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COVID-19 is a serious global infectious disease impairing the quality of life of people across the world. SARS-CoV-2 may reside in nasopharyngeal and salivary secretions of COVID-19-infected patients and spreads mainly through respiratory droplets and fomites. It has presented a challenge to dentistry, as many dental procedures generate aerosols that could lead to cross-contamination. It also presents many post-infection complications that may continue to debilitate patients, even after successful management of the virus. One such complication may be osteomyelitis of the jaw. Two cases of post-COVID-19 osteomyelitis of the jaw are presented that were determined to be unrelated to mucormycosis in otherwise healthy individuals with no prior dental complaints. An attempt is made to shed light on clinical signs in post-COVID cases that may point to a diagnosis of the condition. The pathophysiology is also discussed, which may help in formulating guidelines to prevent and manage post-COVID osteomyelitis of the jaw. [ABSTRACT FROM AUTHOR]

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Background: Ventriculostomy-associated infection (VAI) is common after external ventricular drains (EVD) insertion but is difficult to diagnose in patients with acute brain injury. Previously, we proposed a set of criteria for ruling out VAI in traumatic brain injury. This study aimed to validate these criteria. For exploratory purposes, we sought to develop and validate a score for VAI risk assessment in patients with different types of severe acute brain injury. Methods: This retrospective cohort study included adults with acute brain injury who received an EVD and in whom CSF samples were taken over a period of 57 months. As standard non-coated bolt-connected EVDs were used. The predictive performance of biomarkers was analyzed as defined previously. A multivariable regression model was performed with five variables. Results: A total of 683 patients with acute brain injury underwent EVD placement and had 1272 CSF samples; 92 (13.5%) patients were categorized as culture-positive VAI, 130 (19%) as culture-negative VAI, and 461 (67.5%) as no VAI. A low CSF WBC/RBC ratio (< 0.037), high CSF/plasma glucose ratio (> 0.6), and low CSF protein (< 0.5g/L) showed a positive predictive value of 0.09 (95%CI, 0.05–0.13). In the multivariable logistic regression model, days to sample (OR 1.09; 95%CI, 1.03–1.16) and CSF WBC/RBC ratio (OR 34.86; 95%CI, 3.94–683.15) were found to predict VAI. Conclusion: In patients with acute brain injury and an EVD, our proposed combined cut-off for ruling out VAI performed satisfactorily. Days to sample and CSF WBC/RBC ratio were found independent predictors for VAI in the multivariable logistic regression model. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the current management of tinea capitis in the United States, specifically focusing on patients aged 0–2 months, 2 months to 2 years, and 2 years to 18 years. An online survey, distributed through the Pediatric Dermatology Research Alliance and the Society of Pediatric Dermatology, revealed the following preferences: fluconazole for those under 2 months, griseofulvin for those aged 2 months to 2 years, and terbinafine for those aged 2 years and older. There exists inter‐provider variation in tinea capitis treatment regimens within the pediatric dermatology community. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a conditional pathogen, which is a common pathogen in nosocomial infections and relatively rare in community infections. At present, there are few reports on the clinical manifestations of Pseudomonas aeruginosa infection, especially regarding the lymphoid tissue infection caused by Pseudomonas aeruginosa. This paper reported a case of lymphoid tissue infection caused by Pseudomonas aeruginosa, summarized its clinical manifestations and treatment process, in order to improve the clinical understanding of the diagnosis and treatment of this disease.

Objective To explore the predictive value of serum soluble leukocyte differentiation antigen subtype 14 (sCD14 st) and pentamerin-3 (PTX-3) in severe acute pancreatitis (SAP) complicated with peripancreatic necrosis infection. Methods A total of 112 SAP patients were selected and divided into the infection group (54 cases) and the non-infection group. Cultures of pathogenic bacteria were performed in patients of the infection group. Enzyme-linked immunosorbent assay was used to detect serum levels of sCD14 st, PTX-3, procalcitonin (PCT) and C-reactive protein (CRP). Results A total of 61 strains of pathogenic bacteria were detected in the infection group, including 45 strains of Gram-negative bacteria (73.77%), 14 strains of Gram-positive bacteria (22.95%) and 2 strains of fungi (3.28%). The serum levels of sCD14-ST, PTX-3, PCT and CRP were significantly higher in the infected group than those in the non-infected group (P＜0.05). Serum sCD14-ST was positively correlated with PTX-3, PCT and CRP in SAP patients (P＜0.05). Serum PTX-3 was positively correlated with sCD14-ST, PCT and CRP (P＜0.05). The high levels of sCD14-ST, PTX-3, PCT and CRP were the risk factors of peripancreatic necrosis infection in SAP patients (P＜0.05). The areas under the curve of sCD14-ST, PTX-3, PCT and CRP predicting peripancreatic necrosis infection in SAP patients were 0.854 (95%CI: 0.784-0.925), 0.851 (95%CI: 0.780-0.923), 0.837 (95%CI: 0.756-0.919) and 0.749 (95%CI: 0.654-0.844) respectively. Conclusion The serum levels of sCD14-ST and PTX-3 are abnormally elevated in SAP patients with peripancreatic necrosis infection, and their expression levels are closely related to the risk of infection. Both of them have high predictive value for SAP patients with peripancreatic necrosis infection. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Pulmonary cryptococcosis is an uncommon infection mainly affecting immunocompromised individuals. Presentation of cryptococcal disease ranges from asymptomatic pulmonary colonization to severe pneumonia. It can progress to acute respiratory failure and life-threatening meningoencephalitis. Case Report: A 55-year-old woman with a history of a kidney transplant, on immunosuppressive therapy, presented to the hospital with persistent low-grade fever, headache, weight loss, and fatigue for 2 weeks. On arrival, she was tachycardic, normotensive, and saturating 99% on room air. Her chest X-ray showed right middle lung opacity measuring 1.9x2.8 cm. She was admitted and started on broad-spectrum antibiotics for suspected pneumonia. Her chest computed tomography (CT) scan showed a 3.0x1.7 cm hypo-dense opacity at the right upper lobe. Overnight, she developed a severe headache and neck stiffness. Her serum cryptococcal antigen and cerebrospinal fluid culture results were positive. The patient was started on intravenous liposomal amphotericin B plus flucytosine. A CT-guided lung biopsy was performed to rule out malignancy. Cultures came back positive for Cryptococcus neoformans. She completed a 2-week course of amphotericin and flucytosine and was switched to oral fluconazole to complete an 8-week course. Conclusions: Prompt diagnosis and effective management of the cryptococcal disease can decrease morbidity and mortality. Diagnosis requires CT-guided lung biopsy, with culture growing mucoid colonies of Cryptococcus neoformans. Antifungal therapy with intravenous liposomal amphotericin B plus flucytosine is the mainstay of treatment. Clinicians should be aware of the various presentations of pulmonary cryptococcosis, especially in immunocompromised patients. [ABSTRACT FROM AUTHOR]