ABSTRACT
We describe an outbreak of simultaneous Clostridium difficile and norovirus infections in a long-term-care facility. Thirty patients experienced acute gastroenteritis, and four had co-infection with identical C. difficile 027 and genotype II.4 New Orleans norovirus strains. Co-occurring infection requires improved understanding of risk factors, clinical impact, and testing strategies.
Subject(s)
Caliciviridae Infections/epidemiology , Clostridioides difficile/physiology , Cross Infection/epidemiology , Disease Outbreaks , Enterocolitis, Pseudomembranous/epidemiology , Gastroenteritis/epidemiology , Norovirus/physiology , Aged , Aged, 80 and over , Caliciviridae Infections/virology , California/epidemiology , Clostridioides difficile/genetics , Coinfection/epidemiology , Coinfection/microbiology , Coinfection/virology , Cross Infection/microbiology , Cross Infection/virology , Enterocolitis, Pseudomembranous/microbiology , Gastroenteritis/microbiology , Gastroenteritis/virology , Health Facilities , Humans , Long-Term Care , Middle Aged , Norovirus/genetics , Risk FactorsABSTRACT
We report a case of acute hepatitis B virus genotype A vaccine escape mutant infection with loss of HBV vaccine-induced seropositivity in a HIV-1 infected patient. His HBV is unresponsive to tenofovir/emtricitabine treatment demonstrated by persistent viremia despite lacking known resistance mutations and while having an undetectable HIV-1 viral load.
Subject(s)
HIV Infections/complications , HIV-1 , Hepatitis B Antibodies/immunology , Hepatitis B Surface Antigens/immunology , Hepatitis B Vaccines/immunology , Hepatitis B/complications , Hepatitis B/virology , Adenine/administration & dosage , Adenine/analogs & derivatives , Adenine/therapeutic use , Antiviral Agents/administration & dosage , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Coinfection/virology , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Deoxycytidine/therapeutic use , Drug Resistance, Viral , Emtricitabine , Hepatitis B/immunology , Hepatitis B Surface Antigens/genetics , Hepatitis B e Antigens/immunology , Hepatitis B virus/genetics , Hepatitis B virus/immunology , Hepatitis B virus/pathogenicity , Humans , Male , Middle Aged , Mutation , Organophosphonates/administration & dosage , Organophosphonates/therapeutic use , Tenofovir , Viral Load , Viremia/drug therapy , Viremia/virologyABSTRACT
AIM OF THE STUDY: The aim of this prospective multicentric study was to compare two different types of pain drawings in terms of acceptance and gain of information in patients with orofacial pain. PATIENTS AND METHODS: A total of 204 patients from 9 centers, who visited their dentist or physician for orofacial pain, received two different diagrams for pain drawings in random order. One was the original pain diagram of the Deutsche Schmerzfragebogen (German Pain Questionnaire, diagram A), and the other diagram had been developed to achieve a symmetrical representation of the body and to allow computer-assisted analysis (diagram B). This diagram was larger and contained a drawing of the head. The patients' answers were analyzed for the preference between diagrams, the number and distribution of pain areas, and the concordance between the diagrams. The results were correlated with the patients' data. RESULTS: Data from 183 patients could be analyzed: 100 of 183 patients preferred diagram B and 57 of 183 preferred diagram A, independent of gender, age, or duration of disease. Most patients reported pain in more than one area; in only 43 of 183 patients was the pain limited to the face and head. The number and distribution of pain areas were not different between the two pain diagrams. CONCLUSIONS: Detailed head and body diagrams can be used in the diagnostic evaluation of patients with orofacial pain without fear of placing excessive demands on the patients and are useful for detecting comorbidities.
