Demographic characteristics, clinical features, and optimal management of hospitalized patients with staphylococcal scalded skin syndrome

2021 ◽  
Author(s):  
Steven Vernali ◽  
Rachel C. Blasiak ◽  
Dean S. Morrell
Keyword(s):  
Clinical Features ◽  
Demographic Characteristics ◽  
Hospitalized Patients ◽  
Optimal Management ◽  
Staphylococcal Scalded Skin Syndrome

scholarly journals Staphylococcus aureus ventilator-associated pneumonia in patients with COVID-19: clinical features and potential inference with lung dysbiosis

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Gennaro De Pascale ◽  
Flavio De Maio ◽  
Simone Carelli ◽  
Giulia De Angelis ◽  
Margherita Cacaci ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Features ◽  
Hospitalized Patients ◽  
Fold Change ◽  
Ventilator Associated Pneumonia ◽  
Icu Mortality ◽  
Unifrac Distance ◽  
Saps Ii ◽  
Medical Icus ◽  
Patient Groups

Abstract Background Hospitalized patients with COVID-19 admitted to the intensive care unit (ICU) and requiring mechanical ventilation are at risk of ventilator-associated bacterial infections secondary to SARS-CoV-2 infection. Our study aimed to investigate clinical features of Staphylococcus aureus ventilator-associated pneumonia (SA-VAP) and, if bronchoalveolar lavage samples were available, lung bacterial community features in ICU patients with or without COVID-19. Methods We prospectively included hospitalized patients with COVID-19 across two medical ICUs of the Fondazione Policlinico Universitario A. Gemelli IRCCS (Rome, Italy), who developed SA-VAP between 20 March 2020 and 30 October 2020 (thereafter referred to as cases). After 1:2 matching based on the simplified acute physiology score II (SAPS II) and the sequential organ failure assessment (SOFA) score, cases were compared with SA-VAP patients without COVID-19 (controls). Clinical, microbiological, and lung microbiota data were analyzed. Results We studied two groups of patients (40 COVID-19 and 80 non-COVID-19). COVID-19 patients had a higher rate of late-onset (87.5% versus 63.8%; p = 0.01), methicillin-resistant (65.0% vs 27.5%; p < 0.01) or bacteremic (47.5% vs 6.3%; p < 0.01) infections compared with non-COVID-19 patients. No statistically significant differences between the patient groups were observed in ICU mortality (p = 0.12), clinical cure (p = 0.20) and microbiological eradication (p = 0.31). On multivariable logistic regression analysis, SAPS II and initial inappropriate antimicrobial therapy were independently associated with ICU mortality. Then, lung microbiota characterization in 10 COVID-19 and 16 non-COVID-19 patients revealed that the overall microbial community composition was significantly different between the patient groups (unweighted UniFrac distance, R2 0.15349; p < 0.01). Species diversity was lower in COVID-19 than in non COVID-19 patients (94.4 ± 44.9 vs 152.5 ± 41.8; p < 0.01). Interestingly, we found that S. aureus (log2 fold change, 29.5), Streptococcus anginosus subspecies anginosus (log2 fold change, 24.9), and Olsenella (log2 fold change, 25.7) were significantly enriched in the COVID-19 group compared to the non–COVID-19 group of SA-VAP patients. Conclusions In our study population, COVID-19 seemed to significantly affect microbiological and clinical features of SA-VAP as well as to be associated with a peculiar lung microbiota composition.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

Clinical, Microbial, and Biochemical Aspects of the Exfoliative Toxins Causing Staphylococcal Scalded-Skin Syndrome

1999 ◽  
Vol 12 (2) ◽  
pp. 224-242 ◽  
Author(s):  
Shamez Ladhani ◽  
Christopher L. Joannou ◽  
Denise P. Lochrie ◽  
Robert W. Evans ◽  
Susan M. Poston
Keyword(s):  
Clinical Features ◽  
Treatment Options ◽  
Entire Body ◽  
Secondary Complications ◽  
Staphylococcal Scalded Skin Syndrome ◽  
Treatment And Prevention ◽  
Causative Agents ◽  
Underlying Diseases ◽  
Disease Understanding ◽  
Significant Mortality

