ABSTRACT
Achromobacter xylosoxidans is an aerobic, Gram-negative rod with a broad intrinsic and acquired antimicrobial resistance, usually isolated in patients with cystic fibrosis (CF), immunodeficiencies, or those undergoing invasive procedures. We report a case of a previously healthy 14-year-old girl who was hospitalized in our institution due to a prolonged, progressive cough and exertional dyspnea, which started after a mild viral respiratory tract infection. To elucidate the cause of her symptoms, a bronchoscopy was finally performed, showing bilateral purulent bronchitis caused by A. xylosoxidans, isolated from bronchoalveolar lavage (BAL) sample. Since the patient had positive serological testing for coronavirus disease 2019 (COVID-19), we concluded that it was the initial viral infection, although of a mild clinical course, the one that created favorable conditions for proliferation and further inflammation caused by A. xylosoxidans.
ABSTRACT
The goal of the study was to present patients’ demographic characteristics and clinical course of SARS-CoV-2 infection in children with malignancies treated at our Department. Additional goals were to evaluate the impact of infection on the course of diagnosis, treatment and/or follow up of the primary malignant disease and to determine anti-SARS-CoV-2 antibodies by quantitative assay after recovery from infection.The study’s participants were oncological patients, treated and monitored at our Department, who developed SARS-CoV-2 infection. Demographic data, symptoms and the impact of infection on diagnosis, treatment and/or follow up of the primary disease were collected from questionnaires, filled by patients’ parents, in the presence of a medical doctor. Patients and their parents were informed about the study’s concept, and all signed consent forms before data and sample collection took place. Laboratory tests (total proteins, albumins, A, M, G immunoglobulin classes) as well as anti-SARS-CoV-2 antibodies were done at Department of Medical Biochemistry of the Children’s Hospital Zagreb.At the time of writing this abstract we have collected complete data on 14 patients, 9 boys. Primary diagnoses were: ALL (5), Wilms tumor (3), Hodgkin’s lymphoma (2), rhabdomyosarcoma (2), desmoplastic infantile ganglioglioma (1) and yolk sack tumor (1). Three patients were diagnosed with SARS-CoV-2 infection during intensive treatment, 2 at initial presentation of primary disease, 4 during maintenance treatment, and 5 during follow up. All the participants, except one patient who was initially treated at another hospital and had underwent only rapid antigen test, had positive RT-PCR test. The common most symptom was fever (9), followed by rhinorrhea (5), loss of appetite (4), cough (2), dyspnoea (2), loss of taste/smell (2), sore throat (1), lethargy (1), vomiting (1), diarrhea (1) and abdominal pain (1). None of the patients developed multisystemic inflammatory syndrome. Four patients had asymptomatic infection. Serology test was done 2.5-4.5 months post-infection, and was positive in 10 patients, while 1 patient had values just below the cut off limit (0.8 U/mL). Out of 9 patients infected during the treatment (initiation, intensive or maintenance treatment), 5 reported short postponement in oncological therapy, and none had delay in crucial diagnostics.Our study is still ongoing, but according to the results so far, none of our patients developed severe clinical presentation of SARS-CoV-2 infections, and the infection itself did not interfere much with oncological treatment.Majority of patients developed detectable anti-SARS-CoV-2 antibodies.