001155798900049
View details for PubMedID 35720147
View details for PubMedCentralID PMC8817945
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CHARACTERIZATION OF THE FIRST 391 REPORTS OF MYOCARDITIS AFTER MRNA COVID-19 VACCINES SUBMITTED TO THE VACCINE ADVERSE EVENT REPORTING SYSTEM - UNITED STATES
ELSEVIER SCIENCE INC. 2022: 1839
View details for Web of Science ID 000781026602040
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Gemella morbillorum as the Culprit Organism of Post-Colonoscopy Necrotizing Perineal Soft Tissue Infection in a Diabetic Patient With Crohn's Disease
JOURNAL OF MEDICAL CASES
2022; 13 (3): 99-103
Abstract
Gemellsa morbillorum (G. morbillorum) is a Gram-positive facultative anaerobe and a known commensal organism of the oropharyngeal and gastrointestinal tracts. It is considered a rare cause of infections in humans. Most of the documented infections, whereas G. morbillorum has been implicated as a causative pathogen, were infective endocarditis and deep visceral abscesses. However, there are only a handful of cases in the current literature that have reported G. morbillorum as the primary organism causing necrotizing soft tissue infections. The authors presented a rare case of post-colonoscopy necrotizing perineal soft tissue infections in an elderly patient with poorly controlled diabetes mellitus and Crohn's disease with G. morbillorum being the culprit pathogen of this necrotizing infection. The reported case raises concerns for this commensal organism as an emerging virulent pathogen in certain high-risk patients. The authors proposed that a combination of the long-standing Crohn's disease and the recent colonoscopy with rectal polypectomy has predisposed the patient to G. morbillorum bacteremia with perineal sepsis in the setting of diabetic immunosuppression. Further studies are warranted to ascertain whether G. morbillorum is acquiring increased virulence that would have enabled this organism to cause novel soft tissue infections.
View details for DOI 10.14740/jmc3896
View details for Web of Science ID 001220883100009
View details for PubMedID 35356394
View details for PubMedCentralID PMC8929211
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Clinical outcomes after IL-6 blockade in patients with COVID-19 and HIV: a case series
AIDS RESEARCH AND THERAPY
2022; 19 (1): 6
Abstract
In hospitalized people with HIV (PWH) there is an increased risk of mortality from COVID-19 among hospitalized PWH as compared to HIV-negative individuals. Evidence suggests that tocilizumab-a humanized monoclonal interleukin (IL)-6 receptor inhibitor (IL-6ri) antibody-has a modest mortality benefit when combined with corticosteroids in select hospitalized COVID-19 patients who are severely ill. Data on clinical outcomes after tocilizumab use in PWH with severe COVID-19 are lacking.We present a multinational case series of 18 PWH with COVID-19 who were treated with IL-6ri's during the period from April to June 2020. Four patients received tocilizumab, six sarilumab, and eight received an undocumented IL-6ri. Of the 18 patients in the series, 4 (22%) had CD4 counts < 200 cells/mm3; 14 (82%) had a suppressed HIV viral load. Eight patients (44%), all admitted to ICU, were treated for secondary infection; 5 had a confirmed organism. Of the four patients with CD4 counts < 200 cells/mm3, three were treated for secondary infection, with 2 confirmed organisms. Overall outcomes were poor-12 patients (67%) were admitted to the ICU, 11 (61%) required mechanical ventilation, and 7 (39%) died.In this case series of hospitalized PWH with COVID-19 and given IL-6ri prior to the common use of corticosteroids, there are reports of secondary or co-infection in severely ill patients. Comprehensive studies in PWH, particularly with CD4 counts < 200 cells, are warranted to assess infectious and other outcomes after IL-6ri use, particularly in the context of co-administered corticosteroids.
