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Harada N, Shibano I, Izuta Y, Kizawa Y, Shiragami H, Tsumura A, Ohji G, Mugitani A. Infectious mononucleosis due to Epstein-Barr virus reactivation in an immunocompromised 60-year-old patient with COVID-19. J Infect Chemother 2024:S1341-321X(24)00107-7. [PMID: 38570136 DOI: 10.1016/j.jiac.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/20/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
Epstein-Barr virus (EBV) reactivation in COVID-19 patients has been reported, but studies on its clinical significance are lacking. We herein report the occurrence of infectious mononucleosis (IM) due to EBV reactivation in a 60-year-old man with rheumatoid arthritis being treated with methotrexate and tocilizumab. The patient presented with a fever and tested positive for COVID-19. Laboratory findings revealed an increased atypical lymphocyte count, decreased platelet count, and elevated liver enzyme levels. Flow cytometry showed predominant expansion of reactive T cells. EBV reactivation was confirmed using real-time polymerase chain reaction. The patient was treated with remdesivir, and clinical improvement was observed after 10 days of treatment. Follow-up showed a gradual decrease in the EBV-DNA load with no recurrence of atypical lymphocytes. These findings suggest that COVID-19 in immunocompromised patients may lead to unexpected EBV reactivation and IM, even for patients outside the age at which IM is likely to occur.
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Affiliation(s)
| | - Ikumi Shibano
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | - Yuto Izuta
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | - Yusuke Kizawa
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | | | - Akiko Tsumura
- Department of Infectious Diseases, Fuchu Hospital, Osaka, Japan
| | - Goh Ohji
- Division of Infectious Disease Therapeutics, Department of Infectious Disease, Kobe University Graduate School of Medicine, Japan
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2
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Solís-Huerta F, Martinez-Guerra BA, Roman-Montes CM, Tamez-Torres KM, Rajme-Lopez S, Ortíz-Conchi N, López-García NI, Villalobos-Zapata GY, Rangel-Cordero A, Santiago-Cruz J, Xancal-Salvador LF, Méndez-Ramos S, Ochoa-Hein E, Galindo-Fraga A, Ponce-de-Leon A, Gonzalez-Lara MF, Sifuentes-Osornio J. Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19. Antibiotics (Basel) 2023; 12:1108. [PMID: 37508204 PMCID: PMC10376785 DOI: 10.3390/antibiotics12071108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
Recognition of risk factors for hospital-acquired infections (HAI) in patients with COVID-19 is warranted. We aimed to describe factors associated with the development of HAI in patients with severe COVID-19. We conducted a retrospective cohort study including all adult patients admitted with severe COVID-19 between March 2020 and November 2020. The primary outcome was HAI development. Bivariate and multiple logistic regression models were constructed. Among 1540 patients, HAI occurred in 221 (14%). A total of 299 episodes of HAI were registered. The most common HAI were hospital-acquired/ventilation-associated pneumonia (173 episodes) and primary bloodstream infection (66 episodes). Death occurred in 387 (35%) patients and was more frequent in patients with HAI (38% vs. 23%, p < 0.01). Early mechanical ventilation (aOR 18.78, 95% CI 12.56-28.07), chronic kidney disease (aOR 3.41, 95% CI 1.4-8.27), use of corticosteroids (aOR 2.95, 95% CI 1.92-4.53) and tocilizumab (aOR 2.68, 95% CI 1.38-5.22), age ≥ 60 years (aOR 1.91, 95% CI 1.27-2.88), male sex (aOR 1.52, 95% CI 1.03-2.24), and obesity (aOR 1.49, 95% CI 1.03-2.15) were associated with HAI. In patients with severe COVID-19, mechanical ventilation within the first 24 h upon admission, chronic kidney disease, use of corticosteroids, use of tocilizumab, age ≥ 60 years, male sex, and obesity were associated with a higher risk of HAI.
