scholarly journals A Case of Malaria Predisposing to Salmonella Bacteremia in a Returning Traveler from Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Robert Jakubowski ◽  
Lisa L. Steed ◽  
Susan E. Dorman ◽  
Camelia Marculescu
Keyword(s):  
Infectious Diseases ◽  
Typhoid Fever ◽  
Blood Cultures ◽  
Antigen Testing ◽  
The U.S

We describe a febrile adult returning to the U.S. from Nigeria. Malaria was diagnosed by rapid antigen testing, but recognition of invasive nontyphoidal Salmonella disease was delayed. While the moniker, “typhomalaria,” once used to describe an illness with features of malaria and typhoid fever, has fallen out of favor, it may nevertheless be a helpful reminder to clinicians that both infectious diseases can arise in the same patient. Blood cultures should be obtained routinely in febrile returning travelers from malaria-endemic regions, including those in whom the diagnosis of malaria has already been established.

scholarly journals Vaccine completion and infectious diseases screening in a cohort of adult refugees following resettlement in the U.S.: 2013–2015

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amir M. Mohareb ◽  
Bryan Brown ◽  
Kevin S. Ikuta ◽  
Emily P. Hyle ◽  
Aniyizhai Annamalai
Keyword(s):  
Infectious Diseases ◽  
Hepatitis A ◽  
Medical Data ◽  
Hiv Screening ◽  
Consensus Guidelines ◽  
Active Infection ◽  
Vaccine Completion ◽  
Hcv Screening ◽  
One Year ◽  
The U.S

Abstract Background Refugees are frequently not immune to vaccine-preventable infections. Adherence to consensus guidelines on vaccination and infectious diseases screening among refugees resettling in the U.S. is unknown. We sought to determine rates of vaccine completion and infectious diseases screening in refugees following resettlement. Methods We conducted a retrospective cohort study of refugees resettling in a region in the U.S. using medical data from June 2013–April 2015. We determined the proportion of vaccine-eligible refugees vaccinated with measles-mumps-rubella (MMR), hepatitis A/B, tetanus, diphtheria, and acellular pertussis (Tdap), and human papillomavirus (HPV) following resettlement. We also determined the proportion of refugees who completed HIV and hepatitis C (HCV) screening. Results One hundred and eleven subjects were included, primarily from Iraq (53%), Afghanistan (19%), and Eritrea (11%). Of the 84 subjects who were vaccine-eligible, 78 (93%) initiated and 42 (50%) completed vaccinations within one year of resettlement. Odds of completing vaccination were higher for men (OR: 2.38; 95%CI:1.02–5.71) and for subjects with English proficiency (OR: 3.70; 95%CI:1.04–17.49). Of the 78 subjects (70%) completing HIV screening, two (3%) were diagnosed with HIV. Nearly all subjects completed screening for HCV, and one had active infection. Conclusion While most refugees initiate vaccinations, only 50% completed vaccinations and 70% completed HIV screening within 1 year of resettlement. There is a need to emphasize vaccine completion and HIV screening in refugee patients following resettlement.

Minor liver failure

1930 ◽  
Vol 26 (11) ◽  
pp. 1088-1091
Author(s):  
- Tutkovsky
Keyword(s):  
Infectious Diseases ◽  
Typhoid Fever ◽  
Liver Failure

Small liver failure, which the British call "torpid liver", and Carriere calls "petit hepatisme", can be, especially in the initial stages, a purely transient moment: it is found in infectious diseases (typhoid fever, dysentery, flu), then it can be observed during attacks of hepatic colic, or after them, sometimes this insufficiency is noted with catarrhal jaundice.Liver failure is noted with chloroform anesthesia, with some transient poisoning, especially arsenic.It is observed in persons with a weak liver inherited, it happens quite often in children, as well as in women, during pregnancy.

scholarly journals Culture proven Salmonella typhi co-infection in a child with Dengue fever: a case report

2015 ◽  
Vol 9 (09) ◽  
pp. 1033-1035 ◽  
Author(s):  
Rangan Srinivasaraghavan ◽  
Parameswaran Narayanan ◽  
Thandapani Kanimozhi
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Case Report ◽  
Infectious Diseases ◽  
Typhoid Fever ◽  
Dengue Fever ◽  
Salmonella Typhi ◽  
Infectious Agents ◽  
Dengue Outbreak ◽  
Concurrent Infections

Infectious diseases are one of the major causes of morbidity and mortality in developing countries. Sometimes concurrent infections with multiple infectious agents may occur in one patient, which make the diagnosis and management a challenging task. The authors here present a case of co-infection of typhoid fever with dengue fever in a ten-year-old child and discuss the pertinent issues. The authors emphasize that the risk factors predicting the presence of such co-infections, if developed, will be immensely useful in areas where dengue outbreak occurs in the background of high transmission of endemic infections.

