Subject(s)
Abdomen, Acute , COVID-19 , Meningitis , Myocarditis , Pediatrics , Sepsis , Systemic Inflammatory Response Syndrome , Abdomen, Acute/diagnosis , Abdomen, Acute/etiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/prevention & control , COVID-19/therapy , Child , Communicable Disease Control/methods , Diagnosis, Differential , Disease Transmission, Infectious/prevention & control , Emergency Medical Services/methods , Emergency Medical Services/organization & administration , Humans , Meningitis/diagnosis , Meningitis/etiology , Myocarditis/diagnosis , Myocarditis/etiology , Pediatrics/methods , Pediatrics/organization & administration , Pediatrics/standards , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , SARS-CoV-2 , Sepsis/diagnosis , Sepsis/etiology , Symptom Assessment/methods , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/physiopathology , Systemic Inflammatory Response Syndrome/therapy , United States/epidemiologyABSTRACT
Candida meningitis is a rare life-threatening yeast infection mostly involving immunocompromised or paediatric patients undergoing neurosurgical procedures or shunt placement. Due to difficulties in diagnosis because of diverse clinical manifestations, the number of patients affected is most likely underestimated. Therefore, the correct diagnosis may be delayed for months, and accurate species identification is highly recommended for administering appropriate antifungal therapy. We report the first case of fluconazole-resistant Candida auris meningitis in a paediatric patient in Iran. This strain was probably imported, as it genotypically belonged to Clade I from South Asia. Furthermore, we include a literature review of C auris meningitis cases, as the number of cases with C auris meningitis has increased with reports from the United Kingdom, India and Iran. This problem might increase further in the era of COVID-19 due to attrition of experienced healthcare personnel and a high workload of hospital healthcare workers. To understand the precise prevalence of this emerging multidrug resistance pathogen, epidemiological surveillance studies are urgently warranted.
Subject(s)
Candida auris , Candidiasis/diagnosis , Meningitis , Antifungal Agents/therapeutic use , Child , Humans , Iran , Meningitis/diagnosis , Meningitis/microbiology , Microbial Sensitivity TestsABSTRACT
The common presenting symptoms of fever, fatigue, and mild respiratory symptoms like dry cough, are associated with COVID-19, however, patients can also develop neurological manifestations like headache, anosmia, hyposmia, dysgeusia, meningitis, encephalitis, and acute cerebrovascular accidents during the disease. Although very rare, these neurological manifestations are sometimes the sole initial presenting complaint of COVID-19. This case report discusses patients where the initial presenting symptoms seemed to be exclusive to meningitis but the later diagnosis was COVID-19. It is important to increase awareness of these rare presentations in physicians and healthcare workers and facilitate early diagnosis and management to prevent the horizontal spread of the disease.
Subject(s)
COVID-19 , Meningitis , Nervous System Diseases , Dysgeusia , Humans , Meningitis/diagnosis , SARS-CoV-2ABSTRACT
A pandemic due to novel coronavirus arose in mid-December 2019 in Wuhan, China, and in 3 months' time swept the world. The disease has been referred to as COVID-19, and the causative agent has been labelled SARS-CoV-2 due to its genetic similarities to the virus (SARS-CoV-1) responsible for the severe acute respiratory syndrome (SARS) epidemic nearly 20 years earlier. The spike proteins of both viruses dictate tissue tropism using the angiotensin-converting enzyme type 2 (ACE-2) receptor to bind to cells. The ACE-2 receptor can be found in nervous system tissue and endothelial cells among the tissues of many other organs.Neurological complications have been observed with COVID-19. Myalgia and headache are relatively common, but serious neurological disease appears to be rare. No part of the neuraxis is spared. The neurological disorders occurring with COVID-19 may have many pathophysiological underpinnings. Some appear to be the consequence of direct viral invasion of the nervous system tissue, others arise as a postviral autoimmune process, and still others are the result of metabolic and systemic complications due to the associated critical illness. This review addresses the preliminary observations regarding the neurological disorders reported with COVID-19 to date and describes some of the disorders that are anticipated from prior experience with similar coronaviruses.