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Fever without source

Pietro Ferrara, Luciana Albano
BACKGROUND: Since correct maintenance of intravascular catheters is an effective strategy for preventing central-line infections, the aim of this study was to assess the level of adherence to guidelines for CVC maintenance amongst Italian HCWs. METHODS: From July 2016 thru January 2017, a cross sectional survey was carried out in a random sample of 549 HCWs working in different hospitals of Campania region (Italy). RESULTS: The 68.9% of interviewees returned the questionnaire...
December 3, 2018: BMC Infectious Diseases
Borja Gomez, Haydee Diaz, Alba Carro, Javier Benito, Santiago Mintegi
OBJECTIVES: To determine the performance of procalcitonin (PCT), C reactive protein (CRP) and absolute neutrophil count (ANC) in identifying invasive bacterial infection (IBI) among well-appearing infants ≤21 days old with fever without source and no leukocyturia. To compare this performance with that in those 22-90 days old. DESIGN: Substudy of a prospective single-centre registry performed between September 2008 and August 2017. SETTING: Paediatric emergency department of a tertiary teaching hospital...
November 29, 2018: Archives of Disease in Childhood
Marina N Boushra, Susan N Miller, Alex Koyfman, Brit Long
BACKGROUND: Evaluation and treatment of the acutely ill patient is typically complicated by multiple comorbidities and incomplete medical histories. This is exemplified by patients with sepsis, whose care is complicated by variable presentations, shifting definitions, and a variety of potential sources. Many practitioners fail to consider and recognize less-common sources of infection in a timely manner. Additionally, multiple noninfectious conditions can present with the fever and tachycardia typical of the septic patient...
November 2, 2018: Journal of Emergency Medicine
Jérémy Lafolie, André Labbé, Anne Sophie L'Honneur, Fouad Madhi, Bruno Pereira, Marion Decobert, Marie Noelle Adam, François Gouraud, Frédéric Faibis, Francois Arditty, Stéphanie Marque-Juillet, Marie Aline Guitteny, Gisele Lagathu, Matthieu Verdan, Flore Rozenberg, Audrey Mirand, Hélène Peigue-Lafeuille, Cécile Henquell, Jean-Luc Bailly, Christine Archimbaud
BACKGROUND: Enteroviruses are the most frequent cause of acute meningitis and are seen increasingly in sepsis-like disease and fever without source in the paediatric population. Detection of enterovirus in cerebrospinal fluid (CSF) specimens by PCR is the gold standard diagnostic test. Our aim was to assess a method of detecting enterovirus in blood specimens by PCR. METHODS: We did a prospective, multicentre, observational study at 35 French paediatric and emergency departments in 16 hospitals...
October 30, 2018: Lancet Infectious Diseases
Yoko Deguchi, Yuko Horiuchi, Kensaku Shojima, Naoyuki Iwahashi, Miwa Ikejima, Kazuhiko Ino, Kenichi Furukawa
Although toxic shock syndrome (TSS) is rare, multiorgan failure can occur without early identification and appropriate therapy. In particular, a few cases of postpartum TSS due to methicillin-resistant Staphylococcus aureus (MRSA) have been reported. Here, we describe a rare case in which a 32-year-old Japanese woman had TSS due to MRSA that was caused by a perineal infection after a normal vaginal delivery. Twelve days after giving birth to a healthy child, she was readmitted to our hospital due to a 2-day fever and perineal pain without uterine tenderness...
2018: Case Reports in Obstetrics and Gynecology
Akina Shrestha, Christian Schindler, Peter Odermatt, Jana Gerold, Séverine Erismann, Subodh Sharma, Rajendra Koju, Jürg Utzinger, Guéladio Cissé
BACKGROUND: Infections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two districts of Nepal and determined underlying risk factors. METHODS: A cross-sectional survey was conducted between March and May 2015 in the districts of Dolakha and Ramechhap, Nepal...
September 29, 2018: Parasites & Vectors
Anwen L Cope, Nick Francis, Fiona Wood, Ivor G Chestnutt
BACKGROUND: Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis and acute apical abscess are common causes of dental pain and arise from an inflamed or necrotic dental pulp, or infection of the pulpless root canal system. Clinical guidelines recommend that the first-line treatment for teeth with these conditions should be removal of the source of inflammation or infection by local, operative measures, and that systemic antibiotics are currently only recommended for situations where there is evidence of spreading infection (cellulitis, lymph node involvement, diffuse swelling) or systemic involvement (fever, malaise)...