View details for DOI 10.1186/s12981-022-00430-x
View details for Web of Science ID 000754193400001
View details for PubMedID 35148782
View details for PubMedCentralID PMC8832430
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Myocarditis Attributable to Monkeypox Virus Infection in 2 Patients, United States, 2022.
Emerging infectious diseases
2022; 28 (12): 2508-2512
Abstract
We report 2 immunocompetent and otherwise healthy adults in the United States who had monkeypox and required hospitalization for viral myocarditis. Both patients were unvaccinated against orthopoxviruses. They had shortness of breath or chest pain and elevated cardiac biomarkers. No immediate complications were observed. They were discharged home after symptoms resolved.
View details for DOI 10.3201/eid2812.221276
View details for PubMedID 36179413
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Dark urine as the initial manifestation of COVID-19: a case report
JOURNAL OF MEDICAL CASE REPORTS
2021; 15 (1): 576
Abstract
Rhabdomyolysis is defined as a syndrome consisting of muscle necrosis and the release of intracellular muscle components into the bloodstream. Although rhabdomyolysis has been previously reported as an initial presentation or late complication of COVID-19, the data on it is still limited, and currently, there is no single case of COVID-19 in the literature that describes creatine kinase levels of more than 30,000 IU/L.A 50-year-old African-American male presented to the hospital with decreased urine output, dark urine color, and constipation for the past couple of days. He was found to have acute kidney injury, liver injury, and creatinine kinase of 359,910 IU/L, for which aggressive intravenous fluid therapy was given. Infectious workup resulted in positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. Two days after admission, the patient became symptomatic from a coronavirus disease 2019: he developed fever and hypoxia, and was placed on supplemental oxygen and started on a 10-day course of dexamethasone. The patient responded well to the treatment and supportive care for coronavirus disease 2019 and was successfully discharged.Clinicians should be cognizant of atypical coronavirus disease 2019 presentations. The spectrum of damage of coronavirus disease 2019 is still an evolving topic, and more research is required to reveal the exact mechanisms by which severe acute respiratory syndrome coronavirus 2 leads to rhabdomyolysis.
View details for DOI 10.1186/s13256-021-03173-x
View details for Web of Science ID 000725504400001
View details for PubMedID 34857045
View details for PubMedCentralID PMC8637504
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EXPERIENCE WITH REMDESIVIR FOR THE TREATMENT OF CRITICAL COVID-19 IN A COMMUNITY-BASED HOSPITAL IN EVANSTON, ILLINOIS
ELSEVIER. 2021: 542A-543A
View details for DOI 10.1016/j.chest.2021.07.529
View details for Web of Science ID 000709108700466
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THE FIRST AND SECOND WAVES OF THE COVID-19 PANDEMIC IN A COMMUNITY HOSPITAL ICU
ELSEVIER. 2021: 549A-550A
View details for DOI 10.1016/j.chest.2021.07.534
View details for Web of Science ID 000709108700471
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IN-HOSPITAL MORTALITY IN MECHANICALLY VENTILATED PATIENTS WITH COVID-19 WITH DIFFERENT ARDS PHENOTYPES
ELSEVIER. 2021: 509A
View details for DOI 10.1016/j.chest.2021.07.498
View details for Web of Science ID 000709108700435
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Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019
CLINICAL INFECTIOUS DISEASES
2021; 73 (7): E1964-E1972
Abstract
People living with human immunodeficiency virus (HIV) may have numerous risk factors for acquiring coronavirus disease 2019 (COVID-19) and developing severe outcomes, but current data are conflicting.Health-care providers enrolled consecutively, by nonrandom sampling, people living with HIV (PWH) with lab-confirmed COVID-19, diagnosed at their facilities between 1 April and 1 July 2020. Deidentified data were entered into an electronic Research Electronic Data Capture (REDCap) system. The primary endpoint was a severe outcome, defined as a composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death. The secondary outcome was the need for hospitalization.There were 286 patients included; the mean age was 51.4 years (standard deviation, 14.4), 25.9% were female, and 75.4% were African American or Hispanic. Most patients (94.3%) were on antiretroviral therapy, 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 164 (57.3%) patients were hospitalized, and 47 (16.5%) required ICU admission. Mortality rates were 9.4% (27/286) overall, 16.5% (27/164) among those hospitalized, and 51.5% (24/47) among those admitted to an ICU. The primary composite endpoint occurred in 17.5% (50/286) of all patients and 30.5% (50/164) of hospitalized patients. Older age, chronic lung disease, and hypertension were associated with severe outcomes. A lower CD4 count (<200 cells/mm3) was associated with the primary and secondary endpoints. There were no associations between the ART regimen or lack of viral suppression and the predefined outcomes.Severe clinical outcomes occurred commonly in PWH with COVID-19. The risks for poor outcomes were higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression.NCT04333953.
