[For Once Not Corona Virus - an Uncommon Cause of Fever and Hepatitis]. / Für einmal nicht Coronavirus ­ Eine nicht alltägliche Ursache für Fieber und Hepatitis.

For Once Not Corona Virus - an Uncommon Cause of Fever and Hepatitis Abstract. Our case reports acute Q fever as uncommon cause of fever, typically accompanied by pneumonia and/or hepatitis. It is caused by Coxiella burnetii, a bacterium which is generally hosted by live stock and affects humans by inhaling aerosols of the animals' excrements. If detected, it may be treated effectively. It should be considered in patients living in a typical environment or with a typical history. The route of our patient's infection remains unclear since he plausibly denied contact with any animals.

Focus on Middle East respiratory syndrome coronavirus (MERS-CoV).

Since the first case of human infection by the Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in June 2012, more than 2260 cases of confirmed MERS-CoV infection and 803 related deaths have been reported since the 16th of October 2018. The vast majority of these cases (71%) were reported in Saudi Arabia but the epidemic has now spread to 27 countries and has not ceased 6 years later, unlike SARS-CoV that disappeared a little less than 2 years after emerging. Due to the high fatality rate observed in MERS-CoV infected patients (36%), much effort has been put into understanding the origin and pathophysiology of this novel coronavirus to prevent it from becoming endemic in humans. This review focuses in particular on the origin, epidemiology and clinical manifestations of MERS-CoV, as well as the diagnosis and treatment of infected patients. The experience gained over recent years on how to manage the different risks related to this kind of epidemic will be key to being prepared for future outbreaks of communicable disease.

[COVID-19 in the Family Practice - Outpatient Treatment or Hospitalization?] / COVID-19 in der Praxis ­ wann ambulant, wann stationär behandeln?

COVID-19 in the Family Practice - Outpatient Treatment or Hospitalization? Abstract. Switzerland has been severely affected by the COVID-19 pandemic. The clinical spectrum of this disease in terms of its clinical presentation and course is very broad. A correct initial evaluation in the practice or in the emergency department is important and includes history-taking and clinical examination as well as imaging and laboratory tests. Most patients with COVID-19 can be treated as outpatients. Hospitalization may be necessary in patients with a marked COVID-19 pneumonia or further complications, which occur primarily in the second or third phase of the disease. The dynamics of the disease must also be taken into consideration. In outpatients, symptomatic therapy is often sufficient, antibiotics and corticosteroids are not indicated.

[CME Sonography 98/Answers: Chest Ultrasound]. / CME-Sonografie 98/Antworten: Thoraxsonografie.

CME Sonography 98/Answers: Chest Ultrasound Abstract. Chest sonography has long been an important part of ultrasound diagnostics. Historically, the first evidence found in chest sonography were pleural effusions. Peripheral consolidations (pneumonia, tumors, pulmonary embolism) and pneumothorax were added later. The COVID-19 pandemic with often massive lung infestation has significantly increased the interest in thoracic sonography. The partially specific changes caused by COVID-19 are presented in this article.

[Strong Increase in Lung Ultrasound Due to COVID-19]. / Lungenultraschall begehrt wie nie infolge COVID-19.

Strong Increase in Lung Ultrasound Due to COVID-19 Abstract. Due to the COVID-19 pandemic, lung ultrasound is experiencing a tremendous upswing and rapid diffusion. This affects both publications and clinical use. The typical changes are described here, also for lung consolidations of other genesis and in interstitial lung diseases. Comparisons with other imaging techniques and indications of the accuracy of lung ultrasound are also presented hereafter.

Are Lung Ultrasound Findings in COVID-19 Pneumonia Typical or Specific?

The application of point-of-care lung ultrasound (LUS) in the first diagnosis and management of Corona Virus Disease 2019 (COVID-19) has gained a great interest during a pandemic that is undermining even the most advanced health systems. LUS demonstrated high sensitivity in the visualization of the interstitial signs of the typical pneumonia complicating the infection. However, although this disease gives typical lung alterations, the same LUS signs observed in COVID-19 pneumonia can be detected in other common pulmonary conditions. While being non-specific when considered separately, the analysis of the distribution of the sonographic typical signs allows the assignment of 4 LUS patterns of probability for COVID-19 pneumonia when the whole chest is examined and attention is paid to the presence of other atypical signs. Moreover, the combination of LUS likelihood with the clinical phenotype at presentation increases the accuracy. This mini-review will analyze the LUS signs of COVID-19 pneumonia and how they can be combined in patterns of probability in the first approach to suspected cases.

[CME Sonography 98: Chest Ultrasound]. / CME-Sonografie 98: Thoraxsonografie.

CME Sonography 98: Chest Ultrasound Abstract. Chest sonography has long been an important part of ultrasound diagnostics. Historically, the first evidence found in chest sonography were pleural effusions. Peripheral consolidations (pneumonia, tumors, pulmonary embolism) and pneumothorax were added later. The COVID-19 pandemic with often massive lung infestation has significantly increased the interest in thoracic sonography. The partially specific changes caused by COVID-19 are presented in this article.

Clinical study of pulmonary CT lesions and associated bronchiectasis in 115 convalescent patients with novel coronavirus pneumonia (COVID-19) in China.

