Listeria rhombencephalitis is a rare cause of brain stem encephalitis. We report a case with a history of immunosupressive therapy due to Takayasu's arteritis that was treated with corticosteroids and linezolid for Listeria rhombencephalitis. A 63-year-old woman was admitted to the hospital with fever, headache, nausea, and vomiting. The patient's body temperature was 38°C, and she had a stiff neck. Listeria monocytogenes was isolated from the cerebrospinal fluid (CSF), and penicillin G and gentamicin treatment was initiated. Linezolid and dexamethasone were added. Due to hematuria and thrombocytopenia, the linezolid was discontinued. In immunocompromised patients with CNS infections, Listeria rhombencephalitis should be suspected. Linezolid can be used in combination with dexamethasone.
BACKGROUND: Healthcare workers (HCWs) were seriously affected by the coronavirus disease 2019 (COVID-19). It is a priority to protect HCWs against COVID-19 and ensure the continuity of the health care system. OBJECTIVE: To evaluate the risk factors for COVID-19 in HCWs and the effectiveness of the measures taken on protection. METHODS: A nested case-control study was conducted in two hospitals serving on the same campus which are affiliated with a university from Turkey, between 03.12.2020 and 05.22.2020. We aimed to recruit three controls working in the same unit with the cases diagnosed with COVID-19 by polymerase chain reaction (PCR) and whose SARS-CoV-2 PCR test is negative. Self-reported data were collected from the HCWs by the face-to-face method. Descriptive and analytical methods were used and a logistic regression model was built. Results: The study was completed with 271 HCWs, 72 cases, and 199 controls. Household contact with a COVID-19 patient or a patient with symptoms compatible with COVID-19 was found to be significantly higher in the cases than in the controls (p = 0.02, p < 0.001). When the measures for control the COVID-19 were analyzed, using a medical mask (OR = 0.28, 95% confidence interval = 0.11–0.76, p = 0.01) by COVID-19 patient and using the respiratory mask by HCWs (OR = 0.13, 95% CI = 0.03–0.52, p = 0.004) during close contact was found to be protective against COVID-19 transmission. Conclusion: This study showed an association with using medical masks by the patients as an important protective precaution for the transmission of COVID-19 to HCWs. Respiratory masks should be used by HCWs while in close contact with COVID-19 patients regardless of aerosol-producing procedures.
Human bite wounds are more prone to infection than animal bites, which may cause necrotizing soft tissue infections such as myositis, fasciitis. Both aerobic and anaerobic microorganisms may be responsible, including Streptococcus spp., Staphylococcus aureus, Peptostreptococcus spp. Necrotizing fasciitis is characterized by serious tissue destruction and systemic toxicity with high morbidity and mortality. We report a patient with Streptococcus mitis associated necrotizing fasciitis on the upper extremity resulting from an accidental human bite, which caused nearly fatal infection. Prophylactic antibiotic treatment should be given after a human bite to prevent infection. If the infection signs and symptoms develop, rapid diagnosis, appropriate antibiotic and surgical therapy should be administered immediately. Streptococcus mitis is a viridans streptococcus, usually known as a relatively benign oral streptococcus. To our knowledge, this is the first necrotizing fasciitis case due to Streptococcus mitis after human bite.
Purpose Little is known about the characteristics of neutralizing antibody(NAb) response in patients recovered COVID - 19. We aimed to elucidate the factors affecting presence and titers of in an early phase of infection up to 30 days.Methods A total of 129 laboratory-confirmed COVID-19 patients in a tertiary-care hospital were enrolled. Clinical and laboratory data were obtained retrospectively. SARS-CoV-2 specific NAb, IgM, and IgG antibody responses were analyzed. NAb-positive and negative patients were compared, to examine potential associations between clinical, demographical, and laboratory characteristics and the presence/titers of NAb.Results SARS-CoV-2 specific NAb, IgM and IgG were detected at the time of hospital discharge in 60.5%, 30.2%, and 51.9% of the patients, respectively. The presence of antibodies was 42.4%(NAb), 20.3%(IgM) and 44.1%(IgG) among patients within 5-9 days since onset; increased to 79.5%(NAb), 34.1%(IgM) and 47.7%(IgG) by 10-14 days; and detected in 66.7%(NAb), 50%(IgM), 83.3%(IgG) at/after day-15, following symptom onset. The median titer of neutralizing antibody(SN 50) was significantly higher in severe patients(25 versus 7.5, p= 0.009). Of the 23 severe patients, 52.2%(n=12) had higher NAb titers (i.e., SN 50 ≥ 1:25) when compared to that in non-severe patients(p= 0.021; OR = 2.89; 95%CI= 1.15 – 7.28), yet, potential effect of follow-up time on NAb status and titers could not be ruled out.Conclusion Presence and higher titers of NAb were detected more in severe patients compared to their non-severe counterparts. Survival analysis suggested that this difference could at least be partially explained by the length of follow-up after symptoms’ onset.
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