Geertsenhelms6750

Patients with Down syndrome should be adequately monitored by family doctors in case of pharyngitis with early testing for group A hemolytic Streptococcus infection and administration of the correct antibacterial treatment, if the test is positive.

Infective endocarditis (IE) due to

species is a rare disease representing about 1-2% of all IE cases and carries a high mortality rate. Given the rarity of the disease, there are no clear guidelines on the type and duration of antifungal therapy. Thus, long-term or even life-long antifungal treatment is commonly used.

We report two patients with prosthetic valve

IE and persistent candidemia that failed conservative treatment and ultimately developed heart failure. They underwent prosthetic valve replacement and prolonged antifungal treatment with favorable outcome.

IE commonly occurs in the setting of underlying malignancy, chronic liver disease, previous endocarditis, previous antimicrobial exposure, previous abdominal surgery, intravenous drug use, presence of a central venous catheter, and previous cardiac surgery. Both present patients had undergone a cardiac surgery and had a prosthetic heart valve, while one patient had an underlying autoimmune disease that could be associated with higher risk of IE. In both patients transthoracic ultrasound failed to diagnose IE. In our patients, conservative treatment alone was not enough to control the infection, thus, both patients underwent valve replacement and were subsequently treated with antifungals for 6 weeks. Furthermore, both patients were put on long-term antifungal suppression treatment.

Given the absence of controlled randomized trials, the treatment of

endocarditis mostly relies on experts' opinion, and, thus, future studies focusing on the type and duration of antifungal treatment are required.

Given the absence of controlled randomized trials, the treatment of Candida endocarditis mostly relies on experts' opinion, and, thus, future studies focusing on the type and duration of antifungal treatment are required.

The etiopathogenesis of purulent pericarditis has changed significantly in modern antibiotic era with the emergence of community-acquired methicillin-resistant

(CA-MRSA) in the last few decades. Pericarditis due to MRSA is rarely reported in the literature without risk factors like immunosuppression, thoracic surgery, chest trauma or pre-existing pericardial diseases.

We describe an 18-year-old male who presented with 5 days history of fever, chest pain and shortness of breath. Echocardiogram and thorax CT showed significant pericardial effusion. The patient underwent pericardiocentesis, MRSA was isolated from blood and pericardial fluid. The patient improved with intravenous antibiotics (linezolid). selleck products Follow-up echocardiography at 3 months was unremarkable, without any residual fluid or features of constrictive pericarditis.

In the absence of known risk factors, MRSA is an extremely rare cause of pericarditis in modern antibiotics era. The possibility of MRSA pericarditis should be sought in every case of pericarditis to achieve prompt diagnosis and treatment.

Our case highlights the role of aggressive pericardiocentesis and appropriate antibiotic therapy in purulent pericarditis.

Our case highlights the role of aggressive pericardiocentesis and appropriate antibiotic therapy in purulent pericarditis.

Parvovirus B19 infection generally presents as a transient viral illness in children but rarely shows systemic lupus erythematosus-like symptoms.

Here we present a 7-year-old girl with parvovirus B19 infection who had prolonged fever, rash, pancytopenia and hypocomplementemia making it difficult do differentiate from the first episode of systemic lupus erythematosus. Because she had severe progressive pancytopenia she was administered intravenous immune globulin treatment and her clinical course was dramatically improved.

Parvovirus B19 infection can mimic systemic lupus erythematosus and it may be difficult to differentiate a recent parvovirus B19 infection and the first presentation of systemic lupus erythematosus. Absence of discoid lesions, alopecia, Raynaud phenomenon and autoimmune hemolytic anemia may help to distinguish parvovirus B19 infection from systemic lupus erythematosus.

Parvovirus B19 infection may cause a severe clinical picture resembling systemic lupus erythematosus even in otherwise healthy children. Intravenous immune globulin treatment might be considered in cases resistant to supportive management.

Parvovirus B19 infection may cause a severe clinical picture resembling systemic lupus erythematosus even in otherwise healthy children. Intravenous immune globulin treatment might be considered in cases resistant to supportive management.Medical student training in the United Kingdom has undoubtedly been impacted by the COVID-19 pandemic. Most notably, there have been disruptions to teaching, cancellation of exams and clinical electives and the abandonment of research projects. In response, medical education has been reshaped to facilitate the continuation of studies, such as the online deliverance of course material, digital examinations and implementing welfare and financial support systems. There has also been a surge in student volunteers, often playing critical roles in primary and secondary care to support National Health Service (NHS) staff working on the frontlines. This opinion piece will aim to address the effects of COVID-19 on medical students and their training, and further evaluate how well medical schools responded to the challenges presented by the pandemic. This should highlight aspects requiring improvement and will allow medical schools to be better prepared to tackle similar dilemmas in the future.Proteus spp. are members of the Enterobacteriaceae family and are Gram-negative, rod-shaped bacteria known to mainly cause urinary tract infections (UTIs) in humans. However, even though scarce evidence exists suggesting their potential to cause infective endocarditis (IE), a study summarizing the existing evidence is lacking. The purpose of this study was to systemically review all published cases of IE by Proteus species in the literature. A systematic review of PubMed, Scopus and Cochrane Library (through 5th May 2020) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of IE by Proteus species was performed. A total of 16 studies, containing data of 16 patients, were included. A prosthetic valve was present in 25%, while the most common causative pathogen was P. mirabilis. Aortic valve was the most common infected site in 33.3%, followed by mitral valve in 26.7%. Diagnosis was set with transesophageal echocardiography in 37.5%, and transthoracic echocardiography in 25%, while the diagnosis was set at autopsy in 25%.