[Perimyocarditis as a complication of a multiple drug therapy in the treatment of a severe ulcerative colitis episode]. / Perimyokarditis als Komplikation einer medikamentösen Mehrfachtherapie bei Colitis ulcerosa.

HISTORY AND CLINICAL FINDINGS: A 19-year-old patient presented as an inpatient with an acute flare-up of ulcerative colitis for about six weeks and symptom progression for one and a half weeks. The patient was treated with topical and oral 5-aminosalicylic acid (5-ASA) preparations and oral prednisolone. With an intensification of the prednisolone dose, administration of a monoclonal antibody (Vedolizumab) and antibiotic therapy, inpatient discharge against medical advice. Oral administration of ciprofloxacin due to continued elevated infection parameters. The 5-ASA administration was continued. In the following two weeks, recurrent episodes of fever and renewed inpatient admission. INVESTIGATIONS AND DIAGNOSIS: Microbiological detection of Acinetobacter ursingii in blood cultures. Echocardiographic evidence of pericardial effusion. Transesophageal echocardiography revealed no evidence of infective endocarditis. Serological evidence of elevated cardiac enzyme levels. An MRI scan of the heart confirmed the diagnosis of perimyocarditis. TREATMENT AND COURSE: Intensive medical care and resistogram-based antibiotic therapy with meropenem, stopping the topical and oral 5-ASA doses and not continuing the integrin antagonist therapy. In addition, start of guideline-based cardiac insufficiency therapy and change of therapy to a tumor necrosis factor alpha blocker. Under the accelerated application scheme, stabilization and improvement of the general condition protracted. After two months of hospitalization, the patient was discharged to outpatient care. DISCUSSION: Perimyocarditis may occur after long-term administration of 5-ASA. The integrin antagonist as a new therapy can also be a causal factor. Therapeutic management when the cause of the complaint is unclear depends on the symptoms and the most likely cause of the disease. If there is no response to therapy, carry out early re-evaluations.

Seroprevalence of SARS-CoV-2 Antibodies in Employees of Three Hospitals of a Secondary Care Hospital Network in Germany and an Associated Fire Brigade: Results of a Repeated Cross-Sectional Surveillance Study Over 1 Year.

Healthcare workers (HCWs) are playing a vital role in the current SARS-CoV-2 pandemic. This study investigated how infection spreads within three local hospitals and an associated fire brigade in Germany by testing employees for the presence of SARS-CoV-2 IgG antibodies over one year. The three observational periods corresponded to the initial three pandemic waves: first wave: June-September 2020, second wave: October 2020-January 2021, and third wave: February-June 2021. We analysed 3285 serum samples of 1842 employees, which represents 65.7% of all employees. Altogether, 13.2% employees were seropositive: 194/1411 HCWs (13.7%) and 49/431 non-HCWs (11.4%) with a clear increase of seroprevalence from the first (1.1%) to the second (13.2%) and third (29.3%) pandemic wave. HCWs presumably had an additional occupational risk for infection in the second and third wave due to an increase of infection pressure with more COVID-19 patients treated, showing possible weak points in the recommended infection prevention strategy.

COVID-19: Hotspot hospital?- seroprevalence of SARS-CoV-2 antibodies in hospital employees in a secondary care hospital network in Germany: Intermediate results of a prospective surveillance study.

PURPOSE: The objective of the ongoing study was to investigate how SARS-CoV-2 infection spread within two hospitals in North Rhine-Westphalia, Germany by testing the employees working in high-risk, intermediate-risk and low-risk-areas for the presence of SARS-CoV-2 IgG antibodies. Presented intermediate results evaluate the first infection period until the end of September 2020. METHODS: The study "COVID-19: Hotspot hospital?- Seroprevalence of SARS-CoV-2 antibodies in hospital employees in a secondary care hospital network in Germany " is a prospective, single centre observational cohort study conducted at the St. Vincenz Hospital Datteln with 316 beds. The presented data include one other hospital: St. Laurentius Stift Waltrop, Germany with 172 beds. RESULTS: Between June 2020 and September 2020 we analyzed serum samples of 907 employees which represents 62.1% of all employees. Thirteen employees (1.4%), respectively 13/696 healthcare workers (HCWs) (1.9%) had detectable SARS-CoV-2 IgG antibodies. Among them, 4 (30.8%) were aware of COVID-19 exposure, and 5 (38.5%) reported clinical symptoms. HCWs working in high-risk areas had a seroprevalence rate of 1.6% (1/64), HCWs working in intermediate-risk area 1.7% (11/632) and 0.5% employees (1/211) in low-risk areas with no contact to patients were seropositive. CONCLUSION: Even if we treated COVID-19 positive patients, we found no clear evidence that infection was transmitted to HCWs in contact to these patients. As knowledge about SARS-CoV-2 transmission evolves, the concept of infection prevention must be continuously reviewed and adapted as needed to keep hospitals a safe place.