Don't Ignore the Cow in Field Investigations of Chemical, Biological, or Toxin Warfare

1992 ◽  
Vol 11 (1) ◽  
pp. 26-28
Author(s):  
David L. Huxsoll
Keyword(s):  
Infectious Diseases ◽  
Medical Research ◽  
Medical Research Institute ◽  
Army Medical ◽  
Unconventional Warfare ◽  
Epidemiologic Investigation ◽  
Short Notice ◽  
Field Investigations ◽  
Army Medical Research ◽  
The U.S

Anyone interested in assessing an allegation of unconventional warfare would agree with the statement by Peter Barss that “the investigation of an alleged outbreak of CBTW should be conducted, whenever possible, in accordance with the well-tested steps that guide the standard epidemiologic investigation of an outbreak of disease or injuries.” In fact, during my tenure as commander of the U.S. Army Medical Research Institute of Infectious Diseases, response teams were organized in various configurations to deploy on short notice to carry out thorough epidemiological investigations should an incident occur in which the use of biological agents might be suspected or considered. The teams were equipped and organized with the appropriate mix of expertise to carry out the type of epidemiological investigations discussed by Barss.

scholarly journals The comparison of cultures, widal agglutination test and polymerase chain reaction as a diagnostic tool in typhoid fever

Open Medicine ◽  
2008 ◽  
Vol 3 (4) ◽  
pp. 470-474 ◽  
Author(s):  
Ilker Devrim ◽  
Koray Ergünay ◽  
Ates Kara ◽  
Hasan Tezer ◽  
Inci Yiğitkanl ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
Antimicrobial Agents ◽  
Blood Cultures ◽  
Chain Reaction ◽  
Specific Test ◽  
Salmonella Infections ◽  
Group I ◽  
Polymerase Chain

AbstractTyphoid fever caused by Salmonella typhi, paratyphi A and B, is an important cause of morbidity and mortality in many developing countries. A rapid and sensitive method for the detection of S. typhi is essential for early diagnosis of typhoid fever and effective therapy. In this study 45 febrile patients who were suspected to have enteric fever were enrolled, and the results of blood cultures, widal agglutination tests and Polymerase Chain Reaction in these cases were evaluated. Group I consisted of 11 patients with diseases other than salmonella infections, group II represented 6 patients with positive cultures, and group III represented 28 patients with negative blood cultures negative but who were clinically suspected cases that had a medical history of using variable antimicrobial agents. Two positive PCR results were present; one of them was in culture positive group (16,6%) and the other was in culture negative group (3,5%). In our study widal agglutination tests and cultures were found not to be helpful in differential dignosis. Although PCR based detection of S. typhi is reported to be a sensitive and specific test for the diagnosis of enteric fever, in our study the benefit of this method in the diagnosis of especially patients who were treated with antimicrobial therapy was not clearly determined. Other methods to increase sensitiviy and specificity to levels such as those of real time PCR should be developed and large-scaled studies should be done in endemic and non-epidemic regions.

scholarly journals Update on the “Choosing Wisely” initiative in infectious diseases in Germany

Infection ◽  
2020 ◽  
Vol 48 (3) ◽  
pp. 317-321
Author(s):  
Rika Draenert ◽  
◽  
Norma Jung
Keyword(s):  
Infectious Diseases ◽  
Immune Suppression ◽  
Scientific Evidence ◽  
Pneumococcal Vaccination ◽  
German Society ◽  
Blood Cultures ◽  
Choosing Wisely ◽  
Time Interval ◽  
Advanced Liver Cirrhosis ◽  
Severe Infections

