Sterile cyst formation after intrathecal stem cell transplant for Parkinson's disease: A case presentation and literature review.

In recent years, fetal or autologous stem cell transplant for the treatment of Parkinson's disease (PD) has been practiced in a few medical organizations. However, the potential complications related to the growth of allograft tissue have not yet been well described apart from case reports. Here, we present a 42-year-old Saudi male who suffered from early onset Parkinson's disease. He sought medical care in China and received autologous intrathecal stem cell transplantation. He did not demonstrate any significant improvement. A few months later, the patient went back to China and underwent fetal cell transplantation into the left hemisphere and a second stem cell transplantation intrathecally. He presented with seizures and had a left frontal brain cyst. The cyst was drained and contained clear fluid. All cultures were negative. He had an uneventful recovery.

Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients.

BACKGROUND: There is a paucity of data regarding the differentiating characteristics of patients with laboratory-confirmed and those negative for Middle East respiratory syndrome coronavirus (MERS-CoV). METHODS: This is a hospital-based case-control study comparing MERS-CoV-positive patients (cases) with MERS-CoV-negative controls. RESULTS: A total of 17 case patients and 82 controls with a mean age of 60.7 years and 57 years, respectively (P = .553), were included. No statistical differences were observed in relation to sex, the presence of a fever or cough, and the presence of a single or multilobar infiltrate on chest radiography. The case patients were more likely to be overweight than the control group (mean body mass index, 32 vs 27.8; P = .035), to have diabetes mellitus (87% vs 47%; odds ratio [OR], 7.24; P = .015), and to have end-stage renal disease (33% vs 7%; OR, 7; P = .012). At the time of admission, tachypnea (27% vs 60%; OR, 0.24; P = .031) and respiratory distress (15% vs 51%; OR, 0.15; P = .012) were less frequent among case patients. MERS-CoV patients were more likely to have a normal white blood cell count than the control group (82% vs 52%; OR, 4.33; P = .029). Admission chest radiography with interstitial infiltrates was more frequent in case patients than in controls (67% vs 20%; OR, 8.13; P = .001). Case patients were more likely to be admitted to the intensive care unit (53% vs 20%; OR, 4.65; P = .025) and to have a high mortality rate (76% vs 15%; OR, 18.96; P < .001). CONCLUSIONS: Few clinical predictors could enhance the ability to predict which patients with pneumonia would have MERS-CoV. However, further prospective analysis and matched case-control studies may shed light on other predictors of infection.

Pandemic influenza A (2009 H1N1) in hospitalized patients in a Saudi Arabian hospital: epidemiology and clinical comparison with H1N1-negative patients.

BACKGROUND AND OBJECTIVES: The World Health Organization (WHO) declared that pandemic influenza A (H1N1) was a public health emergency of international concern in April 2009. Herein, we describe the characteristics of patients in a Saudi Arabian hospital with and without H1N1 infection. METHODS: We reviewed the records of patients admitted with influenza-like illness and compared confirmed pandemic H1N1 cases to the H1N1-negative patients admitted to the hospital. Infections due to the novel H1N1 virus were confirmed using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). RESULTS: During the study period, a total of 165 patients were admitted with influenza-like illness and underwent rRT-PCR testing. Of these patients, 47 (28.4%) had confirmed novel H1N1 virus infection. Thus, the hospitalization incidence rate was 13.4 cases per 100,000 persons. The remaining patients had negative H1N1 rRT-PCR test results. The mean age±SD of the H1N1-positive patients was 30.3±28.5 years compared with 25.3±23 years for the H1N1-negative group (P=0.28). Severe obesity was observed in 6.7% and 8.5% of H1N1-positive and H1N1-negative patients, respectively (P=0.74). The clinical picture was similar between the two groups, except for the higher prevalence of nausea (25.5% vs. 11%) and diarrhea (21.3% vs. 7.6%) in the H1N1-positive group than in the H1N1-negative group (P=0.03) The mortality rate was low in both groups. CONCLUSION: The clinical presentation and outcome are insufficient to differentiate between influenza-like illness (ILI) caused by H1N1 and that cause by other pathogens. In general, both groups had mild disease in this cohort of patients in Saudi Arabia.