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Affiliation(s)
- Fernando Solís-Huerta
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Medicine, Mexico City 14080, Mexico;
| | - Bernardo Alfonso Martinez-Guerra
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (C.M.R.-M.); (K.M.T.-T.); (S.R.-L.); (A.P.-d.-L.)
| | - Carla Marina Roman-Montes
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (C.M.R.-M.); (K.M.T.-T.); (S.R.-L.); (A.P.-d.-L.)
| | - Karla Maria Tamez-Torres
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (C.M.R.-M.); (K.M.T.-T.); (S.R.-L.); (A.P.-d.-L.)
| | - Sandra Rajme-Lopez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (C.M.R.-M.); (K.M.T.-T.); (S.R.-L.); (A.P.-d.-L.)
| | - Narciso Ortíz-Conchi
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Norma Irene López-García
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Guadalupe Yvonne Villalobos-Zapata
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Andrea Rangel-Cordero
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Janet Santiago-Cruz
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Luis Fernando Xancal-Salvador
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Steven Méndez-Ramos
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Eric Ochoa-Hein
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Epidemiology Department, Mexico City 14080, Mexico; (E.O.-H.); (A.G.-F.)
| | - Arturo Galindo-Fraga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Epidemiology Department, Mexico City 14080, Mexico; (E.O.-H.); (A.G.-F.)
| | - Alfredo Ponce-de-Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (C.M.R.-M.); (K.M.T.-T.); (S.R.-L.); (A.P.-d.-L.)
| | - Maria Fernanda Gonzalez-Lara
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Department of Infectious Diseases, Mexico City 14080, Mexico; (N.O.-C.); (N.I.L.-G.); (G.Y.V.-Z.); (A.R.-C.); (J.S.-C.); (L.F.X.-S.); (S.M.-R.); (M.F.G.-L.)
| | - Jose Sifuentes-Osornio
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, General Direction, Mexico City 14080, Mexico
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Kim JYH, Ragusa M, Tortosa F, Torres A, Gresh L, Méndez-Rico JA, Alvarez-Moreno CA, Lisboa TC, Valderrama-Beltrán SL, Aldighieri S, Reveiz L. Viral reactivations and co-infections in COVID-19 patients: a systematic review. BMC Infect Dis 2023; 23:259. [PMID: 37101275 PMCID: PMC10131452 DOI: 10.1186/s12879-023-08117-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health. The aim of the study was to conduct a literature review to compare the patient characteristics and outcomes of reactivations and co-infections of different viruses. METHODS Our population of interest included confirmed COVID-19 patients who were diagnosed with a viral infection either concurrently or following their COVID-19 diagnosis. We extracted the relevant literature through a systematic search using the key terms in the online databases including the EMBASE, MEDLINE, Latin American Caribbean Health Sciences Literature (LILACS), from inception onwards up to June 2022. The authors independently extracted data from eligible studies and assessed the risk of bias using the Consensus-based Clinical Case Reporting (CARE) guidelines and the Newcastle-Ottawa Scale (NOS). Main patient characteristics, frequency of each manifestation, and diagnostic criteria used in studies were summarized in tables. RESULTS In total, 53 articles were included in this review. We identified 40 reactivation studies, 8 coinfection studies, and 5 studies where concomitant infection in COVID-19 patients was not distinguished as either reactivation or coinfection. Data were extracted for 12 viruses including IAV, IBV, EBV, CMV, VZV, HHV-1, HHV-2, HHV-6, HHV-7, HHV-8, HBV, and Parvovirus B19. EBV, HHV-1, and CMV were most frequently observed within the reactivation cohort, whereas IAV and EBV within the coinfection cohort. In both reactivation and coinfection groups, patients reported cardiovascular disease, diabetes, and immunosuppression as comorbidities, acute kidney injury as complication, and lymphopenia and elevated D-dimer and CRP levels from blood tests. Common pharmaceutical interventions in two groups included steroids and antivirals. CONCLUSION Overall, these findings expand our knowledge on the characteristics of COVID-19 patients with viral reactivations and co-infections. Our experience with current review indicates a need for further investigations on virus reactivation and coinfection among COVID-19 patients.
