scholarly journals Chondrosternal Arthritis in Infant: An Unusual Entity

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Athina Nikolarakou ◽  
Dana Dumitriu ◽  
Pierre-Louis Docquier
Keyword(s):  
Clinical Symptoms ◽  
Therapeutic Option ◽  
White Blood Cells ◽  
Laboratory Data ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Local Tenderness ◽  
Wait And See

Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

scholarly journals Synchronous cytomegalovirus infection in a newly diagnosed ulcerative colitis patient

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Jin Yu Chieng ◽  
Yasotha Sugumaran ◽  
Sellymiah Adzman ◽  
Pan Yan
Keyword(s):  
Ulcerative Colitis ◽  
Medical Illness ◽  
C Reactive Protein ◽  
Colitis Patient ◽  
Intravenous Ganciclovir ◽  
Reactive Protein ◽  
Chronic Medical Illness ◽  
History Of ◽  
Cmv Colitis

A 61-year-old Punjabi female patient presented with six months history of mild abdominal discomfort with bloody diarrhea. She did not have underlying chronic medical illness; she neither took steroid nor immunosuppressant. She was found anemic, thrombocytosis, and elevated C-reactive protein. Colonoscopy showed moderate left sided colitis, with histopathology evidence of ulcerative colitis (UC) with cytomegalovirus (CMV) infection. Her serum anti-CMV IgM antibody was detected. She was treated with intravenous ganciclovir, together with 5-ASA and tapering dose of steroid. Anemia was corrected. Subsequent clinic reviews and follow up endoscopies showed dramatically improvement. CMV colitis should be considered for the patients presenting with moderate to severe UC. Early prescription of antiviral would be beneficial in the treatment of flare of UC.

scholarly journals Clinical features and laboratory inspection of novel coronavirus pneumonia (COVID-19) in Xiangyang, Hubei

2020 ◽  
Author(s):  
Weiliang Cao ◽  
Li Shi ◽  
Lin Chen ◽  
Xuemei Xu ◽  
Zirong Wu
Keyword(s):  
Risk Factor ◽  
Clinical Symptoms ◽  
White Blood Cells ◽  
Ground Glass Opacity ◽  
C Reactive Protein ◽  
Normal Range ◽  
Reactive Protein ◽  
Cell Counts ◽  
Severe Group ◽  
Novel Coronavirus

AbstractBackgroundSince December 2019, a novel coronavirus pneumonia (COVID-19) rapidly spread in China, reached multiple continents currently.We aimed to reveal the infectious characteristics of COVID-19 that provide more information for the research of novel coronavirus.MethodsWe performed a retrospective study on the clinical characteristics of 128 COVID-19 cases with laboratory-confirmed from Xiangyang No 1 Hospitalad during January 2020 to 16 February 2020.ResultsFemale patients account for 53.1%. The aged below 20 years that accounts for 1.6% of overall patients. The aged in 21∼50, 51∼65, over 66 years were accounts for 44.5%, 35.1%,18.8%, respectively. In the difference age spectrum, all severe groups compared with non-severe groups were difference significantly (P < 0.01). Fever (89.8%) and Cough (67.2%) were common clinical symptoms. The rate of patients with sore throats (14.1%) was rare. The rate of chest computed tomography scan showing ground glass opacity in overall, non-severe, severe groups were 63.3%, 60.7%, 76.2%, respectively. White blood cell counts in the normal range of overall patients, but severe group patients were increased significantly (P < 0.01). Lymphocytes of overall patients were decreased. Alanine transaminase (ALT) and aspartate transaminase (AST) in the normal range of overall patients, but its were elevated in the severe group. Creatinine (CR) and blood urea nitrogen (BUN) of overall patients in the normal range. C-reactive protein (CRP) level of all patients were increased markedly, but it in the severe group was significantly higher than that in the non-severe group (P < 0.01).ConclusionsOur data provide more information that advanced age, lower lymphocytes levels at the diagnosed COVID-19 patients may be a risk factor for unfavourable prognosis. The white blood cells and C-reactive protein level elevated in severe COVID-19 patients may be accompanying bacterial infection. 2019-nCov may be carries a risk factor of impaired liver and kidney function.

scholarly journals Criteria for Differentiation of Non-Bacterial and Haematogenous Osteomyelitis: A Case-Control Study With Prospective Verification of the Outcomes

