Invasive Meningococcal Disease and COVID-19 Co-Infection: A Case Report.

This case report presents a 53-year-old male patient infected with COVID-19 who developed acute respiratory distress syndrome (ARDS) and septic shock due to meningococcemia, despite the absence of clinical signs of meningitis. This patient's condition was complicated by pneumonia in the setting of myocardial failure. In the curse of the disease, it is remarked that the importance of early recognition of sepsis symptoms is crucial in distinguishing patients with COVID-19 from those with other infections and preventing fatal outcomes. The case presented an excellent opportunity to review meningococcal disease's intrinsic and extrinsic risk factors. With the identified risk factors, we propose different measures to be considered to diminish and recognize this fatal disease early.

Paragonimiasis Misdiagnosed as Pulmonary Tuberculosis: A Case Report.

Paragonimiasis is a zoonosis caused by the ingestion of raw or undercooked crustaceans parasitized with metacercaria of Paragonimus spp. In Peru, Cajamarca is considered an endemic region for paragonimiasis. A 29-year-old man from the department of San Martín, Peru presented with a three-year history of cough, chest pain, fever, and hemoptysis. Treatment for tuberculosis (TB) was initiated even with negative results for sputum acid-fast bacillus (AFB), due to the patient's clinical characteristics and the high prevalence of the condition in the region. After eight months, due to the lack of any clinical improvement, he was referred to a regional hospital, where Paragonimus eggs were evidenced in direct sputum cytology. The patient received treatment with triclabendazole and showed clinical and radiological improvement. It is important to consider eating habits, even in non-endemic areas, for diagnosing paragonimiasis in patients with TB symptoms who do not respond to a specific treatment.

Conformational Response of 30S-bound IF3 to A-Site Binders Streptomycin and Kanamycin.

Aminoglycoside antibiotics are widely used to treat infectious diseases. Among them, streptomycin and kanamycin (and derivatives) are of importance to battle multidrug-resistant (MDR) Mycobacterium tuberculosis. Both drugs bind the small ribosomal subunit (30S) and inhibit protein synthesis. Genetic, structural, and biochemical studies indicate that local and long-range conformational rearrangements of the 30S subunit account for this inhibition. Here, we use intramolecular FRET between the C- and N-terminus domains of the flexible IF3 to monitor real-time perturbations of their binding sites on the 30S platform. Steady and pre-steady state binding experiments show that both aminoglycosides bring IF3 domains apart, promoting an elongated state of the factor. Binding of Initiation Factor IF1 triggers closure of IF3 bound to the 30S complex, while both aminoglycosides revert the IF1-dependent conformation. Our results uncover dynamic perturbations across the 30S subunit, from the A-site to the platform, and suggest that both aminoglycosides could interfere with prokaryotic translation initiation by modulating the interaction between IF3 domains with the 30S platform.