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A 64-year-old never-smoker man, with professional exposure, presented to Marius Nasta Pneumophtisiology Institute for fatigability to effort, in the context of severe SARS-COV2 infection one month previously. His medical history includes pulmonary tuberculosis (55 years ago) and newly diagnosed type II diabetes (261 mg/dL glycemia). The thoracic tomography computer in the immediate post-COVID period (Fig. 1A) revealed the presence of glass ground lesions and a 3 cm nodule with cystic degeneration in the upper left lobe. A gross examination of the specimen identified a condensation area of 2.5 cm diameter, brown-grey colored, with necrosis and central ulceration. Microscopic examination showed the presence of bronchiectasis with squamous metaplasia of the epithelium, which appears ulcerated;numerous calcium oxalate crystals with adjacent foreign body granulomatous reaction;endobronchial are present fibrinous and inflammatory debris, brown-black pigment, and septate, dichotomous branching hyphae, suggestive of Aspergillus spp. A periodic acid-Schiff stain was performed, identifying the fungal hyphae. The histopathological diagnosis was bronchiectasis supra-infected and colonized with fungal filaments (Aspergillus niger).
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Objective: To explore the distribution and correlation of pathogens in the elderly patients with AECOPD, so as to guide the rational use of antibiotics and hormones in clinic. Methods: A total of 111 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to Nanjing First Hospital from January 2019 to January 2020 were retrospectively analyzed. The basic data such as eosinophil, neutrophil and lymphocyte count, the levels of C-reactive protein(CRP) and erythrocyte sedimentation rate (ESR)in blood routine examination were collected. Further, the pathogens were qualified by sputum fluorescence quantitative polymerase chain reaction, and the pathogens distribution was analyzed. Results: The level of ESR and the ratio of cardiovascular diseases showed significant differences between the pathogen-positive group and pathogen-negative group. In this study, the top five pathogens in AECOPD patients were EB virus (21.6%), Haemophilus influenzae (19.8%), Streptococcus pneumoniae (17.1%), herpes simplex virus(14.4%), influenza A virus(14.4%). The detection rate of influenza A virus was correlated with influenza B virus and Aspergillus (P < 0.05);The detection rate of respiratory syncytial virus was correlated with Candida, Moraxella catarrholis, Streptococcus pneumoniae and Haemophilus influenzae (P < 0.05);The detection rate of Escherichia coli was correlated with rhinovirus, adenovirus, Klebsiella pneumoniae and Acinetobacter baumannii (P < 0.05);The detection rate of Candida was correlated with that of Moraxella catarrholis and Pseudomonas aeruginosa(P<0.05);The detection rate of human coronavirus was correlated with Haemophilus influenzae, herpes simplex virus and Streptococcus pneumoniae(P < 0.05). Conclusions: AECOPD are mostly induced by different pathogens, especially mixed infection of bacteria and virus. It is helpful to guide the rational use of antibiotics by analyzing the etiological characteristics in the elderly patients with AECOPD.
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Background: The coronavirus disease 2019 (COVID- 19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread over the world. Although there are minimal microbiological and antibiotic data on COVID-19, bacterial co-infections have been related to poor outcomes in respiratory viralinfections. Adequate antibiotic use in conformity withantibiotic stewardship (ABS) recommendations is necessary during the pandemic. Material and procedure: We conducted a retrospective single-center cohort analysis of 140 adulthospitalised patients (ages 17-99) with confirmed COVID-19 who were admitted between February 16, 2021, and April 22, 2021, and who were discharged onMay 6, 2021. From 140 COVID-19 participants, the following clinical data was gathered: Men made up 63.5 percent of the participants, with a median age of 63.5 years (range 17-99). Results: According to local ABS recommendations, the most commonly administered antibiotic regimen was ampicillin/sulbactam (41.5 percent) with a median length of 6 (range 1-13) days. Urine antigen testing for Legionella pneumophila and Streptococcus peumoniaewas negative in all of the patients. In critically ill patients hospitalised to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were discovered. Blood cultures obtained at admission had a diagnostic yield of 4.2 percent. Conclusion: While bacterial and fungal co-infections are rare in COVID-19 patients, they are widespread in critically ill individuals. More investigation into the impact of antimicrobial therapy on therapeutic success in COVID-19 patients is essential to prevent antibiotic abuse. COVID-19 management might be improved with the aid of ABS standards. It's also necessary to look at the microbiological patterns of infectious consequences in COVID-19 individuals who are severely unwell.
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The possession of exotic animals as pets is a social practice that has become more visible in Mexico in recent years, so it is interesting to understand its environmental and social implications and those related to human health. The present study aims to identify the main species of exotic animals kept as pets and the zoonotic diseases reported in these species. We analyzed official figures of seizures of exotic fauna in Mexico and reviewed specialized literature on zoonotic diseases documented in Mexico in these species. We identified zoonoses in species of fauna that can be acquired legally and illegally in the country, reported in environments in which animals coexist with other species and are in direct contact with people, which represents an important factor in the spread and propensity of this type of disease. We conclude that the sanitary regulation of wildlife markets, the monitoring and studying microorganisms associated with wildlife are valuable strategies to prevent the emergence of zoonoses.
