Impact of Lung Disease on COVID-19 Health Outcomes in People Living With HIV.

Introduction COVID-19 most commonly causes pulmonary/lung infection, and these pulmonary diseases can complicate HIV infection. Underlying pulmonary diseases in people living with HIV (PLWH) could affect health outcomes if infected with COVID-19. Therefore, this study was designed to determine the impact of pulmonary diseases on the health outcomes of PLWH that were infected with COVID-19. Materials and methods We conducted a retrospective study to assess the impact of superimposed COVID-19 infection on pre-existing lung pathologies in patients living with human immunodeficiency virus (HIV) infection using data from the Minnesota Fairview network from January 1, 2020 to December 31, 2022. Ordinal logistic regressions were used to determine the effect of lung comorbidities on COVID-19 severity, COVID-19-specific mortality, and all-cause mortality, adjusting for patient age and gender.  Results Two hundred sixteen PLWH tested positive for COVID-19. 24.54% of these patients had one or more pulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases (interstitial lung diseases and pulmonary hypertension). The severity of COVID-19 outcomes was evaluated by the ranking of patients' medical records of testing positive, admitted to the hospital, being admitted to the ICU, and death. COVID-19-specific and all-cause mortality were evaluated separately. PLWH with underlying asthma or COPD was not associated with increased all-cause or COVID-19-specific mortality. Interstitial lung disease or pulmonary hypertension was significantly associated with poor health outcomes for COVID-19-specific mortality and all-cause mortality (Fisher's Exact p-value <0.001), with ICU admissions accounting for the most impact. Using the multivariate models, interstitial lung disease and pulmonary hypertension was significantly associated with an increased risk of more severe COVID-19 outcomes and COVID-19-specific mortality (OR=6.6153, CI=2.5944, 17.0795, p-value < 0.001). Interstitial lung disease and pulmonary hypertension were also significantly associated with an increased risk of more severe COVID-19 outcomes and all-cause mortality (OR=​​5.0885, CI=2.0590, 12.5542, p-value < 0.001). Conclusions To mitigate the poor outcomes associated with interstitial lung diseases and pulmonary hypertension in PLWH due to COVID-19, healthcare providers must educate their patients about safety measures against the COVID-19 vaccine. They can also encourage the COVID-19 vaccine uptake among their eligible patients.

Splenic Abscess: A Rare Complication of Bacterial Pneumonia.

Splenic abscess is a rare condition with potentially life-threatening evolution. Hematogenous spread is the most common cause of splenic abscess. Contiguous spread after bacterial pneumonia has rarely been reported in the literature. Early diagnosis can be made by a combination of imaging modalities and clinical features. The successful management of splenic abscess includes timely medical therapy, computed tomography (CT)-guided percutaneous aspiration, and splenectomy. In this report, we discuss a rare case of splenic abscess after hospitalization for bacterial pneumonia. The aim of this case report is to raise awareness about this rare complication so that prompt and appropriate management can be quickly performed to prevent severe outcomes.

Late Evolution of Deep Neck Space Abscess: Was Intubation the Cause?

Introduction: Deep neck abscess in adults may occur as a result of local trauma, foreign body inoculation or immunosuppression. Method: We describe a case of deep neck abscess that developed after recent hospitalization and intubation for chronic obstructive pulmonary disease (COPD) exacerbation. Discussion: The incidence of deep neck abscesses has dramatically reduced due to the use of antibiotics. However, if present, they need prompt surgical drainage due to their proximity to the nearby vasculature of the neck. Conclusion: This case highlights the need for physician awareness of the clinical presentation of the unique complications of deep neck abscess developing after hospitalization. LEARNING POINTS: Recent intubation or the introduction of a foreign body into the airway should be considered as possible causes of deep neck abscess infection.The diagnosis may be suggested by a CT scan.Incision and drainage may be required for the treatment of deep neck space infection.

A Rare Case of Pyrethroid Poisoning Presenting as Auditory Hallucination.

Pyrethroid is an insecticide which is widely used for household pests. Even though they are relatively less toxic to humans, reports of accidental poisoning are not uncommon. Cases of anosmia, tremors and arrhythmias after pyrethroid exposure have been reported; however auditory hallucinations have not been presented yet. Herein, we present a case of auditory hallucination in the form of ringing in the ear after exposure to airborne pyrethrin in a 69-year-old male. The significance of this case report is related to the wide use of insecticides containing pyrethrin and highlights the need for physician awareness of this uncommon pathology.

When Influenza, Bacterial Pneumonia, and COVID-19 Co-exist.

In the United States, influenza virus and bacterial pneumonia are known to be the leading causes of hospitalization in the winter season. Although healthcare workers are knowledgeable about the management of these co-infections, with the coronavirus disease 2019 (COVID-19) global pandemic that occurred in 2019, a significant change has occurred. The symptoms and clinical manifestations of COVID-19 are similar to that of influenza virus and bacterial pneumonia which can present a unique challenge for healthcare workers. Many reports are available for influenza virus and bacterial pneumonia but none about influenza, bacterial pneumonia, and COVID-19 co-infection. Here, we present the case of a patient who was admitted with COVID-19, influenza, and bacterial pneumonia co-infection, along with his clinical characteristics, laboratory findings, treatment plan, and outcomes.