A total of 115 convalescent inpatients with COVID-19 were enrolled. According to the results of scans of lung lesions via computed tomography (CT), the patients were divided into mild, moderate, and severe groups. The clinical data of the patients were collected, including age, gender, finger pulse oxygen pressure, ventricular rate, body temperature, etc. The correlation between the clinical indicators and the lesions of high-resolution CT (HRCT) and bronchiectasis was analyzed. Among the 115 patients, 82 had no bronchiectasis and 33 had bronchiectasis. The bronchodilation-prone layers mainly included the left and right lower lobe of the lung. The probability of branching in the inflamed area was greater than that in the noninflamed area in patients with COVID-19. There were significant differences in gender, CT lesion range, and number of incidents of bronchiectasis between noninflamed and inflamed areas (P < 0.05). Moreover, there were significant differences in age, total proportion of CT lesions, volume of CT lesions, and total number of patients with bronchiectasis among the three groups (P < 0.05). CT lesion range was positively correlated with the total number of patients with bronchiectasis and patient age (respectively, r = 0.186, P < 0.05; r = 0.029, P < 0.05). The lesion range in HRCT images of lungs in patients with COVID-19 is correlated with bronchodilation. The larger the lesion, the higher the probability of bronchiectasis and the more incidents of bronchiectasis.

Profil clinique, biologique et radiologique des patients Algériens hospitalisés pour COVID-19: données préliminaires.

INTRODUCTION: Aucune étude antérieure n'a élaboré le profil des patients Algériens hospitalisés pour COVID-19. L'objectif de cette étude était de déterminer le profil clinique, biologique et tomodensitométrique des patients Algériens hospitalisés pour COVID-19. MÉTHODES: Une étude prospective était menée auprès des patients hospitalisés pour COVID-19 (période: 19 mars-30 avril 2020). Les données cliniques, biologiques et radiologiques, le type de traitement reçu et la durée de l'hospitalisation étaient notés. RÉSULTATS: Le profil clinique des 86 patients atteints de COVID-19 était un homme non-fumeur, âgé de 53 ans, qui était dans 42% des cas en contact avec un cas suspect/confirmé de COVID-19 et ayant une comorbidité dans 70% des cas (hypertension artérielle, diabète sucré, pathologie respiratoire chronique et allergie, cardiopathie). Les plaintes cliniques étaient dominées par la triade «asthénie-fièvre-toux¼ dans plus de 70% des cas. Les anomalies biologiques les plus fréquentes étaient: syndrome inflammatoire biologique (90,1%), basocytémie (70,8%), lymphopénie (53,3%), augmentation de la lactico-deshydrogénase (52,2%), anémie (38,7%), augmentation de la phosphokinase (28,8%) et cytolyse hépatique (27,6%). Les signes tomodensitométriques les plus fréquents étaient: verre dépoli (91,8%), condensations alvéolaires (61,2%), verre dépoli en plage (60,0%), et verre dépoli nodulaire (55,3%). Un traitement à base de «chloroquine, azithromycine, zinc, vitamine C, enoxaparine, double antibiothérapie et ± corticoïdes¼ était prescrit chez 34,9% des patients. La moyenne de la durée d'hospitalisation était de 7±3 jours. CONCLUSION: La connaissance des profils des formes modérées et sévères du COVID-19 contribuerait à faire progresser les stratégies de contrôle de l'infection en Algérie.

[Guide for management of patients with possible respiratory sequelae after a SARS-CoV-2 pneumonia. Support proposals developed by the French-speaking Respiratory Medicine Society. Version of 10 November 2020]. / Guide de prise en charge des séquelles respiratoires post infection à SARS-CoV-2. Propositions de prise en charge élaborées par la Société de Pneumologie de Langue Française. Version du 10 novembre 2020.

The French-speaking Respiratory Medicine Society (SPLF) proposes a guide for the management of possible respiratory sequelae in patients who have presented with SARS-CoV-2 pneumonia (COVID-19). The proposals are based on known data from previous epidemics, preliminary published data on post COVID-19 follow-up and on expert opinion. The proposals were developed by a group of experts and then submitted, using the Delphi method, to a panel of 22 pulmonologists. Seventeen proposals were validated ranging from additional examinations after the minimum assessment proposed in the SPLF monitoring guide, to inhaled or systemic corticosteroid therapy and antifibrotic agents. These proposals may evolve over time as knowledge accumulates. This guide emphasizes the importance of multidisciplinary discussion.

Legionella co-infection in a patient with COVID-19.

We describe a case of an 80-year-old man with COVID-19 and Legionella bacterial co-infection who initially presented to hospital with fever, respiratory symptoms, and diarrhea with radiographic evidence of atypical infection. His initial nasopharyngeal swab was negative; however, a subsequent swab was positive. A Legionella urinary antigen test was positive for Legionella pneumophilia serogroup 1 antigen. Despite a low prevalence of bacterial co-infection in patients with COVID-19, a large number of patients receive antimicrobial therapy. Based on clinical context, a high index of suspicion is warranted for both bacterial and viral infectious processes during the COVID-19 pandemic; this will help to ensure that appropriate antimicrobial therapy is used.

Les auteurs décrivent le cas d'un homme de 80 ans co-infecté par la COVID-19 et la légionellose bactérienne qui a consulté à l'hôpital à cause de fièvre, de symptômes respiratoires et de diarrhée et dont la radiographie démontrait une infection atypique. Le premier écouvillon nasopharyngé a donné un résultat négatif, mais un écouvillon subséquent s'est révélé positif. Un test d'antigène urinaire des légionelles était positif à l'antigène Legionella pneumophilia du sérogroupe 1. Malgré une faible prévalence de co-infection bactérienne chez les patients atteints de la COVID-19, de nombreux patients reçoivent des antimicrobiens. D'après le contexte clinique, il faut faire preuve de vigilance à l'égard des processus bactériens et viraux pendant la pandémie de COVID-19 afin de s'assurer d'utiliser des antimicrobiens appropriés.