scholarly journals What about the others: differential diagnosis of COVID-19 in a German emergency department

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Fistera ◽  
Annalena Härtl ◽  
Dirk Pabst ◽  
Randi Manegold ◽  
Carola Holzner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Health Care Systems ◽  
Clinical Signs ◽  
Vital Signs ◽  
Main Diagnosis ◽  
Clinical Trial Registry ◽  
Airway Infections

Abstract Background The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections. Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.

scholarly journals „What about the others – differential diagnosis of COVID-19 in a German emergency department“

2020 ◽  
Author(s):  
David Fistera ◽  
Annalena Haertl ◽  
Dirk Pabst ◽  
Randi Manegold ◽  
Carola Holzner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Health Care Systems ◽  
Clinical Signs ◽  
Vital Signs ◽  
Nasopharyngeal Swab ◽  
Main Diagnosis ◽  
Airway Infections

Abstract Background: The ongoing COVID-19 pandemia is a major challenge for worldwide health care systems. Especially an early and safe triage in the emergency department (ED) is crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases thus differential diagnosis remains challenging.Method: We performed a retrospective study of 314 ED patients presenting with possible symptoms of COVID-19. All were tested for COVID-19 with SARS-Cov2-nasopharyngeal swab. 47 patients were positive for COVID-19. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms and vital signs. Results: Among the 267 COVID-19 negative patients 42.7% had respiratory, 14.2% other infectious and 11.2% cardiovascular diseases, followed by 9.0% oncological and 6.7% gastroenterological diagnosis. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea but more dysgeusia. Their hospital stay was significantly longer and their mortality significantly higher. Conclusion: For many common ED diagnoses COVID-19 should be considered as a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.

scholarly journals Optimization of Early Diagnostics of Prostate Cancer

2020 ◽  
Vol 6 (5) ◽  
pp. 97-104
Author(s):  
N. Stepanov ◽  
Z. Duvayarov ◽  
I, Bystrova ◽  
T. Chepaikina ◽  
V. Kostrova
Keyword(s):  
Prostate Cancer ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Diagnostic Errors ◽  
Decay Products ◽  
Examination Methods ◽  
Special Examination ◽  
Diagnostic Capabilities

The prevalence and incidence of prostate cancer is gradually increasing both in our country and in countries near and far abroad. The difficulties in the differential diagnosis of prostate cancer are convincingly evidenced by the fact that the level of diagnostic errors reaches 40%. It should be noted that in assessing the differential diagnostic capabilities of the indicators of the clinical and special examination methods for patients with lower urinary tract symptoms, disagreements were found in 46–77% of the analyzed clinical signs, the changes of which mainly reflect the negative nature of the effect of tumor decay products on the patient’s body. The aim of the study was to improve the early diagnosis of prostate cancer by using the mathematical method of differential diagnosis of prostate pathology, as well as the rationale for the proposed method for early diagnosis of prostate cancer in patients with clinical symptoms. Using our proposed method for early diagnosis of prostate cancer makes the diagnosis not only reliable and accurate, but also independent of the level of qualification of the urologist and his personal experience, allows you to unify, optimize and personify the differential diagnosis of prostatic hypertrophy and prostate cancer.

Clinic and CNS pathology of natural Visna cases

2007 ◽  
Vol 35 (03) ◽  
pp. 219-224
Author(s):  
P. Henze ◽  
P. Wohlsein ◽  
M. Ganter
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Mononuclear Cells ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Lymphocytic Infiltration ◽  
Serological Screening ◽  
Laboratory Findings ◽  
Cytologic Examination ◽  
Important Differential Diagnosis

