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Milla Salguero SE, Perdomo Domínguez ES. White islands in a sea of red. IDCases 2024; 38:e02072. [PMID: 39301561 PMCID: PMC11409066 DOI: 10.1016/j.idcr.2024.e02072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024] Open
Abstract
Dengue is a viral disease caused by a single-stranded RNA virus from the Flaviviridae family, primarily transmitted by the Aedes aegypti mosquito, although Aedes albopictus also plays a role as a vector. Clinical features of dengue range from nonspecific symptoms to severe forms like dengue shock syndrome. Among these clinical features, dermatological manifestations are particularly noteworthy, as they can aid in differentiating dengue from other illnesses.
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de Aguiar BRL, Ferreira EB, De Luca Canto G, Guerra ENS, Dos Reis PED. Prevalence of skin manifestations in patients with COVID-19: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1390775. [PMID: 39234048 PMCID: PMC11371801 DOI: 10.3389/fmed.2024.1390775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Background COVID-19 presents extrapulmonary manifestations that can aid in the diagnosis. Skin manifestations have been reported but their characteristics are not yet clear. Health professionals need information about its prevalence and main characteristics. Methods This systematic review followed the PRISMA criteria. The protocol was registered in the PROSPERO (number CRD42020193173). Seven electronic databases and the gray literature were searched independently by two researchers. Observational analytical studies that presented data on the prevalence of skin manifestations in patients aged 19 or older with COVID-19 were included. Prevalence estimates were synthesized through a meta-analysis using random-effects models. Association meta-analysis and comparisons were performed for individual characteristics. Results We included 31 studies with 10,934 patients, of which 10,121 tested positive for COVID-19. The general prevalence of skin manifestations was 29% (95% CI: 17.0-43.0; I2: 99%), the most in Africa, with a mean duration between 7 and 9 days and the most frequently affecting feet+hands (75%) and the trunk (71%). Patients with mild/moderate COVID-19 had more of chilblain-like+pernio-like lesions (97%) and inflammatory lesions (86%) than patients with severe or critical COVID-19. Manifestations of vascular origin were only in elderly patients and were significant with the severity of COVID-19 (p = 0). Conclusion The global prevalence of skin manifestations is similar to other signs and symptoms of COVID-19. Skin assessment should be considered when investigating and diagnosing COVID-19 in adult and elderly patients.Systematic review registration: PROSPERO, identifier CRD42020193173, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173.
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Affiliation(s)
- Beatriz Regina Lima de Aguiar
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Elaine Barros Ferreira
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Eliete Neves Silva Guerra
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Paula Elaine Diniz Dos Reis
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
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3
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Henriques P, Caldeira-Araújo H, Brazão MDL, Abreu AM, Vigário AM, Rosa A. Primary Dengue and Long-Term Health Status in Madeira Island, Portugal: A Retrospective Questionnaire-Based Study. Am J Trop Med Hyg 2024; 111:403-411. [PMID: 38955194 PMCID: PMC11310610 DOI: 10.4269/ajtmh.23-0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 03/18/2024] [Indexed: 07/04/2024] Open
Abstract
Dengue is among the most important mosquito-borne viral diseases worldwide. Although its acute manifestations are well known, little is known about the long-term impact of dengue on the population's health status. Madeira Island experienced a single outbreak of autochthonous dengue from September 2012 to March 2013. To extend our knowledge about the clinical impact of the outbreak on this naive population, we applied an online questionnaire to 168 adults diagnosed with dengue at the time to characterize retrospectively their symptoms during the infection and to identify long-term manifestations, possibly triggered by dengue. The most frequent symptoms during the clinical period, reported by more than three-quarters of our participants, were fever, myalgia, extreme tiredness, and headaches, whereas vomiting, pruritus, nausea, retro-orbital pain, and arthralgia occurred in 35% to 50% of participants. In the 8 years after dengue, 61.5% of participants reported at least one recurrent previously nonexistent symptom, the most frequent being headaches, abundant hair loss, extreme tiredness, arthralgia, and myalgia, experienced by 25% to 35% of participants. Nearly 20% of the participants with persistent symptoms reported the onset of chronic illness in the 4 years after dengue, most frequently ophthalmological and autoimmune diseases (5.6% each), versus only 2.2% of chronic disease onset in participants without persistent symptoms. Our results suggest that the occurrence of persistent symptoms after primary dengue might be more frequent than anticipated and may persist for several years, having an impact on the health status and well-being of a considerable proportion of the infected population.