View details for DOI 10.1093/cid/ciaa1339
View details for Web of Science ID 000729829500103
View details for PubMedID 32905581
View details for PubMedCentralID PMC7499544
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Development of cavitary lung disease as a long-term complication of coronavirus disease 2019 in a young previously healthy patient: a case report
JOURNAL OF MEDICAL CASE REPORTS
2021; 15 (1): 377
Abstract
Cavities are frequent manifestations of a wide variety of pathological processes involving the lung. There has been a growing body of evidence of coronavirus disease 2019 leading to a cavitary pulmonary disease.A healthy 29-year-old Filipino male presented to the hospital a couple of months after convalescence from coronavirus disease 2019 with severe pleuritic chest pain, fever, chills, and shortness of breath, and was found to have a cavitary lung lesion on chest computed tomography. While conservative management alone failed to improve the patient's condition, he ultimately underwent left lung video-assisted thoracoscopic surgery decortication. Even though the surgical pathology revealed only necrosis with dense acute inflammation and granulation tissue with no microorganisms, he gradually improved with medical therapy adjunct with surgical therapy.Documented cases of cavitary lung disease secondary to coronavirus disease 2019 have been mostly reported in the acute or subacute phase of the infection. However, clinicians should recognize this entity as a late complication of coronavirus disease 2019, even in previously healthy individuals.
View details for DOI 10.1186/s13256-021-02961-9
View details for Web of Science ID 000674658600001
View details for PubMedID 34256831
View details for PubMedCentralID PMC8276840
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COMPARISON OF CLINICAL CHARACTERISTICS AND OUTCOMES OF HOSPITALIZED PATIENTS WITH SEASONAL CORONAVIRUS INFECTION AND COVID-19
SPRINGER. 2021: S145
View details for Web of Science ID 000679443300350
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Disproportionality analysis of anaphylactic reactions after vaccination with messenger RNA coronavirus disease 2019 vaccines in the United States
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY
2021; 127 (1): 139-+
View details for Web of Science ID 000665053500023
View details for PubMedID 33838338
View details for PubMedCentralID PMC8026243
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COMPARISON OF RESPIRATORY VIRAL COINFECTION RISK BETWEEN PATIENTS HOSPITALIZED WITH COVID-19 AND SEASONAL CORONAVIRUS
SPRINGER. 2021: S145-S146
View details for Web of Science ID 000679443300352
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Posterior reversible encephalopathy syndrome in a patient with Richter's syndrome on combination DA-R-EPOCH chemotherapy regimen: a case report
JOURNAL OF MEDICAL CASE REPORTS
2021; 15 (1): 161
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiologic entity characterized by headaches, altered mental status, seizures, visual loss, and a characteristic imaging pattern in brain magnetic resonance images. The exact etiology and pathogenesis of this condition are not yet fully elucidated.A 72-year-old White man presented with 2 weeks of low-grade fever and chills, night sweats, fatigue, dysphagia, and new-onset rapidly increasing cervical lymphadenopathy. He had a history of chronic lymphocytic leukemia with transformation to diffuse large B-cell lymphoma for which he was started on dose-adjusted rituximab, etoposide, prednisone vincristine, cyclophosphamide, and doxorubicin (DA-R-EPOCH). Shortly after treatment initiation, the patient developed severe airway obstruction due to cervical lymphadenopathy that required emergency intubation. A few days later, the cervical lymphadenopathy and the status of the airway improved, and sedation was consequently weaned off to plan for extubation. However, the patient did not recover consciousness and developed generalized refractory seizures. Brain magnetic resonance imaging revealed edema in the cortical gray and subcortical white matter of the bilateral occipital and inferior temporal lobes, consistent with PRES.Posterior reversible encephalopathy syndrome refers to a neurological disorder and imaging entity characterized by subcortical vasogenic edema in patients who develop acute neurological signs and symptoms of a usually reversible nature in different settings, including chemotherapy. Despite its name, PRES is not always fully reversible, and permanent sequelae can persist in some patients. Clinicians should be aware of the possible association between chemotherapy and PRES to ensure early recognition and timely treatment.