Summary Objective: This study summarizes the clinical, serological, pathomorphological and laboratory findings in 19 sheep with spontaneous Visna in Germany. The cases occurred over a period of 13 years in 13 flocks. In all affected sheep cytologic examination of cerebrospinal fluid (CSF) was performed. In addition in six flocks from which 12 of the Visna cases came the whole flock was tested for Maedi/Visna virus (MVV) antibodies. Material and methods: The diagnosis of spontaneous Visna with typical clinical signs was proven by serological and histopathological investigations. Serological screening for MVV antibodies was performed with the agargel-immuno- precipitation-test (AGIDT). Additionally, cerebrospinal fluid (CSF) was obtained by lumbosacral puncture and examined cytologically. Results: Nine of the 19 cases were Texels and six East Frisian Milk sheep. Six out of nine Texels came from the same flock with a MVV-antibody intra-flock prevalence of 0.94. The mean age of the sheep was 3.9 ± 2.3 years (0.5–10 years). Time between onset of clinical symptoms until euthanasia due to recumbency was 35 ± 23 days (6–102 days). In most cases clinical signs started with ataxia, staggering and circling, followed by increasing paresis of the hind legs. In the late stages of the disease 14 sheep suffered from tetraparesis. Trembling of lips or eye lids, blindness and scratching were rare signs. In all cases pleocytosis (11–876 M/l, mean = 167 M/l) with mononuclear cells, predominantly macrophages, was found. This finding provides an additional diagnostic aid to support the clinical differentiation from other infectious diseases with neurological manifestation in sheep. Histopathology of the CNS revealed in most cases a severe leukoencephalitis and demyelinisation with perivascular lymphocytic infiltration. Conclusion and clinical relevance: Visna is an important differential diagnosis in CNS disorders of sheep. It also occurs in animals younger than one year. Visna occurs especially in highly infected flocks of susceptible sheep breeds. CSF cytology can help to differentiate Visna from other CNS diseases. Clinically, Visna may be an important differential diagnosis to Scrapie.

Clinical symptoms cannot predict influenza infection during the 2013 influenza season in Bavaria, Germany

2015 ◽  
Vol 144 (5) ◽  
pp. 1045-1051 ◽  
Author(s):  
H. CAMPE ◽  
S. HEINZINGER ◽  
C. HARTBERGER ◽  
A. SING
Keyword(s):  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Influenza Season ◽  
Influenza Infection ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Case Definition ◽  
Influenza Surveillance ◽  
Case Definitions ◽  
Laboratory Confirmation

SUMMARYFor influenza surveillance and diagnosis typical clinical symptoms are traditionally used to discriminate influenza virus infections from infections by other pathogens. During the 2013 influenza season we performed a multiplex assay for 16 different viruses in 665 swabs from patients with acute respiratory infections (ARIs) to display the variety of different pathogens causing ARI and to test the diagnostic value of both the commonly used case definitions [ARI, and influenza like illness (ILI)] as well as the clinical judgement of physicians, respectively, to achieve a laboratory-confirmed influenza diagnosis. Fourteen different viruses were identified as causing ARI/ILI. Influenza diagnosis based on clinical signs overestimated the number of laboratory-confirmed influenza cases and misclassified cases. Furthermore, ILI case definition and physicians agreed in only 287/651 (44%) cases with laboratory confirmation. Influenza case management has to be supported by laboratory confirmation to allow evidence-based decisions. Epidemiological syndromic surveillance data should be supported by laboratory confirmation for reasonable interpretation.

scholarly journals GAMBARAN GEJALA DAN TANDA KLINIS DIARE AKUT PADA ANAK KARENA BLASTOCYSTIS HOMINIS

e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Mona C. U. Aman ◽  
Jeanette I. Ch. Manoppo ◽  
Rocky Wilar
Keyword(s):  
Acute Diarrhea ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Vital Signs ◽  
Age Group ◽  
Blastocystis Hominis ◽  
Design Data ◽  
Cross Sectional ◽  
Hominis Infection ◽  
Group 1