2019 ◽  
Vol 17 (6) ◽  
pp. 458-464
Author(s):  
Mikhail M. Kostik ◽  
Olga L. Kopchak ◽  
Alexey I. Taschilkin ◽  
Vyacheslav I. Zorin ◽  
Alexey S. Maletin ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Disease Onset ◽  
Diagnostic Errors ◽  
Bone Destruction ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Haematogenous Osteomyelitis

Background. Patients with haematogenous and non-bacterial osteomyelitis have similar clinical symptoms (pain in the nidus area, soft tissue swelling, fever) and laboratory signs (increased erythrocyte sedimentation rate, leukocyte count, C-reactive protein concentration). The criteria for distinguishing these two states are not determined.Objective. Our aim was to determine diagnostic criteria to differentiate haematogenous and non-bacterial osteomyelitis.Methods. The study included data of patients under the age of 18 years with non-bacterial or haematogenous osteomyelitis hospitalised to two clinical centres from 2009 to 2016. The diagnosis was established and re-verified according to archival data (medical history) and after two years of observation (at least once a year). Clinical, anamnestic and laboratory data (haemoglobin, leukocytes, leukocyte formula, platelets, ESR and C-reactive protein, CRP) as well as the results of radiation diagnostics (X-ray, CT scan, MRI or osteosyntigraphy) obtained at the disease onset were taken into account as potential diagnostic criteria.Results. Out of 145 patients with non-bacterial or haematogenous osteomyelitis, the diagnosis was re-verified in 138, of them non-bacterial osteomyelitis — in 91, haematogenous osteomyelitis — in 47. The following criteria had the highest diagnostic value for establishing cases of non-bacterial osteomyelitis: detection of bone destruction foci surrounded by osteosclerosis area [sensitivity (Se) 1.0; specificity (Sp) 0.79]; absence of fever (Se 0.66; Sp 0.92); the number of bone destruction foci > 1 (Se 0.73; Sp 1.0); CRP 55 mg/L (Se 0.94; Sp 0.73); negative results of bacteriological examination of the material from the bone destruction focus (Se 1.0; Sp 0.67).Conclusion. Diagnostic criteria for differentiation of non-bacterial and haematogenous osteomyelitis have been described. Further research on the efficacy of using these criteria to reduce the risk of diagnostic errors, decrease the diagnostic pause, reduce the risk of non-bacterial osteomyelitis complications is needed.

scholarly journals Sex differences in a cohort of COVID-19 Italian patients hospitalized during the first and second pandemic waves.

2021 ◽  
Author(s):  
Virginia Quaresima ◽  
Cristina Scarpazza ◽  
Alessandra Sottini ◽  
Chiara Fiorini ◽  
Simona Signorini ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Death Rate ◽  
White Blood Cells ◽  
Laboratory Data ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Mean ◽  
Second Wave ◽  
Length Of Hospitalization ◽  
Older Males

Abstract Background: Coronavirus Disease 2019 (COVID-19) severity seems to be influenced by genetic background, sex, age, and presence of specific comorbidities. So far, little attention has been paid to sex-specific variations of demographic, clinical and laboratory features of COVID-19 patients referred to the same hospital in the two consecutive pandemic waves.Methods: Demographic, clinical and laboratory data were collected in 1,000 COVID-19 patients (367 females and 633 males), 500 hospitalized in the first wave and 500 in the second one, at the ASST Spedali Civili of Brescia from March to December 2020. Statistical analyses have been employed to compare data obtained in females and males, taking into account their age, and during the first and second COVID-19 waves. Results: The mean age at the time of hospitalization was similar in females and males but was significantly higher for both in the second wave; the time elapsed from symptoms onset to hospital admission did not differ between sexes in the two waves and no correlation was observed between delayed hospital admission and length of hospitalization. The number of multi-symptomatic males was higher than that of females and patients with a higher number of comorbidities were more frequently admitted to intensive care unit (ICU) and more frequently died. Older males remained in ICU longer than females and showed a longer disease duration, mainly the first wave. The highest levels of white blood cells, neutrophils, C-reactive protein and fibrinogen were significantly higher in males and in the first, and along with higher levels of D-dimer, ferritin, lactate dehydrogenase and procalcitonin which were preferentially documented in patients requiring ICU or died. While the ICU death rate was higher in males, the overall death rate did not differ between the sexes; however, the deceased women were older.Conclusions: These data indicate that once patients were hospitalized, the risk of dying was similar between females and males. Therefore, future studies should aim at understanding the reasons why, for a given number of SARS-CoV-2 infection, less females develop the disease requiring hospitalization.