View details for DOI 10.1186/s13256-021-02780-y
View details for Web of Science ID 000704773900003
View details for PubMedID 33840384
View details for PubMedCentralID PMC8040238
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Type 2 diabetes is associated with increased risk of critical respiratory illness in patients COVID-19 in a community hospital.
Obesity medicine
2021; 22: 100316
Abstract
BACKGROUND: Type 2 diabetes (T2D) is the leading non-communicable disease worldwide and is associated with several microvascular and macrovascular complications. Individuals with T2D are more prone to acquiring selected types of infections and are more susceptible to complications due to these infections. This study aimed to evaluate the relationship between T2D and COVID-19 in the community setting.METHODS: This was a single-center retrospective analysis that included 147 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital. Demographics, medical history, symptoms and signs, laboratory findings, complications during the hospital course, and treatments were collected and analyzed. The Kaplan-Meier method was used to describe the probability of intubation in patients with T2D as compared with patients without T2D. The hazard ratio for intubation in the survival analysis was estimated using a bivariable Cox proportional-hazards model.RESULTS: Of 147 patients, 73 (49.7%) had a history of T2D. Patients with T2D had higher requirement of ICU admission (31.5% vs 12.2%; p=.004), higher incidence of ARDS (35.6% vs 16.2%, p=.007), higher rates of intubation (32.9% vs 12.2%, p=.003), and higher use neuromuscular blocking agents (23.3% vs 9.5%, p=.02). In the survival analysis at 28 days of follow-up, patients with T2D showed an increased hazard for intubation (HR 3.00; 95% CI, 1.39 to 6.46).CONCLUSION: In our patient population, patients with COVID-19 and T2D showed significantly higher ARDS incidence and intubation rates. The survival analysis also showed that after 28 days of follow-up, patients with T2D presented an increased risk for shorter time to intubation.
View details for DOI 10.1016/j.obmed.2020.100316
View details for PubMedID 33392411
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Clinical Characteristics and Risk Factors for Death of Hospitalized Patients With COVID-19 in a Community Hospital: A Retrospective Cohort Study.