Abstract: This study aimed to obtain the description of symptoms and clinical signs of acute diarrhea in children because of Blastocystis hominis. This was a descriptive study with a cross-sectional retrospective design. Data were obtained from medical records of pediatric patients diagnosed as acute diarrhea due to Blastocystis hominis infection from January 2010 - September 2014 in Gastroenterology Children ward Prof. Dr. R. D. Kandou Hospital Manado. Data were clinical symptoms, vital signs, and nutritional status. There were 31 samples, 24 (77.4 %) males and 7 (22.6 %) females. Most children who suffered were in the age group 1-3 years as many as 18 (58.1 %) children. The most frequent clinical symptoms were diarrhea 29 (93.5 %) patients, fever 27 (87.1 %) patients, and vomiting 21 (67.7 %) patients. Conclusion: Children of acute diarrhea due to Blastocystishominis infection were most frequent in the age group 1-3 years, males, with clinical symptoms acute diarrhea, fever, and vomiting.Keywords: acute diarrhea, blastocystishominis, childrenAbstrak: Penelitian ini bertujuan untuk mengetahui gambaran gejala dan tanda klinis diare akut pada anak karena Blastocystis hominis. Penelitian ini bersifat deskriptif retrospektif dengan pendekatan potong lintang. Data diperoleh dari rekam medik pasien anak dengan diagnosis diare akut karena infeksi Blastocystis hominis periode Januari 2010-September 2014 di Bangsal Gastroenterologi Anak Rumah Sakit Prof. Dr. R. D. Kandou Manado. Data berisi gejala klinis dan tanda vital serta status gizi. Sampel penelitian berjumlah 31 anak, 24 (77,4%) anak laki-laki dan 7 (22,6%) anak perempuan. Umur yang paling banyak menderita diare akut karena Blastocystis hominis yaitu 1 – 3 tahun sebanyak 18 (58,1%) anak. Gejala klinis yang paling sering muncul yaitu buang air besar cair sebanyak 29 (93,5%) pasien, demam sebanyak 27 (87,1%) pasien,dan muntah sebanyak 21 (67,7%) pasien. Tanda vital menunjukkan nilai normal. Simpulan: Anak diare akut karena infeksi Blastocystis hominis terbanyak pada kelompok umur 1 – 3 tahun. Anak diare akut karena infeksi Blastocystis hominis terbanyak pada jenis kelamin laki-laki. Gejala klinis yang ditemukan pada pasien diare akut karena infeksi Blastocystis hominis ialah buang air besar cair, demam dan muntah dengan tanda vital normal.Kata kunci: anak, blastocystishominis,diare, akut

scholarly journals Prevention of acute ruminal lactic acidosis in sheep by probiotic or monensin supplementation: clinical aspects

2018 ◽  
Vol 39 (4) ◽  
pp. 1575 ◽  
Author(s):  
Leonardo Frasson dos Reis ◽  
Carolina Akiko Sato Cabral de Araújo ◽  
Rejane Santos Sousa ◽  
Antonio Humberto Hamad Minervino ◽  
Francisco Leonardo Costa de Oliveira ◽  
...  
Keyword(s):  
Lactic Acidosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Vital Signs ◽  
Clinical Aspects ◽  
Control Group ◽  
Probiotic Group ◽  
Ruminal Ph ◽  
Physical Examinations ◽  
And Control

The aim of this study was to evaluate the effects of two additives (probiotic and monensin) over clinical parameters of sheep submitted to acute ruminal lactic acidosis (ARLA). Eighteen sheeps were divided into three groups of six animals each as follows: probiotic group, supplemented with 4×109 CFU/animal/day of Saccharomyces cerevisiae; monensin group, supplemented with 33 mg of monensin sodium per kg of diet; and control group, without any supplementation. After 30 days of diet (75% of Coast-cross hay and 25% concentrate with 14% of crude protein) and additive intake, ARLA was induced in the all animals by intraruminal administration of 15g of sucrose per kilogram (kg) of body weight. Complete physical examinations to assess the vital signs of the animals were conducted at the following times: baseline (T0), six (T6h), 12 (T12h), 18 (T18h), 24 (T24h), 36 (T36h), and 48 (T48h) hours after ARLA induction. At those times, blood samples were obtained to determine the plasma volume deficit (PVD) and ruminal content for pH measurement. All animals experienced clinical signs of ARLA with ruminal pH lower than 4.9 at T24h. The heart rate and PVD were lower (P < 0.05) in the probiotic group at T36h. Compared to the control and monensin groups, the probiotic group experienced milder ARLA characterized by lower degrees of dehydration and fewer clinical symptoms.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

COVID-19: how nuclear medicine can provide a differential diagnosis in very dubious case

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Maria Silvia De Feo ◽  
Viviana Frantellizzi ◽  
Giuseppe De Vincentis
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Ct Scan ◽  
Imaging Technique ◽  
False Negative ◽  
Clinical Signs ◽  
Negative Results ◽  
Infectious Disease Department ◽  
False Negative Results ◽  
99Mtc Hmpao

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

Sign in / Sign up

Export Citation Format

Share Document