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Affiliation(s)
- Jenny Yeon Hee Kim
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
| | - Martin Ragusa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Fernando Tortosa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Ana Torres
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Lionel Gresh
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Jairo Andres Méndez-Rico
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | | | - Thiago Costa Lisboa
- Critical Care Department, Hospital de Clinicas de Porto Alegre, PPG Ciencias Pneumologicas, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Sandra Liliana Valderrama-Beltrán
- Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
- Internal Medicine Department, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sylvain Aldighieri
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Ludovic Reveiz
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
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Yazar U, Aydın ZGG, Özkaya AK, Kırımlı K, Güvercin AR. Subdural empyema in immunocompetent pediatric patients with recent SARS-CoV-2 positivity: case report. Childs Nerv Syst 2022; 39:1335-1339. [PMID: 36534133 PMCID: PMC9762647 DOI: 10.1007/s00381-022-05803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Subdural empyema refers to the collection of purulent material in the subdural space and the most source of it is bacterial meningitis in infants while sinusitis and otitis media in older children. It has been very recently reported that coronaviruses (CoV) exhibit neurotropic properties and may also cause neurological diseases. CoV-related complications as hypercoagulability with thrombosis and associated inflammation, catastrophic cerebral venous sinus thrombose sand bacterial-fungal superinfections have been well documented in adult patients. Hereby, we describe 15-year-old and 12-year-old female children with subdural empyema after SARS-CoV2. The patients presented limitation of eye in the outward gaze, impaired speech, drowsiness, fever, vomiting and they also were tested positive for COVID-19. MRI indicated subdural empyema and surgical interventions were needed to relieve intracranial pressure and drain pus after receiving broad spectrum antibiotics treatments. The microbiological analysis of abscess material revealed Streptococcus constellatus which is extremely rare in an immunocompetent child and the patients received appropriate IV antibiotic therapy. Eventually, patients became neurologically intact. Pediatric patients with CoV infections should be closely monitored for neurological symptoms. Further research and more data on the correlation between CoV infections would provide better recognition and treatment options in an efficient manner in children.
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Affiliation(s)
- Uğur Yazar
- Department of Neurosurgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
| | - Zeynep Gökçe Gayretli Aydın
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Kağan Özkaya
- Department of Pediatrics and Department of Pediatric Emergency, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Kaan Kırımlı
- Department of Neurosurgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ali Rıza Güvercin
- Department of Neurosurgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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5
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Leonso AA, Brown K, Prol R, Rawat S, Khunger A, Bromberg R. A Rare Case of Latent Tuberculosis Reactivation Secondary to a COVID-19 Infection. Infect Dis Rep 2022; 14:446-452. [PMID: 35735758 PMCID: PMC9222568 DOI: 10.3390/idr14030048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are currently the two leading causes of death among infectious diseases. As we progress towards a “new normal”, more information is required regarding post-COVID-19 syndromes. We present a case of latent tuberculosis reactivation 3 months after a successful inpatient treatment of COVID-19. A 74-year-old female from the Philippines presented with a new left mid-lung infiltrate with worsening shortness of breath and lethargy for one week prior to admission. The clinical course of the patient deteriorated despite broad-spectrum antibiotics, diuretics, and high-dose steroid therapy requiring intubation and mechanical ventilation. Her sputum culture yielded the microbiological diagnosis of TB. Anti-tubercular medications were started and the patient had a favorable clinical outcome. Our case demonstrates that immunosuppression secondary to COVID-19 and its treatments may promote the development of an active TB infection from a latent infection. It is important to be aware of this potential increase in risk during and after a COVID-19 treatment. This is especially important in high-risk populations to ensure an early diagnosis and prompt management as well as to reduce transmission.
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Affiliation(s)
- Ana-Alicia Leonso
- Department of Graduate Medical Education, Memorial Hospital West, Pembroke Pines, FL 33028, USA; (R.P.); (S.R.); (A.K.)