Mayo Clinic proceedings. Innovations, quality & outcomes
2021; 5 (1): 1-10
Abstract
OBJECTIVE: To describe the clinical characteristics, outcomes, and risk factors for death of patients with coronavirus disease 2019 (COVID-19) in a community hospital setting.PATIENTS AND METHODS: This single-center retrospective cohort study included 313 adult patients with laboratory-confirmed COVID-19 admitted to a community hospital in Cook County, Illinois, from March 1, 2020, to May 25, 2020. Demographics, medical history, underlying comorbidities, symptoms, signs, laboratory findings, imaging studies, management, and progression to discharge or death data were collected and analyzed.RESULTS: Of 313 patients, the median age was 68 years (interquartile range, 59.0-78.5 years; range, 19-98 years), 182 (58.1%) were male, 119 (38%) were white, and 194 (62%) were admitted from a long-term care facility (LTCF). As of May 25, 2020, there were 212 (67.7%) survivors identified, whereas 101 (32.3%) nonsurvivors were identified. Multivariable Cox regression analysis showed increasing hazards of inpatient death associated with older age (hazard ratio [HR] 1.02; 95% CI, 1.01-1.04), LTCF residence (HR, 3.23; 95% CI, 1.68-6.20), and quick Sequential Organ Failure Assessment scores (HR, 2.59; 95% CI, 1.78-3.76).CONCLUSION: In this single-center retrospective cohort study of 313 adult patients hospitalized with COVID-19 illness in a community hospital in Cook County, Illinois, older patients, LTCF residents, and patients with high quick Sequential Organ Failure Assessment scores were found to have worse clinical outcomes and increased risk of death.
View details for DOI 10.1016/j.mayocpiqo.2020.10.007
View details for PubMedID 33173851
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An overlooked cause of septic shock: Staphylococcal Toxic Shock Syndrome secondary to an axillary abscess
IDCASES
2021; 23: e01039
Abstract
Staphylococcal Toxic Shock Syndrome (TSS) is characterized by rapid onset of fever, rash, hypotension, and multiorgan system involvement. Clinical manifestations of staphylococcal TSS include fever, chills, hypotension, and a diffuse macular erythroderma followed by desquamation one to two weeks later. The disease came to public attention in the 1980s with the occurrence of a series of menstrual-associated cases. However, the relative incidence of staphylococcal TSS not associated with menstruation has increased, and still, it remains an overlooked cause of septic shock. We present the case of a healthy 19-year-old male that presented with fever, chills, malaise, near-syncope, and a non-fluctuant, mobile nodule in the left armpit. The patient developed septic shock requiring critical care. He underwent extensive investigations resulting negative except for PCR for the detection of MRSA, raising the suspicion for STSS. For that reason, antibiotics for staphylococcal coverage were started, after which he started to improve. Ultimately, the mobile nodule evolved to fluctuant access. Incision and drainage was performed, and cultures confirmed the presence of Staphylococcus aureus.
View details for DOI 10.1016/j.idcr.2020.e01039
View details for Web of Science ID 000635404900010
View details for PubMedID 33473349
View details for PubMedCentralID PMC7803642
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Performance of the quick COVID-19 severity index and the Brescia-COVID respiratory severity scale in hospitalized patients with COVID-19 in a community hospital setting
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
2021; 102: 571-576
Abstract
To evaluate the performance of the Quick COVID-19 Severity Index (qCSI) and the Brescia-COVID Respiratory Severity Scale (BCRSS) in predicting intensive care unit (ICU) admissions and in-hospital mortality in patients with coronavirus disease 2019 (COVID-19) pneumonia.This was a retrospective cohort study of 313 consecutive hospitalized adult patients (18 years or older) with confirmed COVID-19. The area under the receiver operating characteristic curve (AUC) was used to assess the discriminatory power of the qCSI score and BCRSS prediction rule compared to the CURB-65 score for predicting mortality and intensive care unit admission.The overall in-hospital fatality rate was 32.3%, and the ICU admission rate was 31.3%. The CURB-65 score had the highest numerical AUC to predict in-hospital mortality (AUC 0.781) compared to the qCSI score (AUC 0.711) and the BCRSS prediction rule (AUC 0.663). For ICU admission, the qCSI score had the highest numerical AUC (AUC 0.761) compared to the BCRSS prediction rule (AUC 0.735) and the CURB-65 score (AUC 0.629).The CURB-65 and qCSI scoring systems showed a good performance for predicting in-hospital mortality. The qCSI score and the BCRSS prediction rule showed a good performance for predicting ICU admission.
