Tuberculous myocarditis has a high mortality rate and is often associated with a delay in the diagnosis because of the low index of suspicion and insidious course. Most of the reported cases predominantly occur in young, immunocompetent patients. Delays in diagnosis may result in fatal complications. Through this case report, we aim to shed light on some of the clinical features of tuberculous myocarditis and promote a high index of suspicion for early diagnosis and timely management.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes severe bilateral pneumonia and acute respiratory distress syndrome (ARDS) which can lead to difficulty breathing. Many cases require mechanical ventilation and intensive care unit management. The need for mechanical ventilation and ICU admission seems to be more evident in patients that were unvaccinated for COVID-19 at the time of admission. We discuss a case of a 63-year-old African-American woman who presented as a transfer to our hospital facility with acute hypoxic respiratory failure. She was already intubated and mechanically ventilated prior to her transfer. She had a one-week history of shortness of breath and cough productive of white, blood-tinged sputum. A two-day history of diarrhea was also reported before admission to the other hospital where she stayed for a week before transfer to our intensive care unit. She had no significant past medical history and was unvaccinated for COVID-19, and was suspected to be infected with the Delta strain of COVID-19. Her primary diagnosis at admission was COVID pneumonia and acute hypoxic respiratory failure. Her condition worsened over a period of one week. Chest X-Ray, at the time of arrival, showed bilateral patchy opacities consistent with COVID-19 pneumonia. After an extensive review of her labs and reports, the patient was attributed to be at a high risk for acute decompensation (or catastrophically ill), thus requiring critical care management. Over a course of 12 days, she was aggressively treated with antibiotics, steroids, remdesivir and tocilizumab. Her condition gradually deteriorated and she eventually passed away. It can be noted that most of the severe cases, especially ICU admissions, comprise people who are unvaccinated. We can safely conclude that although vaccination may not prevent re-infection, it does result in better clinical outcomes.
The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posted a devastating global health crisis for almost a year already. Very little is known about this virus that scientists, physicians and the medical community struggled to find treatments of this novel virus. The vaccine that can potentially combat this virus is still an unknown reality hence, the repurposing of existing medical treatments such as chlorpheniramine maleate (CPM) could be a possible treatment and is being widely utilized. CPM is a safe and effective antihistamine with potent antiviral activity against various strains of influenza A/B, thus highlighting its great antiviral potential. We tested the virucidal potential of chlorpheniramine maleate (CPM) in a nasal spray composition currently in development as an anti-allergy medication. The coronavirus disease 2019 (COVID-19) has a droplet mode transmission with a notably high viral load in the upper respiratory tract, especially the nose. Several studies had already postulated that the nose is possibly the primary route of entry of SARS-CoV-2 owing to the high expression of Angiotensin 2 converting enzyme receptors. We hypothesize that utilizing (CPM) nasal spray as an adjunct treatment to COVID-19 positive patients and reduce their clinical course and hasten their time to negativization via RT-PCR via nasopharyngeal swab. We present a series of four symptomatic patients with mild-moderate risks. CPM nasal spray was added to their current supportive treatment. All four patients showed rapid improvement of their clinical symptoms with a shorter than average time to negativization on repeat nasopharyngeal swab via RT-PCR. No safety issues were encountered during the course of treatment. Given its years of excellent safety profile with remarkable clinical results as shown in this case series, we conclude that CPM nasal spray may be a potential adjunct treatment option in patients with mild to moderate COVID-19 symptoms.
Hypoxic-ischemic encephalopathy (HIE) typically manifests in the neonatal period. The degree of hypoxia following intrapartum asphyxia determines the structural changes in the brain, which can cause functional deficits in the affected child leading to developmental deficits and recurrent seizures. Management requires physical therapy, occupational therapy, and anti-seizure medications. We present a rare case of an 11-yearold female with a past medical history of epilepsy and cerebral atrophy secondary to hypoxic injury at birth. The patient presented to the hospital following a witnessed seizure and loss of consciousness for one hour. Given the past medical history and clinical findings, it was determined that a mild-to-moderate encephalopathic process resulted in a lower seizure threshold. HIE can manifest beyond the neonate years mainly due to the structural changes within the brain. Therefore, it is essential to understand aspects of HIE beyond the neonate years to manage this condition for a better patient outcome.
Background and Aims: The peak of the third wave of COVID-19 infection was in the summer (August–September) of 2021, dominated by the Delta variant. Florida was the epicenter of the third wave with more than 151,449 cases in the first week of August with a positivity rate of 20%. The purpose of this study is to identify the percentage of COVID-19 infection in vaccinated patients in a minority population in south Florida and to elucidate the relationship, if any, between demographics and breakthrough infections, the rate of vaccine hesitancy, as well as the willingness to receive the monoclonal antibody REGEN-COV for the treatment of COVID-19. Methods: This cross-sectional study was performed at the Emergency Department, Larkin Community Hospital Palm Spring Campus, located in Hialeah, the fourth largest city in Florida. Hialeah is dominated (94.7%) by Hispanics and Latinos. This city represents a cross-sectional sample of US cities in general and Florida in specific. We enrolled 127 COVID-19 PCR-positive patients. Results: The infection in vaccinated patients (breakthrough) was found to be about one in three (34%). Despite the high infection rate and mounting death toll, about 73% of our unvaccinated patients answered no to the question ‘knowing the consequences of being infected with COVID-19 and the fact that you are positive, would you have chosen to be vaccinated earlier?’ However, about 27% of these patients agreed to receive the vaccine and 20.5% received the monoclonal antibody REGEN-COV. Conclusions: Our study revealed that vaccine hesitancy in South Florida continues to be a major challenge, especially with the emergence of mutations including Delta plus and Omicron.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.