scholarly journals Bacteriological Characteristics of COVID-19 Patients Nosocomially Co-infected at a Designated Hospital: A Retrospective Study

2020 ◽  
Author(s):  
Jing Yu ◽  
Lei Nie ◽  
Xia Zhou ◽  
Dongde Wu ◽  
Jian Chen ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
White Blood Cells ◽  
Laboratory Data ◽  
Critical Factor ◽  
Severe Pneumonia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Extensive Drug Resistance ◽  
Causative Agents ◽  
Secondary Bacterial Pneumonia

Abstract Background: Bacterial co-infection in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a critical factor that increases the complexity and treatment of coronavirus disease 2019 (COVID-19). Methods: We collected the clinical laboratory data of 1799 patients with confirmed COVID-19 who were admitted to Jinyintan Hospital in Wuhan, China, between January 1 to April 26, 2020. The bacterial co-infection along with disease progression was analyzed. Other inflammatory markers, including C-reactive protein (CRP), white blood cells (WBC), lymphocytes (L), neutrocytes (N), interleukin-6 (IL-6), and procalcitonin (PCT), were assessed to estimate the progression of COVID-19. Results: We found that 191 of the 1799 (10.62%) patients had bacterial co-infection. The most prevalent causative agents for bacterial co-infection were Klebsiella pneumoniae (91 cases, 5.06%) and Acinetobacter baumannii (66 cases, 3.67%). The most patients with bacterial co-infection showed extensive drug-resistance. The outcomes of patients with bacterial co-infection were worse than those of patients without bacterial co-infection.Conclusions: Secondary bacterial pneumonia during virus infection is a major risk factor for high mortality resulting from severe pneumonia caused by COVID-19.

scholarly journals Clinical features and laboratory inspection of novel coronavirus pneumonia (COVID-19) in Xiangyang, Hubei 

2020 ◽  
Author(s):  
Weiliang Cao ◽  
Li Shi ◽  
Lin Chen ◽  
Xuemei Xu ◽  
Zirong Wu
Keyword(s):  
Risk Factor ◽  
Clinical Symptoms ◽  
White Blood Cells ◽  
Ground Glass Opacity ◽  
C Reactive Protein ◽  
Normal Range ◽  
Reactive Protein ◽  
Cell Counts ◽  
Severe Group ◽  
Novel Coronavirus

Abstract Background: Since December 2019, a novel coronavirus pneumonia (COVID-19) rapidly spread in China, reached multiple continents currently.We aimed to reveal the infectious characteristics of COVID-19 that provide more information for the research of novel coronavirus. Methods: We performed a retrospective study on the clinical characteristics of 128 COVID-19 cases with laboratory-confirmed from Xiangyang No.1 People’s Hospital during January 2020 to 16 February 2020.Results: Female patients account for 53.1%. The aged below 20 years that accounts for 1.6% of overall patients. The aged in 21~50, 51~65, over 66 years were accounts for 44.5%, 35.1%,18.8%, respectively. In the difference age spectrum, all severe groups compared with non-severe groups were difference significantly ( P < 0.01 ). Fever ( 89.8% ) and Cough ( 67.2% ) were common clinical symptoms. The rate of patients with sore throats (14.1%) was rare. The rate of chest computed tomography scan showing ground glass opacity in overall, non-severe, severe groups were 63.3%, 60.7%, 76.2%, respectively. White blood cell counts in the normal range of overall patients, but severe group patients were increased significantly ( P < 0.01). Lymphocytes of overall patients were decreased. Alanine transaminase (ALT) and aspartate transaminase (AST) in the normal range of overall patients, but its were elevated in the severe group. Creatinine (CR) and blood urea nitrogen (BUN) of overall patients in the normal range. C-reactive protein (CRP) level of all patients were increased markedly, but it in the severe group was significantly higher than that in the non-severe group ( P < 0.01 ).Conclusions: Our data provide more information that advanced age, lower lymphocytes levels at the diagnosed COVID-19 patients may be a risk factor for unfavourable prognosis. The white blood cells and C-reactive protein level elevated in severe COVID-19 patients may be accompanying bacterial infection. 2019-nCov may be carries a risk factor of impaired liver and kidney function.

