The objective of this study was to highlight the emergence of COVID-19 bacteria pneumonia co-infections in patients infected with SARS-Cov-2 and risk factors related to its incidence and outcomes. We reported two cases of elderly patients with multiple comorbidities infected with SARS-Cov-2 and developed COVID-19 bacterial pneumonia requiring admission to intensive care unit (ICU) with one mortality preceded by septicemic shock and multi-organ failures. Observing the potential risk factors for being infected with SARS-Cov-2 and developing COVID-19 bacterial pneumonia we strongly advocate for rapid detection of COVID-19 bacterial pneumonia in SARS-Cov-2 infected patients and rapidly characterized the bacterial involved for a better outcome and importantly for efficient antimicrobial stewardship. COVID-19 bacterial pneumonia is an emerging disease requiring rapid detection and bacterial characterization with the ongoing management for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2
Keywords: COVID-19, bacterial pneumonia, acute respiratory syndrome
Managing melioidosis with fulminant sepsis is difficult and challenging. We describe the case of a 30-year-old man with clinical presentation of non-specific septicemic shock with multi organ impairment and severe respiratory distress. The causative organism, Burkholderia pseudomallei was only identified on day 4 of ICU admission. Imaging investigation revealed multiple lung and splenic abscesses. This led to delay in the diagnosis and initiating specific antimicrobial therapy which arise from difficulties in clinical recognition and laboratory diagnosis. Our patient was managed in the ICU for 23 days with intensive antimicrobial therapy. As for now, we should increase the awareness of melioidosis in treating our patients and realize its burden to our community and hoping that a better diagnostic test will arise and helps us in achieving early confirmatory diagnosis and guide for better therapeutic efficacy and survival of the patients.
Objective:To highlight the importance of immediate initiation of perimortem caesarean delivery in maternal with sudden cardiac arrest.
Case report: We reported the outcomes of three cases of perimortem caesarean delivery secondary to maternal cardiac arrest. A 28-year-old G3P2 at 36 weeks of gestation who developed severe hypoxaemia secondary to acute pulmonary oedema which was arise from pre-eclampsia related hypertensive crisis. The second case was a 29-year-old G1P0 at 38 weeks of gestation who developed severe hypoxaemia secondary to spinal anaesthesia complication (total spinal)and the third case was a 44-year-old G5P4 at 39 weeks of gestation who developed severe hypoxaemia secondary to failed intubation and ventilation during induction of anaesthesia. Observing the outcomes of the three maternal after post perimortem caesarean delivery, we are strongly agreed that the time from maternal cardiac arrest to the initiation of resuscitative hysterotomy should be shifted from 4 minute to immediately.
Conclusion: Preparations for perimortem caesarean delivery should be made simultaneously with the initiation of maternal resuscitative efforts.
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