Syphilis in pregnancy remains an important medical condition due to its consequences. We present two cases of young pregnant women who were diagnosed syphilis during their antenatal visit. The first case was a 29-year-old Malay lady diagnosed with syphilis during the first trimester of pregnancy, while the second case was a 21-year-old Chinese lady diagnosed with syphilis during the third trimester of pregnancy. The diagnosis and management of the syphilis in pregnancy are discussed.

Based on available evidence, the COVID-19 virus is thought to spread through close contact and droplet transmission. However, some have debated that it could be airborne. Airborne transmission occurs when particles of less than 0.5 μm within droplets spread through exhaled air via a process called aerosolisation. These particles can remain in the air for long periods and can disseminate over distances further than 1 meter. In the context of COVID-19, airborne particles can occur during certain aerosolised-generating-procedures (AGP). WHO underlines the use of N95 respirators or equivalent as part of personal protective equipment (PPE) for healthcare workers (HCW) managing COVID-19 positive patients when aerosolised-generating-procedures (AGP) are being conducted. This retrospective observational study describes the result of COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) in health care workers (HCW) wearing different form of personal protective equipment (PPE) who had had close contact with a confirmed COVID-19 patient during performing such procedures. All HCWs were quarantined for 14 days after the exposure. COVID-19 RT-PCR nasopharyngeal swabs were performed at different intervals. Little is known about the effectiveness of different types of personal protective equipment (PPE) for preventing SARS-CoV-2 in HCWs. We describe the clinical outcome of HCWs exposed to sudden acute respiratory infection patient before the diagnosis of COVID-19 was known.

Background: Terrisporobacter glycolicus (formerly known as Clostridium glycolicum) is a rare cause of infection and emerging anaerobic pathogen. It is a gram-positive, rod shaped obligate anaerobic organism, first identified in 1963 by Gaston and Stadman. However, the first human infection was reported only in 2007, more than 4 decades after its discovery. There are few published case reports reporting these gram-positive bacilli causing infection to human and mostly as part of a polymicrobial infection. Here, we described a case of septicaemia with mortality.Case description: We described a case of a 78-year-old gentleman with multiple co-morbidities and sacral sore admitted for altered sensorium due to cerebrovascular accident with uremia. During admission he developed urinary tract infection and was treated with intravenous cefuroxime, which he has responded well. However, he deteriorated later with poor oral intake and reduced in Glasgow coma scale of 8/15. Blood culture from anaerobic bottle isolated greyish colonies on anaerobic plate after 48 h of incubation, susceptible to metronidazole. By using Vitex 2.0 system, there was low discrimination between T. glycolicus and Clostridium sporogenes. The isolate was later identified by Matrix-assisted laser desorption/ionization -time of flight (MALDI-TOF) mass spectrometry as Terrisporobacter glycolicus. The result from the reference laboratory showed two anaerobic organisms were isolated (Grampositive anaerobic bacilli and gram-negative anaerobic bacilli). The gram-positive anaerobic bacilli was identified as Terrisporobacter glycolicus which was susceptible to penicillin [minimum inhibitory concentration (MIC) of 0.380 ug/mL], amoxycillin-clavulanate (MIC of 0.750 mg/mL), imipenem (MIC of 0.500 ug/mL), clindamycin (MIC of 0.064 ug/mL) and metronidazole (MIC of 1.000 ug/mL). The patient however deteriorated further and was decided for DNR status. He succumbed to illness on day 15 of admission.Discussion: MALDI-TOF MS has become the method of choice for identification of anaerobic bacteria, replacing 16S rRNA gene sequencing and gas-liquid chromatography. The advent of MALDI-TOF MS has demonstrated increased specificity, cost-effectiveness, and decreased turnaround time.Conclusion: Infection by this organism could be fatal in elderly patient with co-morbidities. In this group of patients, the presentation is usually atypical. In addition, up-to-date laboratory identification such as MALDI-TOF plays important role in confirming the identity of this organism.

Acute respiratory infections cause significant morbidity and mortality in children. Several new respiratory viruses have been identified and co-detection of multiple viruses is commonly reported. This is part of a prospective study which aims to detect respiratory viruses by multiplex molecular method and conventional methods. Nasopharyngeal aspirate specimens were taken from hospitalised children aged less than 5 years with lower respiratory tract infections. These were tested using viral culture, immunofluorescence and Seegene Anyplex™ II RV16 real-time polymerase chain reaction. From 102 samples, 69 (67.6%) were positive by PCR, 12 (11.8%) positive by culture method and 13 (12.7%) positive by IF. A single viral pathogen was detected in 48 samples (47.1%), while 21 samples (20.6%) had co-detection of 2 to 4 viral pathogens. Respiratory syncytial virus (RSV) was most common, detected in 17 samples (16.7% of all samples), followed by adenovirus and rhinovirus in 16 (15.7%), respectively. Bocavirus was detected in 15, enterovirus in 15, influenza A in 8 and parainfluenza-4 in 4 samples, with highest occurrences in co-detection (12/15, 10/15, 5/8 and 3/4, respectively). RSV was the least likely detected in co-detection (3/17). In PCR-positive samples, 54/69 (78.3%) were patients aged up to 24 months. Molecular methods detect more viral aetiologies than conventional methods, with simultaneous detection of multiple respiratory viruses. More sensitive, specific and rapid tools to determine aetiological agents could be incorporated into diagnostic algorithms of respiratory tract infections. Interpretations, significance, and applicability in clinical practice could be further explored, particularly for patients up to 2 years old.

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