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Italian Journal of Medicine ; 16(SUPPL 1):71, 2022.
Article in English | EMBASE | ID: covidwho-1912982


Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis. Discussion: A 58-years man was admitted to the Emergency Department in January 2022 for myalgia and weakness of lower limbs in recent COVID-19 infection. He had a clinical history of allergic asthma and eosinophilic pneumonia (ANCA negative) diagnosed as secondary to sensitization work-related in 2001. Blood test showed a severe hypereosinophilia (absolute eosinophil count: 9875/microL) and elevated creatine kinase (CK: 7555 U/L). He was hospitalized in HUB COVID. During hospitalization reported paraesthesia of upper and lower limbs and fever;blood test showed elevation of inflammation markers. Autoimmune screening showed a antineutrophil cytoplasmic antibodies positivity (ANCA anti-MPO 178UI/mL). A sinus CT showed nasal polyposis. A neurological evaluation and electromyography were performed with the evidence of polyneuropathy. Muscle biopsy showed eosinophil-associated vascular occlusion and eosinophilassociated tissue damage. The investigation excluded renal, cardiac, pulmonary and gastro-intestinal involvement. A steroid therapy (Prednisone 1 mg/kg/die) was started with clinical improvement. Conclusions: EGPA is a multisystemic disorder, typically suspected based on a combination of clinical findings, such as asthma, nasal and sinus symptoms, peripheral neuropathy, and eosinophilia ≥1500/microL. ANCA antibodies are positive in around 40% of patients and diagnosis can often be challenging and delayed.

Medicine (United Kingdom) ; 2021.
Article in English | EMBASE | ID: covidwho-1228113


The skin serves as a highly effective and renewable barrier against microbial pathogens and infestations. However, it is constantly under attack and if barrier function is impaired by trauma, dermatoses, poor nutritional status or systemic disease, susceptibility to infection is increased. Skin and soft tissue infections are common and readily noticeable by patients and clinicians alike. It is important for clinicians in primary and secondary care settings to be able to correctly diagnose and treat them. This article gives an overview of the most common cutaneous bacterial, fungal and viral infections and parasitic infestations that occur in the UK and other temperate-climate countries. Cutaneous features of COVID-19 infection are also included.

Anaesthesia ; 75(6): 724-732, 2020 06.
Article in English | MEDLINE | ID: covidwho-27731


Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.

Coronavirus Infections/therapy , Disease Outbreaks , Pneumonia, Viral/therapy , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Coronavirus Infections/epidemiology , Humans , Infant , Infant, Newborn , Intubation, Intratracheal , Italy/epidemiology , Male , Middle Aged , Oxygen/therapeutic use , Pandemics , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Young Adult