September 27, 2018: Cochrane Database of Systematic Reviews
Sharfuddin Chowdhury, Abdullah Maher Alenazi, Yam Alwi Alharthi
BACKGROUND: Meckel's diverticulum, with an incidence of 2%, is the most common congenital anomaly in the gastrointestinal tract. Its main complications are perforation, obstruction, and bleeding. A few studies have reported that blunt abdominal trauma may result in perforation or obstruction to Meckel's diverticulum. However, reports of significant major intestinal bleeding from Meckel's diverticulum as a complication of blunt abdominal trauma is rare. This paper present what we believe to be the first reported case of significant intestinal bleeding from a Meckel's diverticulum following blunt abdominal trauma...
September 19, 2018: Journal of Medical Case Reports
Jessica L Bloom, Jeffrey R Darst, Lori Prok, Jennifer B Soep
BACKGROUND: Henoch-Schonlein Purpura (HSP) is one of the most common vasculitides of childhood, with 10-20 cases per 100,000 children. It frequently occurs following an infectious trigger and involves IgA and C3 deposition in small vessel walls. HSP is characterized by palpable purpura plus IgA deposition on biopsy, arthritis/arthralgia, renal involvement (hematuria and/or proteinuria), and/or abdominal pain. It is not generally recognized as a cause of dilated coronary arteries. CASE PRESENTATION: We describe the first reported case of HSP presenting with dilated coronary arteries...
September 4, 2018: Pediatric Rheumatology Online Journal
Chukwuemika Aroh, Chaoying Liang, Prithvi Raj, Benjamin Wakeland, Nan Yan, Edward Wakeland
The second largest outbreak of West Nile encephalitis and West Nile fever ever recorded occurred in the United States (U.S) in the summer of 2012. The outbreak was related to the widespread circulation of closely related clades, or groups, of West Nile virus (WNV) into multiple states where they were not previously found. Whether the invading 2012 strains were able to circulate and overwinter in states with their own endemic population of WNV is unknown and the effect of viral genetics on adaptation and persistence in a new ecological niche is unclear...
August 25, 2018: Infection, Genetics and Evolution
Sonia Parikh, Parijat Goswami, Asha Anand, Harsha Panchal, Apurva Patel, Rahul Kulkarni, Bhadresh Shastri
BACKGROUND: The primary objective of this study is to describe clinical and microbiological profile of infections during induction phase of acute myeloid leukemia (AML). PATIENTS AND METHODS: We reviewed the case records of 50 hospitalized patients with AML undergoing standard dose induction chemotherapy from January to December 2015. RESULTS: Out of 50 cases, 34 were males 16 females with median age of 30 years. Most common presenting symptoms were fever followed by bleeding diathesis...
May 2018: Gulf Journal of Oncology
Erica Leoni, Federica Catalani, Sofia Marini, Laura Dallolio
Legionella spp. is widespread in many natural and artificial water systems, such as hot water distribution networks, cooling towers, and spas. A particular risk factor has been identified in the use of whirlpools and hot tubs in spa facilities and public baths. However, there has been no systematic synthesis of the published literature reporting legionellosis cases or outbreaks related to swimming/spa pools or similar environments used for recreational purposes (hot springs, hot tubs, whirlpools, natural spas)...
July 30, 2018: International Journal of Environmental Research and Public Health
S Read, J Mullins
Introduction: Pyomyoma, or suppurative leiomyoma, is a rare complication of uterine fibroids. It occurs most commonly in the setting of pregnancy, the immediate postpartum period, or postmenopausal status. It may also arise after recent uterine instrumentation, after uterine artery embolization, or in immunocompromised patients. The most likely cause of pyomyoma is vascular compromise followed by bacterial seeding from direct, hematogenous, or lymphatic spread. Diagnosis is difficult, as the condition is rare, presents with vague symptoms, and is difficult to identify on imaging...
