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Fever without source

Eran Lavi, Alex Gileles-Hillel, Natalia Simanovsky, Dina Averbuch, Isaiah D Wexler, Yackov Berkun
Pyogenic sacroiliitis (PS) is rare with less than 100 pediatric cases reported in the medical literature. To better characterize PS in the pediatric population, we investigated a series of children presenting with PS. Retrospective data analysis was done at an academic tertiary center between the years of 2000 and 2017. All hospitalized children ≤ 16 years of age with PS were evaluated. Of the 894 children hospitalized with osteoarticular infections, 18 were diagnosed with PS (2%) and are included in the review...
February 7, 2019: European Journal of Pediatrics
Daniel A H Peach, Regine Gries, Nathan Young, Robyn Lakes, Erin Galloway, Santosh Kumar Alamsetti, Elton Ko, Amy Ly, Gerhard Gries
Plant sugar is an essential dietary constituent for mosquitoes, and hemipteran honeydew is one of the many forms of plant sugar that is important to mosquitoes. Many insects rely on volatile honeydew semiochemicals to locate aphids or honeydew itself. Mosquitoes exploit volatile semiochemicals to locate sources of plant sugar but their attraction to honeydew has not previously been investigated. Here, we report the attraction of female yellow fever mosquitoes, Aedes aegypti , to honeydew odorants from the green peach aphid, Myzus persicae , and the pea aphid, Acyrthosiphon pisum , feeding on fava bean, Vicia faba ...
February 1, 2019: Insects
Jevon Samaroo-Campbell, Arsalan Hashmi, Rajat Thawani, Manfred Moskovits, Dmitriy Zadushlivy, Stephan L Kamholz
BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided endocarditis is in itself rare, with some studies reporting an incidence of 5-10%. The majority of these cases involve the tricuspid valve, and isolated pulmonary valve endocarditis (PVE) is an extremely rare entity affecting less than 2% of patients with infective endocarditis. Identification and early management are crucial to prevent long-term complications and reduce mortality...
February 4, 2019: American Journal of Case Reports
Zvi Shimoni, Vered Hermush, Paul Froom
Since the urinary tract is thought to be one of the common sources of fever in hospitalized geriatric patients, urine analysis and urine cultures are routinely ordered in patients with and without urinary tract symptoms. The widespread lack of understanding of the uncertainties in the diagnosis and treatment of a symptomatic urinary tract infection (UTI) leads to unnecessary laboratory testing, and inappropriate antibiotic therapy. We present evidence for the following proposal that on the one hand will limit urine cultures and unnecessary antibiotic therapy without compromising patient safety and on the other hand will ensure proper antibiotic therapy...
December 2018: Harefuah
Susanna Esposito, Victoria Elisa Rinaldi, Alberto Argentiero, Edoardo Farinelli, Marta Cofini, Renato D'Alonzo, Antonella Mencacci, Nicola Principi
Introduction: Among neonates and infants <3 months of age with fever without a source (FWS), 5% to 15% of cases are patients with fever caused by a serious bacterial infection (SBI). To favour the differentiation between low- and high-risk infants, several algorithms based on analytical and clinical parameters have been developed. The aim of this review is to describe the management of young infants with FWS and to discuss the impact of recent knowledge regarding FWS management on clinical practice...
2018: Mediators of Inflammation
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...
December 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
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