Abstract Purpose The Choosing Wisely® initiative is an international campaign addressing over- and underuse of diagnostic and therapeutic measures in infectious diseases among others. Since 2016, the German Society for Infectious Diseases (DGI) has constantly designed new items in this regard. Here we report the most recent recommendations. Methods The recommendations of the DGI are part of the “Klug entscheiden” initiative of the German Society of Internal Medicine (DGIM). Topics for the new items were suggested by members of the DGI, checked for scientific evidence and consented within the DGI and the DGIM before publication. Results The new recommendations are: (1) individuals with immune-suppression, advanced liver cirrhosis or renal insufficiency should receive a dual pneumococcal vaccination. (2) In case of positive blood cultures with Candida spp. thorough diagnostics and treatment should be initiated. (3) In case of suspected meningitis, adult patients should receive dexamethasone and antibiotics immediately after venipuncture for blood cultures and before potential imaging. (4) In case of suspected meningitis a CT scan before lumbar puncture should not be ordered—except for symptoms indicating high CSF pressure or focal brain pathology or in cases of severe immune-suppression. (5) In patients with suspected severe infections, a minimum of two pairs of blood cultures should be drawn using separate venipunctures prior to antibiotic therapy—regardless of body temperature. There is no need of a minimum time interval in between the blood draws. Conclusion Applying these new Choosing Wisely® recommendations will increase patient safety and the value of health care.

scholarly journals Utility of A Single Widal Test in The Diagnosis of Typhoid Fever

2012 ◽  
Vol 35 (2) ◽  
pp. 53-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Fahim Ahmed Rupam ◽  
Farhana Chaiti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Salmonella Typhi ◽  
Definitive Diagnosis ◽  
Blood Cultures ◽  
Widal Test ◽  
Female Ratio ◽  
The Mean ◽  
Agglutinin Titer

Background & objectives: The clinical diagnosis of typhoid fever is difficult, as the presenting symptoms are often diverse and similar to those observed with other febrile illnesses. The definitive diagnosis of typhoid fever requires the isolation of Salmonella typhi or paratyphi from the patient concerned. Since patients often receive antibiotics prior to a confirmatory diagnosis, there is uncertainty that bacteria can be isolated from the blood cultures. Besides this, the facilities for blood culture are not always available or feasible. All these limitations have made Widal test the most utilized diagnostic test for typhoid fever. Many studies have produced data which had cast serious doubts on the value of the Widal Test and thus reappraisal of the role of a single Widal test is needed.Methods & materials: This study was carried out to determine the changes in clinical pattern of enteric fever. A total of 153 children, aged 0 to 14 years, diagnosed as typhoid fever (either positive blood culture for Salmonella typhi or paratyphi) were induced in the study. Of them, 86 children were with a definitive diagnosis of typhoid or paratyphoid fever as indicated by the isolation of S. typhi or S. paratyphi from the blood and 17 had negative blood culture but were clinically suspected of having typhoid fever. The control group was comprised of 50 children with non-typhoidal fevers The Widal test was carried out using rapid slide agglutination method and its accuracy was assessed by comparing the findings with that obtained through blood culture.Result: The mean age of the patients was 5.2 ± 2.8 years and the youngest and oldest patients were 0.7 and 14 years respectively and male to female ratio was roughly 1:1. Nearly one-quarter (24.6%) of the patients had been suffering from the disease for >10 days and the mean duration of illness was 8.2 ± 3.3 days. Widal Test result showed that an ‘O’ agglutinin titer of cut-off value e”1:40 gave a sensitivity of 87.2%, a specificity of 47.1%, a positive predictive value (PPV) of 89.2% and a negative predictive value (NPV) of 42.1%. The sensitivity and NPV decreased with the increase in titer levels and were 56.9% and 31.5% at cut-off value of e” 1:320, while the specificity and PPV increased with the increase in titer levels from 47.1% and 89.2% respectively at a titer of e”1:40 to 100% at a titer of e” 1:320. The ‘titer behaved in the same way as did the ‘O’ agglutinin titer. Similarly when H’ agglutinin was used the sensitivity and NPV decreased from 65% and 31.7% at a titer of e”1:40 to only 25% and 20% respectively at a titer of > 1:320, while specificity and PPV increased from 76.4% and 81.1% at >1:40 to 94.1% and 95.6% respectively at e” 1:320. When either ‘O’ or ‘H’ antibody titer of e”1:160 was used, a good sensitivity (71%), specificity (70.6%) and PPV (92.4%) resulted, though NPV decreased to 32.4%.Conclusion: The Widal test can be of diagnostic value when blood cultures are not available nor practically feasible.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10377  Bangladesh J Child Health 2011; Vol 35 (2): 53-58

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