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Affiliation(s)
- Paulo Henriques
- Projeto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
| | - Helena Caldeira-Araújo
- Projeto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
- CQM-Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal
| | - Maria da Luz Brazão
- Projeto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
- Serviço de Medicina Interna, Hospital Central do Funchal, SESARAM-EPERAM, Funchal, Portugal
| | - Ana Maria Abreu
- Departamento de Matemática, Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
- Centro de Investigação em Matemática e Aplicações, Universidade de Évora, Évora, Portugal
| | - Ana Margarida Vigário
- Projeto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Alexandra Rosa
- Projeto Medicina, Faculdade de Ciências da Vida, Universidade da Madeira, Funchal, Portugal
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Maillard O, Fera C, Joly E, Diallo K, Mavingui P, Diarra YM, Koumar Y, Cabié A, Bertolotti A. Mucocutaneous Manifestations in Patients with Dengue Fever: From the EPIDENGUE Cohort on Reunion Island. Acta Derm Venereol 2024; 104:adv40334. [PMID: 39023144 PMCID: PMC11262361 DOI: 10.2340/actadv.v104.40334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
Nearly 4 billion people live in a dengue risk area worldwide. The prevalence of dengue-related mucocutaneous manifestations and their association with severe dengue differ across studies. The aim of the study was to describe the characteristics of patients with dengue-related mucocutaneous manifestations and to investigate those were associated with severe dengue. A retrospective study was conducted in 2019 among patients with a positive RT-PCR for dengue at the University Hospital of Reunion, which has been experiencing a re-emergence of dengue since 2018. Of 847 patients with confirmed dengue, 283 (33.4%) developed mucocutaneous manifestations. Only manifestations of dehydration such as glossitis, dysgeusia, or conjunctivitis were associated with severe dengue, unlike pruritus and rash, in bivariate analysis but not in multivariate analysis. The rash and pruritus of dengue appear to be accompanied by a pronounced flu-like syndrome in younger people without comorbidity or severity, although careful examination of mucous membranes would better identify signs of dehydration and thus cases likely to worsen.
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Affiliation(s)
- Olivier Maillard
- Clinical Investigation Center, INSERM CIC1410, University Hospital of Reunion, Saint Pierre, Reunion, France; Department of Public Health and Research, University Hospital of Reunion, Saint-Pierre, Reunion, France.
| | - Clotilde Fera
- Department of Infectious Diseases and Dermatology, University Hospital of Reunion, Saint-Pierre, Reunion, France
| | - Elisa Joly
- Department of Infectious Diseases and Dermatology, University Hospital of Reunion, Saint-Pierre, Reunion, France
| | - Kevin Diallo
- Department of Infectious Diseases and Dermatology, University Hospital of Reunion, Saint-Pierre, Reunion, France
| | - Patrick Mavingui
- UMR PIMIT, CNRS 9192, INSERM 1187, IRD 249, University of Réunion, Sainte-Clotilde, Reunion, France
| | - Yves-Marie Diarra
- Clinical Investigation Center, INSERM CIC1410, University Hospital of Reunion, Saint Pierre, Reunion, France; UMR PIMIT, CNRS 9192, INSERM 1187, IRD 249, University of Réunion, Sainte-Clotilde, Reunion, France
| | - Yatrika Koumar
- Department of Infectious Diseases and Dermatology, University Hospital of Reunion, Saint-Pierre, Reunion, France
| | - André Cabié
- Department of Infectious Diseases, University Hospital of Martinique, Fort-de-France, Martinique, France; Clinical Investigation Center, Inserm CIC1424, University Hospital of Martinique, Fort-de-France, Martinique, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC1410, University Hospital of Reunion, Saint Pierre, Reunion, France; Department of Infectious Diseases and Dermatology, University Hospital of Reunion, Saint-Pierre, Reunion, France
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5
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Huu TN, Le TQ, Phuong TTT. Dengue Fever Associated with Acute Urticaria. Am J Trop Med Hyg 2024; 111:1-2. [PMID: 38834061 PMCID: PMC11229654 DOI: 10.4269/ajtmh.24-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Thanh Nguyen Huu
- Department of Internal Medicine, College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Thang Quoc Le
- Department of Internal Medicine, College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Thuy Tran Thi Phuong
- Department of Internal Medicine, College of Health Sciences, VinUniversity, Hanoi, Vietnam
- Department of Infectious Diseases, Vinmec International Hospital, Hanoi, Vietnam
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Sangal B, Barnwal S, Priya D, Pant A, Vashisht A. Chik Sign With Dermoscopic Findings in 10 Patients With Dengue: Case Series. Dermatol Pract Concept 2024; 14:dpc.1403a187. [PMID: 39122488 PMCID: PMC11313827 DOI: 10.5826/dpc.1403a187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 08/12/2024] Open
Affiliation(s)
- Bhavya Sangal
- Department of Dermatology, Government Doon Medical college, Dehradun, India
| | - Shruti Barnwal
- Department of Dermatology, Government Doon Medical college, Dehradun, India
| | - Devi Priya
- Department of Dermatology, Government Doon Medical college, Dehradun, India
| | - Astha Pant
- Department of Dermatology, Government Doon Medical college, Dehradun, India
| | - Aditi Vashisht
- Department of Dermatology, Government Doon Medical college, Dehradun, India
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7
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Gonzales Y Tucker RD, Addepalli A. Fever and Rash. Emerg Med Clin North Am 2024; 42:303-334. [PMID: 38641393 DOI: 10.1016/j.emc.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses. A provisional diagnosis and immediate treatment with antimicrobials and supportive care are usually required prior to the return of confirmatory laboratory testing.