scholarly journals Interleukine-6 in critically ill COVID-19 patients: A retrospective analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244628
Author(s):  
Julie Gorham ◽  
Anthony Moreau ◽  
Francis Corazza ◽  
Lorenzo Peluso ◽  
Fanny Ponthieux ◽  
...  
Keyword(s):  
Critically Ill ◽  
White Blood Cells ◽  
Laboratory Data ◽  
Repeated Measurements ◽  
Repeated Measure ◽  
Relevant Parameter ◽  
C Reactive Protein ◽  
Course Of Disease ◽  
Reactive Protein ◽  
Significant Difference

Introduction Coronavirus disease 2019 (COVID-19) appeared in China in December 2019 and has spread around the world. High Interleukin-6 (IL-6) levels in COVID-19 patients suggest that a cytokine storm may play a major role in the pathophysiology and are considered as a relevant parameter in predicting most severe course of disease. The aim of this study was to assess repeated IL-6 levels in critically ill COVID-19 patients admitted to our Intensive Care Unit (ICU) and to evaluate their relationship with patient’s severity and outcome. Methods We conducted a retrospective study on patients admitted to the ICU with a diagnosis of COVID-19 between March 10 (i.e. the date of the first admitted patients) and April 30, 2020. Demographic, clinical and laboratory data were collected at admission. On the day of IL-6 blood concentration measurement, we also collected results of D-Dimers, C-Reactive Protein, white blood cells and lymphocytes count, lactate dehydrogenase (LDH) and ferritin as well as microbiological samples, whenever present. Results Of a total of 65 patients with COVID-19 admitted to our ICU we included 41 patients with repeated measure of IL-6. There was a significant difference in IL-6 levels between survivors and non-survivors over time (p = 0.001); moreover, non survivors had a significantly higher IL-6 maximal value when compared to survivors (720 [349–2116] vs. 336 [195–646] pg/mL, p = 0.01). The IL-6 maximal value had a significant predictive value of ICU mortality (AUROC 0.73 [95% CI 0.57–0.89]; p = 0.01). Conclusions Repeated measurements of IL-6 can help clinicians in identifying critically ill COVID-19 patients with the highest risk of poor prognosis.

scholarly journals Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran

2020 ◽  
Vol 23 (11) ◽  
pp. 766-775
Author(s):  
Seyed Farshad Allameh ◽  
Saeed Nemati ◽  
Reza Ghalehtaki ◽  
Esmaeil Mohammadnejad ◽  
Seyed Mojtaba Aghili ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Risk Groups ◽  
Severe Form ◽  
Capital City ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Elevated Lactate

Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters. Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63–38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06–10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00–8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64–3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07–2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study. Conclusion: Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.

scholarly journals Clinical Characteristics for Differentiating Febrile Children with Suspected Kawasaki Disease Diagnosis

2019 ◽  
Author(s):  
Jia-Huei Yan ◽  
Ling-Sai Chang ◽  
Yi-Ju Lin ◽  
Mindy Ming-Huey Guo ◽  
Ying-Hsien Huang ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Heart Association ◽  
Disease Diagnosis ◽  
Old Patients ◽  
Reactive Protein ◽  
Missed Diagnosis ◽  
Group 2

Background: Kawasaki disease (KD) is a form of vasculitis that primarily affects children under the age of 5 years old. Patients may be missed diagnosis when initial clinical symptoms do not fulfill the traditional criteria. We aimed to analyze factors that clinicians could use to differentiate febrile children suspected of KD. Method: We retrospectively enrolled a total of 83 febrile children who were initially suspected of KD, but they did not meet the American Heart Association (AHA) criteria for a diagnosis. However, some of these patients were diagnosed with KD during their second visit. We analyzed patients' characteristics, clinical symptoms, and laboratory data. Results: In total, 50 patients were enrolled in the study. Of those, ten patients were diagnosed with KD on their second visit (group 1), while the other 40 patients still did not fit a KD diagnosis (group 2). A patient with a neutrophil to lymphocyte ratio greater than 1.33 combined with a C-reactive protein more than 33 mg/L was more likely to have KD. Conclusion: Among patients suspected of KD that did not initially meet the criteria, clinicians should pay special attention to elevated neutrophil-to-lymphocyte ratios and CRP levels and closely follow up such patients.

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