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9 papers 25 to 100 followers Infectious diseases as seen and treated in the Emergency Department
By Merlin Curry MD, EMT-P
U Binder, E Maurer, C Lass-Flörl
Mucormycosis is an emerging fungal infection worldwide, with devastating disease symptoms and diverse clinical manifestations. The most important underlying risk factors are immunosuppression, poorly controlled diabetes, iron overload and major trauma. The aetiological agents involved in the disease have been re-classified due to changes in taxonomy and nomenclature, which also led to appropriately naming the disease 'mucormycosis'. This article shortly explains the new nomenclature, clinical manifestations and risk factors and focuses on putative virulence traits associated with mucormycosis, mainly in the group of diabetic ketoacidotic patients...
June 2014: Clinical Microbiology and Infection
Sylvain Baize, Delphine Pannetier, Lisa Oestereich, Toni Rieger, Lamine Koivogui, N'Faly Magassouba, Barrè Soropogui, Mamadou Saliou Sow, Sakoba Keïta, Hilde De Clerck, Amanda Tiffany, Gemma Dominguez, Mathieu Loua, Alexis Traoré, Moussa Kolié, Emmanuel Roland Malano, Emmanuel Heleze, Anne Bocquin, Stephane Mély, Hervé Raoul, Valérie Caro, Dániel Cadar, Martin Gabriel, Meike Pahlmann, Dennis Tappe, Jonas Schmidt-Chanasit, Benido Impouma, Abdoul Karim Diallo, Pierre Formenty, Michel Van Herp, Stephan Günther
In March 2014, the World Health Organization was notified of an outbreak of a communicable disease characterized by fever, severe diarrhea, vomiting, and a high fatality rate in Guinea. Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013...
October 9, 2014: New England Journal of Medicine
Stephen Y Liang, Daniel L Theodoro, Jeremiah D Schuur, Jonas Marschall
Infection prevention remains a major challenge in emergency care. Acutely ill and injured patients seeking evaluation and treatment in the emergency department (ED) not only have the potential to spread communicable infectious diseases to health care personnel and other patients, but are vulnerable to acquiring new infections associated with the care they receive. This article will evaluate these risks and review the existing literature for infection prevention practices in the ED, ranging from hand hygiene, standard and transmission-based precautions, health care personnel vaccination, and environmental controls to strategies for preventing health care-associated infections...
September 2014: Annals of Emergency Medicine
Simon Mead, Sonia Gandhi, Jon Beck, Diana Caine, Dillip Gallujipali, Christopher Carswell, Harpreet Hyare, Susan Joiner, Hilary Ayling, Tammaryn Lashley, Jacqueline M Linehan, Huda Al-Doujaily, Bernadette Sharps, Tamas Revesz, Malin K Sandberg, Mary M Reilly, Martin Koltzenburg, Alastair Forbes, Peter Rudge, Sebastian Brandner, Jason D Warren, Jonathan D F Wadsworth, Nicholas W Wood, Janice L Holton, John Collinge
BACKGROUND: Human prion diseases, although variable in clinicopathological phenotype, generally present as neurologic or neuropsychiatric conditions associated with rapid multifocal central nervous system degeneration that is usually dominated by dementia and cerebellar ataxia. Approximately 15% of cases of recognized prion disease are inherited and associated with coding mutations in the gene encoding prion protein (PRNP). The availability of genetic diagnosis has led to a progressive broadening of the recognized spectrum of disease...
November 14, 2013: New England Journal of Medicine
Shweta Tripathi, Mitchell R White, Kevan L Hartshorn
Influenza A viruses (IAVs) remain a major health threat and a prime example of the significance of innate immunity. Our understanding of innate immunity to IAV has grown dramatically, yielding new concepts that change the way we view innate immunity as a whole. Examples include the role of p53, autophagy, microRNA, innate lymphocytes, endothelial cells and gut commensal bacteria in pulmonary innate immunity. Although the innate response is largely beneficial, it also contributes to major complications of IAV, including lung injury, bacterial super-infection and exacerbation of reactive airways disease...
January 2015: Innate Immunity
Diederik van de Beek, Matthijs C Brouwer, Guy E Thwaites, Allan R Tunkel
Bacterial meningitis kills or maims about a fifth of people with the disease. Early antibiotic treatment improves outcomes, but the effectiveness of widely available antibiotics is threatened by global emergence of multidrug-resistant bacteria. New antibiotics, such as fluoroquinolones, could have a role in these circumstances, but clinical data to support this notion are scarce. Additionally, whether or not adjunctive anti-inflammatory therapies (eg, dexamethasone) improve outcomes in patients with bacterial meningitis remains controversial; in resource-poor regions, where the disease burden is highest, dexamethasone is ineffective...
November 10, 2012: Lancet
George Petrikkos, Anna Skiada, Olivier Lortholary, Emmanuel Roilides, Thomas J Walsh, Dimitrios P Kontoyiannis
Mucormycosis is an emerging angioinvasive infection caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. Mucormycosis has emerged as the third most common invasive mycosis in order of importance after candidiasis and aspergillosis in patients with hematological and allogeneic stem cell transplantation. Mucormycosis also remains a threat in patients with diabetes mellitus in the Western world. Furthermore, this disease is increasingly recognized in recently developed countries, such as India, mainly in patients with uncontrolled diabetes or trauma...
February 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
George Liamis, Haralampos J Milionis, Moses Elisaf
Hyponatremia is a common electrolyte disturbance associated with considerable morbidity and mortality. Hyponatremia may not infrequently be present during the course of an infection, does not cause specific symptoms and may be overlooked by clinicians. Nonetheless, it may reflect the severity of the underlying process. This review focuses on the clinical and pathophysiological aspects of hyponatremia associated with infectious diseases. In the majority of cases, the fall in serum sodium concentration is of multifactorial origin owing to increased secretion of the anti-diuretic hormone either appropriately or inappropriately...
November 2011: Journal of Infection
Heinz Feldmann, Thomas W Geisbert
Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa...
March 5, 2011: Lancet
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