ABSTRACT
INTRODUCTION: Data of COVID-19 in newborns and children are limited, and clinical manifestations are nonspecific and might delay the diagnosis, which might lead to severe complications. In this clinical case, we will describe new-onset diabetes with consciousness impairment as an atypical revealing way of COVID-19. CASE: A 3-year-old child presented to the Emergency Department with loss of consciousness (without fever), lethargy, and stupor. Clinical assessment on admission found an unconscious child with a pediatric Glasgow Coma Scale of 10/15 with no localizing signs or meningeal syndrome, polypneic of 35 breaths/min, pulse oximetry of 90%, with signs of overall dehydration: skin folds, sunken eyes, tachycardia of 160 beats/minute, and recoloring time superior at 3 seconds. Laboratory findings showed hyperleukocytosis of 16000/mm3, lymphopenia of 450/mm3, glycemia of 5 g/L with a correct ionogram : corrected natremia of 139 mmol/L, serum potassium of 4.5 mmol/L, glycosuria of 3+, ketonuria of 2+, and HbA1c of 10%, and COVID-19 RT-PCR came back positive. CONCLUSION: COVID-19 might be revealed with atypical symptoms including new-onset diabetes and diabetic ketoacidosis; therefore, clinicians must suspect it in children with blood glucose and HbA1c at the time of admission. This will help to manage patients with hyperglycemia early.
ABSTRACT
Background: Flies and cockroaches are two insects in close contact with human beings. They are carriers of human pathogenic bacteria on the external areas of their bodies or in their digestive tracts. This study examines Periplaneta americana and Musca domestica collected from the residential areas of six districts in Tangier; Morocco. Methodology: In total; 251 bacteria were isolated from external areas of the participants' bodies and the antimicrobial susceptibility was calculated. Results: The predominant bacterial species included Escherichia coli (17.9); Klebsiella spp. (14.7); Providencia spp. (9.6); Staphylococcus spp. (15.1) and Enterococcus spp. (11.6). The study showed no difference between the species of bacterial strains from American cockroaches and houseflies. Carbapenems and aminoglycosides were active against 100of the Gram-negative bacilli isolated in this study. Staphylococcus spp. strains were susceptible to linezolid; vancomycin; daptomycin; levofloxacin and cotrimoxazole; and no antibiotic resistance was found in Enterococcus spp. Conclusions: In our setting; although both cockroaches and flies collected from residential areas may be vectors of human pathogenic bacteria; the infections caused by them are easily treatable as a result of the high susceptibility of their bacteria to antibiotics routinely used in the community or in hospitals
Subject(s)
Houseflies , Periplaneta , Sprains and StrainsABSTRACT
A case is reported of pneumoencephalus occurring after an accidental dural puncture during a cervical epidural puncture using the loss of resistance technique. Six ml of air were injected intrathecally. The patient recovered spontaneously within five days. This complication may occur more frequently than commonly admitted. It may be difficult to differentiate between headache due to pneumoencephalus and that by stretching of the meninges due to cerebrospinal fluid leakage. Only a CT scan can help to answer this question.