View details for DOI 10.1016/j.ijid.2020.11.003
View details for Web of Science ID 000604663200029
View details for PubMedID 33181332
View details for PubMedCentralID PMC7833674
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A Retrospective Study of Coinfection of SARS-CoV-2 and <i>Streptococcus pneumoniae</i> in 11 Hospitalized Patients with Severe COVID-19 Pneumonia at a Single Center
MEDICAL SCIENCE MONITOR
2020; 26: e928754
Abstract
BACKGROUND A lethal synergism between the influenza virus and Streptococcus pneumoniae has been identified. However, bacterial coinfection is considered relatively infrequent in hospitalized patients with COVID-19, and the co-prevalence of Streptococcus pneumoniae is low. MATERIAL AND METHODS We retrospectively analyzed the clinical characteristics and outcomes of patients subsequently admitted to AMITA Health Saint Francis Hospital between March 1 and June 30, 2020, with documented SARS-CoV-2 and S. pneumoniae coinfection. RESULTS We identified 11 patients with S. pneumoniae coinfection. The median age was 77 years (interquartile range [IQR], 74-82 years), 45.5% (5/11) were males, 54.5% (6/11) were white, and 90.9% (10/11) were long-term care facility (LTCF) residents. The median length of stay was 7 days (IQR, 6-8 days). Among 11 patients, 4 were discharged in stable condition and 7 had died, resulting in an inpatient mortality rate of 64%. CONCLUSIONS At our center, 11 patients with COVID-19 pneumonia who had confirmed infection with SARS-CoV-2 were diagnosed with Streptococcus pneumoniae infection while in hospital. All patients had pneumonia confirmed on imaging and a nonspecific increase in markers of inflammation. The in-hospital mortality rate of 64% (7 patients) was higher in this group than in previous reports. This study highlights the importance of monitoring bacterial coinfection in patients with viral lung infection due to SARS-CoV-2.
View details for DOI 10.12659/MSM.928754
View details for Web of Science ID 000589183400001
View details for PubMedID 33188161
View details for PubMedCentralID PMC7673066
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THE ANTI-INFECTIVE AND IMMUNOMODULATOR PARADOX: INCREASED RISK OF COINFECTION WITH HYDROXYCHLOROQUINE IN CRITICAL PATIENTS WITH COVID-19
ELSEVIER. 2020: 2471A
View details for DOI 10.1016/j.chest.2020.09.048
View details for Web of Science ID 000582625302449
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WHOPPING THE ICU: A CASE OF CRITICAL PERTUSSIS IN AN IMMUNOCOMPETENT ADULT
ELSEVIER. 2020: 467A
View details for DOI 10.1016/j.chest.2020.08.449
View details for Web of Science ID 000582625300393
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SARS-CoV2 and Co-Infections: A Review of Two Cases
CASE REPORTS IN INFECTIOUS DISEASES
2020; 2020: 8882348
Abstract
COVID-19 infection caused by SARS-CoV2 virus is an acute respiratory illness which was declared as a pandemic by the World Health Organization. Usually, SARS-CoV2 infects independently and can cause spectrum of disease ranging from mild illness to severe progressive pneumonia, multiorgan dysfunction, and death; however, co-infections with other respiratory pathogens have been noted. Here, we present 2 fatal cases with co-infection, one with parainfluenza-4 virus and other co-infection/secondary infection with Streptococcus pneumoniae bacteria. Further studies are needed to study the effect of co-infections on morbidity and mortality of patients and establish the outcome of such infections.