SUMMARY The exfoliative (epidermolytic) toxins of Staphylococcus aureus are the causative agents of the staphylococcal scalded-skin syndrome (SSSS), a blistering skin disorder that predominantly affects children. Clinical features of SSSS vary along a spectrum, ranging from a few localized blisters to generalized exfoliation covering almost the entire body. The toxins act specifically at the zona granulosa of the epidermis to produce the characteristic exfoliation, although the mechanism by which this is achieved is still poorly understood. Despite the availability of antibiotics, SSSS carries a significant mortality rate, particularly among neonates with secondary complications of epidermal loss and among adults with underlying diseases. The aim of this article is to provide a comprehensive review of the literature spanning more than a century and to cover all aspects of the disease. The epidemiology, clinical features, potential complications, risk factors, susceptibility, diagnosis, differential diagnoses, investigations currently available, treatment options, and preventive measures are all discussed in detail. Recent crystallographic data on the toxins has provided us with a clearer and more defined approach to studying the disease. Understanding their mode of action has important implications in future treatment and prevention of SSSS and other diseases, and knowledge of their specific site of action may provide a useful tool for physiologists, dermatologists, and pharmacologists.

scholarly journals Case Report: Bilateral mandibular buccal bifurcation cysts

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1502
Author(s):  
Ashwag Aloyouny ◽  
Hamad Albagieh ◽  
Soad Mansour ◽  
Fahmy Mobarak
Keyword(s):  
Case Report ◽  
Clinical Features ◽  
English Language ◽  
Accurate Diagnosis ◽  
Odontogenic Cyst ◽  
Optimal Management ◽  
Review Of The Literature

Buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst, which commonly affects children in the first decade of life. We report a case of a seven-year-old healthy boy with bilateral BBC, which involved unerupted incomplete permanent mandibular first molars. A review of the literature in English language revealed few similar cases. We reviewed 16 manuscripts of bilateral mandibular BBC, reporting a total of 20 cases since 1970. The clinical features of bilateral mandibular BBC summarized here could assist specialists with an accurate diagnosis and provide patients with optimal management.

scholarly journals Drug-drug Interactions of Statins Potentially Leading to Muscle-Related Side Effects in Hospitalized Patients

2015 ◽  
Vol 53 (4) ◽  
pp. 329-335
Author(s):  
Camelia Bucsa ◽  
Andreea Farcas ◽  
D. Leucuta ◽  
Cristina Mogosan ◽  
M. Bojita ◽  
...  
Keyword(s):  
Side Effects ◽  
Drug Interactions ◽  
Elevated Serum ◽  
Statin Treatment ◽  
Demographic Characteristics ◽  
Hospitalized Patients ◽  
Muscular System ◽  
Interventional Study ◽  
Additional Risk ◽  
Muscle Disorders

Abstract Introduction. The associations of drugs that may interact with the statins resulting in elevated serum concentration of the statins are an important risk factor for statin induced muscle disorders. We aimed to determine the prevalence of these associations in all hospitalized patients that had been prescribed statins before/during hospitalization and to find out how often they are associated with muscle-related side effects. Methods. This prospective, non-interventional study performed in two internal medicine departments included patients with statin therapy before/during hospitalization. Data on each patient demographic characteristics, co-morbidities and treatment was collected from medical charts and interviews. We evaluated patients’ therapy for the targeted associations using Thomson Micromedex Drug Interactions checker and we ranked the identified drug-drug interactions (DDIs) accordingly. Each patient with statin treatment before admission was additionally interviewed in order to identify muscular symptoms. Results. In 109 patients on statin treatment we found 35 potential (p) DDIs of statins in 30 (27.5%) patients, most of which were in the therapy before admission (27 pDDIs). The pDDIs were moderate (20 pDDIs) and major (15 pDDIs). Of the total number of pDDIs, 24 were targeting the muscular system. The drugs most frequently involved in the statins’ pDDIs were amiodarone and fenofibrate. Two of the patients with pDDIs reported muscle pain, both having additional risk factors for statin induced muscular effects. Conclusion. The prevalence of statins’ pDDIs was high in our study, mostly in the therapy before admission, with only a small number of pDDIs resulting in clinical outcome.

Impact of influenza in the post-pandemic phase: Clinical features in hospitalized patients with influenza A (H1N1) pdm09 and H3N2 viruses, during 2013 in Santa Fe, Argentina

2017 ◽  
Vol 89 (7) ◽  
pp. 1186-1191 ◽  
Author(s):  
Gabriela Kusznierz ◽  
Cudós Carolina ◽  
Rudi Juan Manuel ◽  
Lejona Sergio ◽  
Ortellao Lucila ◽  
...  
Keyword(s):  
Clinical Features ◽  
Influenza A ◽  
Hospitalized Patients ◽  
Santa Fe ◽  
Influenza A H1n1
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