- Correspondence: (A.-A.L.); (K.B.)
| | - Kyle Brown
- Department of Pharmacy, Memorial Hospital West, Pembroke Pines, FL 33028, USA
- Correspondence: (A.-A.L.); (K.B.)
| | - Raquel Prol
- Department of Graduate Medical Education, Memorial Hospital West, Pembroke Pines, FL 33028, USA; (R.P.); (S.R.); (A.K.)
| | - Saumya Rawat
- Department of Graduate Medical Education, Memorial Hospital West, Pembroke Pines, FL 33028, USA; (R.P.); (S.R.); (A.K.)
| | - Arjun Khunger
- Department of Graduate Medical Education, Memorial Hospital West, Pembroke Pines, FL 33028, USA; (R.P.); (S.R.); (A.K.)
| | - Romina Bromberg
- Department of Infectious Diseases, Memorial Hospital West, Pembroke Pines, FL 33028, USA;
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Blitz SE, McMahon JT, Chalif JI, Jarvis CA, Segar DJ, Northam WT, Chen JA, Bergmark RW, Davis JM, Yawetz S, Arnaout O. Intracranial complications of hypercoagulability and superinfection in the setting of COVID-19: illustrative cases. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE22127. [PMID: 35734230 PMCID: PMC9204919 DOI: 10.3171/case22127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Hypercoagulability with thrombosis and associated inflammation has been well-documented in COVID-19, and catastrophic cerebral venous sinus thromboses (CVSTs) have been described. Another COVID-19–related complication is bacterial superinfection, including sinusitis. Here, the authors reported three cases of COVID-19–associated sinusitis, meningitis, and CVST and summarized the literature about septic intracranial thrombotic events as a cause of headache and fever in COVID-19.
OBSERVATIONS
The authors described three adolescent patients with no pertinent past medical history and no prior COVID-19 vaccinations who presented with subacute headaches, photosensitivity, nausea, and vomiting after testing positive for COVID-19. Imaging showed subdural collections, CVST, cerebral edema, and severe sinus disease. Two patients had decline in mental status and progression of neurological symptoms. In all three, emergency cranial and sinonasal washouts uncovered pus that grew polymicrobial cultures. After receiving broad-spectrum antimicrobials and various additional treatments, including two of three patients receiving anticoagulation, all patients eventually became neurologically intact with varying ongoing sequelae.
LESSONS
These cases demonstrated similar original presentations among previously healthy adolescents with COVID-19 infections, concurrent sinusitis precipitating CVST, and subdural empyemas. Better recognition and understanding of the multisystem results of severe acute respiratory syndrome coronavirus 2 and the complicated sequelae allows for proper treatment.
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Affiliation(s)
| | - J. Tanner McMahon
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua I. Chalif
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Casey A. Jarvis
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - David J. Segar
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Weston T. Northam
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jason A. Chen
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Regan W. Bergmark
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, and Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts; and
| | - Jennifer M. Davis
- Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sigal Yawetz
- Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Omar Arnaout
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Shahab A, Arora A, Chhina SS, Dhillon S, Nazir U. A Unique Triad of Invasive Sinusitis, Brain Abscess with Focal Cerebritis, and COVID-19. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e933177. [PMID: 34702794 PMCID: PMC8557857 DOI: 10.12659/ajcr.933177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 49-year-old
Final Diagnosis: Rhinosinusitis
Symptoms: Cough • fatigue • headache • seizure
Medication: —
Clinical Procedure: —
Specialty: Infectious Diseases
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Affiliation(s)
- Ahmed Shahab
- Department of Hospital Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Alok Arora
- Department of Hospital Medicine, Aurora Medical Center Bay Area, Marinette, WI, USA
| | - Sultan S Chhina
- Department of Hospital Medicine, Baptist Health System, Conway, AR, USA
| | - Saud Dhillon
- Department of Hospital Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Umair Nazir
- Department of Hospital Medicine, Rhode Island Hospital, Providence, RI, USA
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