View details for DOI 10.1155/2020/8882348
View details for Web of Science ID 000578491900001
View details for PubMedID 33014484
View details for PubMedCentralID PMC7519991
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MMR Vaccine Adverse Drug Reactions Reports in the CDC WONDER System, 1989-2019
OPEN FORUM INFECTIOUS DISEASES
2020; 7 (8): ofaa211
Abstract
Dissemination of misleading information regarding vaccine safety has contributed to the reduction in vaccination rates and the resurgence of diseases once considered eliminated. The CDC WONDER interface can be used to perform simple but powerful safety analyses and counter misinformation. The dissemination of false and misleading information regarding vaccine adverse reactions online has led to negative consequences, including raising parents' concerns about vaccine safety and fostering a growing opposition to the use of vaccines. However, health care workers can also use online resources to counter misinformation. The Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) is an online interface that allows health care workers to access the large-linked electronic health record database Vaccine Adverse Event Reporting System and perform near real-time vaccine safety analyses; hence it has the potential to become a powerful and accessible tool to provide information-driven decision-making regarding vaccine safety.
View details for DOI 10.1093/ofid/ofaa211
View details for Web of Science ID 000577171000004
View details for PubMedID 32818137
View details for PubMedCentralID PMC7423292
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Atorvastatin associated with decreased hazard for death in COVID-19 patients admitted to an ICU: a retrospective cohort study
CRITICAL CARE
2020; 24 (1): 429
View details for DOI 10.1186/s13054-020-03154-4
View details for Web of Science ID 000553137300002
View details for PubMedID 32664990
View details for PubMedCentralID PMC7358561
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Bleeding pneumonia: Diffuse alveolar hemorrhage due to human metapneumovirus
IDCASES
2020; 21: e00894
Abstract
Diffuse alveolar hemorrhage is a condition with high morbidity and mortality. The majority of cases are caused by pulmonary capillaritis associated with systemic vasculitis. Infection disease has also been associated with this condition. A 62-year-old woman with a history of chronic alcohol abuse presented with shortness of breath, hemoptysis, constipation, and icterus. Chest x-rays on admission showed diffuse patchy opacities concerning for diffuse alveolar hemorrhage. The patient quickly developed acute respiratory failure requiring intubation. PCR identified human metapneumovirus and bronchoalveolar lavage confirmed alveolar hemorrhage. Despite all efforts, the patient ultimately developed multi-organ failure and died. Human metapneumovirus is usually associated with mild upper and lower respiratory tract infections in young children. Nevertheless, clinicians should recognize that this virus has recently emerged as a significant pathogen, particularly in adult patients with underlying conditions and the elderly population.
View details for DOI 10.1016/j.idcr.2020.e00894
View details for Web of Science ID 000567868500027
View details for PubMedID 32665889
View details for PubMedCentralID PMC7324915
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Advances in medicine and positive natural selection: Prosthetic valve endocarditis due to biofilm producer <i>Micrococcus luteus</i>
IDCASES
2020; 20: e00743
Abstract
Over the past years there has been a considerable increase in the use of aortic bioprostheses for treating aortic valve disease. With the increasing use of implanted medical devices, the incidence of prosthetic valve endocarditis has also increased. This is accompanied by a shift in the microbiology of infectious endocarditis. Micrococcus species are usually regarded as contaminants from skin and mucous membranes that rarely cause infectious diseases, however, they have the capacity to create biofilms from prosthetic materials and hence, to cause disease. We report the case of a 54-year-old woman who developed native valve infective endocarditis due to Micrococcus luteus. To our knowledge, only 18 cases of M. luteus prosthetic valve endocarditis have been described, none in the English literature.
View details for DOI 10.1016/j.idcr.2020.e00743
View details for Web of Science ID 000544758800019
View details for PubMedID 32195120
View details for PubMedCentralID PMC7076149
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Gadolinium-induced anaphylaxis with positive skin test results
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY
2019; 122 (6): 654-655
View details for DOI 10.1016/j.anai.2019.03.022
View details for Web of Science ID 000469983100031
View details for PubMedID 30926309
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A Case of Voriconazole-Induced Pseudoporphyria
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
2019; 7 (2): 653-654
View details for DOI 10.1016/j.jaip.2018.08.018
View details for Web of Science ID 000457641700040
View details for PubMedID 30266284