2018: Case Reports in Obstetrics and Gynecology
Iramiot Jacob Stanley, Henry Kajumbula, Joel Bazira, Catherine Kansiime, Innocent B Rwego, Benon B Asiimwe
BACKGROUND: Antimicrobial resistance is a worldwide public health emergency that requires urgent attention. Most of the effort to prevent this coming catastrophe is occurring in high income countries and we do not know the extent of the problem in low and middle-income countries, largely because of low laboratory capacity coupled with lack of effective surveillance systems. We aimed at establishing the magnitude of antimicrobial resistance among Escherichia coli and Klebsiella pneumoniae carried in the gut of out-patients from pastoralist communities of rural Western Uganda...
2018: PloS One
Sukhyun Ryu, Bryan Inho Kim, Byung Chul Chun
BACKGROUND: An outbreak of respiratory tract infection due to Respiratory Syncytial Virus (RSV) type B in a postpartum center was reported on February 1, 2017. Investigation was conducted to identify the magnitude, possible source of infection and risk factors for this outbreak on February 2, 2017. METHODS: A retrospective cohort study was conducted. A case was defined as a neonate having respiratory symptoms with or without fever and stayed at the postpartum center between January 1, 2017 and February 3, 2017...
September 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Nicole E Breuner, Andrias Hojgaard, Adam J Replogle, Karen A Boegler, Lars Eisen
The relapsing fever spirochete, Borrelia miyamotoi, is increasingly recognized as a cause of human illness (hard tick-borne relapsing fever) in the United States. We previously demonstrated that single nymphs of the blacklegged tick, Ixodes scapularis, can transmit B. miyamotoi to experimental hosts. However, two recent epidemiological studies from the Northeastern United States indicate that human cases of hard tick-borne relapsing fever peak during late summer, after the spring peak for nymphal tick activity but coincident with the peak seasonal activity period of larval ticks in the Northeast...
September 2018: Ticks and Tick-borne Diseases
Emily D Carter, Micky Ndhlovu, Thomas P Eisele, Emmy Nkhama, Joanne Katz, Melinda Munos
Background: Existing population-based surveys have limited accuracy for estimating the coverage and quality of management of child illness. Linking household survey data with health care provider assessments has been proposed as a means of generating more informative population-level estimates of effective coverage, but methodological issues need to be addressed. Methods: A 2016 survey estimated effective coverage of management of child illness in Southern Province, Zambia, using multiple methods for linking temporally and geographically proximate household and health care provider data...
June 2018: Journal of Global Health
Daniel Jungmyung Oh, Stephen Brecher, Marcus Ruopp
We report a rare case of Clostridium perfringens (CP) empyema in a patient with metastatic squamous cell cancer of the lung. Clostridial empyemas are rare and clinically variable with some reports noting consequent necrotizing infections and septic shock and others noting quick resolution with source control and antibiotic treatment. This is the first case report to our knowledge to report a CP empyema in a patient with lung malignancy. Given the comorbid lung malignancy, the patient's presenting symptoms were mild with only mild shortness of breath, fevers, and generalized weakness despite the large CP empyema...
April 2018: International Journal of Critical Illness and Injury Science
David C Sheridan, Beech Burns, Megan Mickley
Pediatric fever is one of the most common presenting complaints to emergency departments (ED). While often due to a viral illness, in young children without a source the most common bacterial infection is pyelonephritis. For this reason, when no focal source can be identified a urinary specimen is recommended. In young children who are unable to urinate on demand, a straight catheter is required to obtain a sterile specimen. This is generally a benign procedure and is performed frequently in EDs. We report a case of a young girl who underwent straight bladder catheterization and was subsequently found to have a retained catheter that had become knotted in the bladder...
February 2018: Clinical practice and cases in emergency medicine
Nicholas J Clark, Ricardo J Soares Magalhães
BACKGROUND: Q fever is a zoonotic disease caused by Coxiella burnetii. This bacterium survives harsh conditions and attaches to dust, suggesting environmental dispersal is a risk factor for outbreaks. Spatial epidemiology studies collating evidence on Q fever geographical contamination gradients are needed, as human cases without occupational exposure are increasing worldwide. METHODS: We used a systematic literature search to assess the role of distance from ruminant holdings as a risk factor for human Q fever outbreaks...
May 15, 2018: BMC Infectious Diseases
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