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This paper describes the clinical signs and use of differential laboratory diagnostic techniques (computed tomography, cytology, histopathology, antigen/antibody detection and polymerase chain reaction) for infectious (viral, bacterial, fungal and parasitic) and non-infectious (inflammatory/immune mediated, neoplastic, cardiac, malformation, foreign body, smoke inhalation, aspiration of caustic material, non-cardiogenic, pulmonary oedema, traumativ, pneumothorax, pulmonary contusions and idiopathic) causes of respiratory diseases in cats and dogs in Ontario, Canada.
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OBJECTIVE: To systematically describe the outcomes of patients with COVID-19-associated pulmonary aspergillosis (CAPA). METHODS: All of the researches covering the clinical outcomes of CAPA were retrieved from databases such as ScienceDirect, PubMed, CNKI and MEDLINE (OVID) from Dec 31, 2019 to Dec 1, 2021. The literatures were screened out based on inclusion and exclusion criteria by 2 writers, the data were extracted, the quality of the literatures was evaluated, and meta-analysis was performed. RESULTS: Totally 14 cohort studies were included in this study, with 2 056 severe COVID-19 patients involved, including 338 CAPA patients and 1 718 non-CAPA patients. The incidence rate of CAPA was 16.4% among the ICU patients. As compared with the non-CAPA patients, the mortality rate of the CAPA patients was increased by 21% [risk difference (RD)]=0.21, 95% CI:0.15-0.27, (I-2=0%). No heterogeneity or publication bias was detected (t=1.98, P=0.069). Among the patients with underlying diseases, the patients with chronic obstructive pulmonary disease (COPD) were 2.37 times the risk of CAPA as high as the patients of the non-CAPA group (95% CI: 1.15-4.88, P=0.020). The creatinine level of the CAPA patients was higher than that of the non-CAPA patients (33.32 micro mol/L, 95% CI: 6.81-59.83, P=0.014). As compared with the non-CAPA patients, the patients who received renal replacement therapy were 2.33 times the risk of CAPA (95% CI: 1.43-3.80, P=0.001). CONCLUSION: 16.4% of the severe COVID-19 patients have CAPA, the mortality rate is high. COPD, serum creatinine and renal replacement therapy may remarkably increase the risk of CAPA, and it is suggested that a prospective screening of CAPA should be carried out for the severe COVID-19 patients.
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The new coronavirus reaches the cells of the lower respiratory tract, starting an inflammatory process. Considering this infection, the immune system must eliminate the pathological agents and mantein cellular homeostasis, tissue repair and generation of immunity memory. When there is a failure in this pathway, this system encounters a series of difficulties for the resumption of balance, in addition to secondary infections, leading to additional clinical complications. Thus, this study sought to address the immune response to Sars-CoV-2, and the main post-Covid secondary infections (bacterial and fungal) and antimicrobial resistance in this context. This is a literature review based on the analysis of journals from the following academic platforms: Google Scholar, Center for Biotechnology Information (PubMed), Science Direct, Scientific Electronic Library Online (SciELO) and Scopus. The research was delimited in a range from 2003 to 2021, using the keywords COVID-19 as a search tool;Immune response;Bacterial infections;Fungal infections;Resistance. The results obtained in the studies demonstrate the impact of secondary infections on mortality, thus, among the main infections, bacterial infections (84%) stand out, including mainly the agents: Staphylococcus aureus, Streptococcus pneumoniae, Clostridioides difficile and Mycoplasma pneumoniae. As for secondary fungal infections, Aspergillus sp. and Candida affected mainly critically ill patients. Based on the data, an evident problem was the difficulty in identifying the agent causing the secondary infection, resulting in a scenario of intense use of broad-spectrum antibiotics, contributing to the selection of resistant pathogens and, controversially, the worsening of the prognosis of the disease patient.
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Invasive fungal diseases (IFDs) are major causes of morbidity and mortality among hospitalized patients all over the world with a global prevalence of 15%. Since the first case of COVID-19 was reported on February 27, 2020, in Nigeria, it had been discovered across all geopolitical zones in Nigeria. As the medical community confronts the ongoing COVID-19 pandemic, determining whether patients infected with SARS-CoV-2 develop fungal complications, especially invasive aspergillosis, is crucial. This review aimed to highlight the fungal co-infections that might be associated with SARS-CoV-2 infection, and modalities for their diagnosis, prevention, and management, with the view to reducing the high mortality associated with these infections.
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Background: Mucormycosis is an opportunistic fungal infection with a high fatality rate and is the third most common fungal infection that is invasive in nature, next to candidiasis and aspergillosis. It is attributed to the poor socio-economic status and triggered by the local trauma due to unhygienic setup or poor health care. The pathway of pathogenesis is not clearly understood in immunocompetent patients and therefore becomes a matter of great concern. Aim& Objective: To explore the pathway of mucormycosis in a case of post SARS-CoV-2 infection Settings and Design: Tertiary Care hospital of Jabalpur DistrictMethods and Material: Interview with the case and care taker and case file review.