ABSTRACT
BACKGROUND: Persistent acute SARS-CoV- 2 infection is characterised by the persistence of symptoms of a COVID-19 illness and a persistently positive SARS-CoV-2 RT PCR result. It is often seen in immunocompromised individuals. Currently, there are no approved treatment regimens or guidelines for management. METHODS: Our patient is a middle-aged male who had received chemotherapy prior to the onset of his SARS- CoV-2 infection and subsequently was diagnosed with a persistent and acute SARS- CoV-2 infection after presenting to us with a pyrexia of unknown origin. He was treated on an off-label basis following informed consent with casirivimab-imdevimab monoclonal antibody therapy, comprising two IgG1 neutralising human monoclonal antibodies at a dose of 600 mg each. RESULTS: Our patient had significant clinical improvement on treatment with the monoclonal antibody therapy and it was well tolerated without any adverse effects. He is currently doing well during follow up. CONCLUSIONS: Casirivimab-imdevimab monoclonal antibody therapy could be beneficial for people with persistent acute SARS-CoV-2 infection. Therapy is warranted on a case-to-case basis. This highlights the need to identify immunocompromised individuals who are at risk of developing persistent acute SARS-CoV-2 infection to enable their prompt treatment.
The COVID-19 pandemic was associated with significant mortality and morbidity globally. People with weakened immune systems, such as cancer patients undergoing chemotherapy, are at an increased risk of developing a prolonged course of COVID-19. At present, no effective treatment options are available to treat SARS-CoV-2 infection in such a group of patients. Here, we describe a patient with Hodgkin's lymphoma and papillary carcinoma of the thyroid who went on to develop persistent COVID-19 and made a full recovery following treatment with anti-SARS-CoV-2 monoclonal antibodies. These results highlight the importance of considering similar treatment options for persistent COVID-19 in cancer patients undergoing chemotherapy, upon appropriate clinical evaluation.
ABSTRACT
Emphysematous pancreatitis (EP) is a rare and potentially fatal condition of the pancreas. It is associated with gas-forming bacteria and is characterized by the presence of gas in or around the pancreas. It is identified by a computed tomography scan of the abdomen. Although predisposing factors are not precisely known, diabetes mellitus, which predisposes to gas gangrene, is seen to be commonly associated with patients of EP. EP being potentially fatal requires immediate management. Surgery is generally indicated in EP. However, EP can also managed conservatively. In our case, the patient developed recurrent pancreatitis, the cause being idiopathic, and the second episode of acute pancreatitis was complicated by EP and gastroduodenal artery pseudoaneurysm.
Résumé La pancréatite emphysémateuse (EP) est une condition rare et potentiellement mortelle du pancréas. Il est associé à des bactéries de formation de gaz et se caractérise par la présence de gaz dans ou autour du pancréas. Il est identifié par une tomodensitométrie calculée de l'abdomen. Bien que les facteurs prédisposants ne soient pas précisément connus, le diabète sucré, qui prédispose à la gangrène du gaz, est considéré comme communément associé aux patients du PE. EP étant potentiellement mortel nécessite une gestion immédiate. La chirurgie est généralement indiquée dans EP. Cependant, EP peut également gérer de manière conservatrice. Dans notre cas, le patient a développé une pancréatite récurrente, la cause étant idiopathique, et le deuxième épisode de pancréatite aiguë a été compliqué par l'EP et le pseudo-anévrisme de l'artère gastroduodénale. Mots-clés: Pancréatite emphysémateuse, pseudo-anévrisme gastroduodénal, pancréatite.
Subject(s)
Aneurysm, False , Emphysema , Pancreatitis , Humans , Pancreatitis/complications , Pancreatitis/diagnostic imaging , Acute Disease , Aneurysm, False/complications , Aneurysm, False/diagnostic imaging , Aneurysm, False/therapy , Abdomen , Emphysema/complications , Emphysema/diagnostic imaging , Emphysema/surgery , ArteriesABSTRACT
A 30-year-old, previously healthy adult male received equine rabies immunoglobulins (Ig) (ERIG) along with anti-rabies vaccinations as per protocol for postexposure prophylaxis after an unprovoked rabid dog bite of grade three wound over the shin of the left lower limb. On the 8th day, he developed urticarial rashes beginning from the site of the wound, which gradually became a widespread maculopapular rash. Development of the rash was followed by low-grade fever, nonspecific arthralgias and soreness in the throat. A diagnosis of serum sickness-like illness was made based on history, temporal correlation of administration of ERIG and development of symptoms. He responded well to antihistaminic and a short course of injectable steroids. The purpose of this article is to increase awareness regarding the clinical presentation and management of this rare yet potentially curable adverse event if identified timely.
Subject(s)
Immunoglobulins , Rabies , Serum Sickness , Male , Humans , Adult , Rabies/drug therapy , Animals , Dogs , Immunoglobulins/therapeutic use , Immunoglobulins/administration & dosage , Rabies Vaccines/adverse effects , Post-Exposure Prophylaxis/methods , Bites and Stings/complications , Bites and Stings/drug therapyABSTRACT
The liver is commonly affected in human brucellosis, reflected the effect of Brucella on the RES (reticuloendothelial system) (Akritidis et al. 2007 [1], Sadia Pérez et al. 2001 [2]). The formation of liver abscess (brucelloma) is uncommon (Rovery et al. 2003 [3]). Here we report an interesting case of brucellosis with a liver abscess in a young immmunocompetent individual with no known comorbidities.