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Affiliation(s)
- Richard Diego Gonzales Y Tucker
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Emergency Medicine, Alameda Health System - Wilma Chan Highland Hospital, 1411 E 31st Street, Oakland, CA 94602, USA.
| | - Aravind Addepalli
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA
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Kim M, Vergara E, Tran A, Paul MJ, Kwon T, Ma JK, Jang Y, Reljic R. Marked enhancement of the immunogenicity of plant-expressed IgG-Fc fusion proteins by inclusion of cholera toxin non-toxic B subunit within the single polypeptide. PLANT BIOTECHNOLOGY JOURNAL 2024; 22:1402-1416. [PMID: 38163285 PMCID: PMC11022806 DOI: 10.1111/pbi.14275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/23/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024]
Abstract
Immunoglobulin G (IgG)-based fusion proteins have been widely exploited as a potential vaccine delivery platform but in the absence of exogenous adjuvants, the lack of robust immunity remains an obstacle. Here, we report on a key modification that overcomes that obstacle. Thus, we constructed an IgG-Fc vaccine platform for dengue, termed D-PCF, which in addition to a dengue antigen incorporates the cholera toxin non-toxic B subunit (CTB) as a molecular adjuvant, with all three proteins expressed as a single polypeptide. Following expression in Nicotiana benthamiana plants, the D-PCF assembled as polymeric structures of similar size to human IgM, a process driven by the pentamerization of CTB. A marked improvement of functional properties in vitro and immunogenicity in vivo over a previous iteration of the Fc-fusion protein without CTB [1] was demonstrated. These include enhanced antigen presenting cell binding, internalization and activation, complement activation, epithelial cell interactions and ganglioside binding, as well as more efficient polymerization within the expression host. Following immunization of mice with D-PCF by a combination of systemic and mucosal (intranasal) routes, we observed robust systemic and mucosal immune responses, as well as systemic T cell responses, significantly higher than those induced by a related Fc-fusion protein but without CTB. The induced antibodies could bind to the domain III of the dengue virus envelope protein from all four dengue serotypes. Finally, we also demonstrated feasibility of aerosolization of D-PCF as a prerequisite for vaccine delivery by the respiratory route.
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Affiliation(s)
- Mi‐Young Kim
- Department of Molecular BiologyJeonbuk National UniversityJeonjuRepublic of Korea
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Emil Vergara
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Andy Tran
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Matthew John Paul
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | | | - Julian K.C. Ma
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Yong‐Suk Jang
- Department of Molecular BiologyJeonbuk National UniversityJeonjuRepublic of Korea
| | - Rajko Reljic
- Institute for Infection and ImmunitySt George's University of LondonLondonUK
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9
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Paz-Bailey G, Adams LE, Deen J, Anderson KB, Katzelnick LC. Dengue. Lancet 2024; 403:667-682. [PMID: 38280388 DOI: 10.1016/s0140-6736(23)02576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 01/29/2024]
Abstract
Dengue, caused by four closely related viruses, is a growing global public health concern, with outbreaks capable of overwhelming health-care systems and disrupting economies. Dengue is endemic in more than 100 countries across tropical and subtropical regions worldwide, and the expanding range of the mosquito vector, affected in part by climate change, increases risk in new areas such as Spain, Portugal, and the southern USA, while emerging evidence points to silent epidemics in Africa. Substantial advances in our understanding of the virus, immune responses, and disease progression have been made within the past decade. Novel interventions have emerged, including partially effective vaccines and innovative mosquito control strategies, although a reliable immune correlate of protection remains a challenge for the assessment of vaccines. These developments mark the beginning of a new era in dengue prevention and control, offering promise in addressing this pressing global health issue.
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Affiliation(s)
| | - Laura E Adams
- Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jacqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Kathryn B Anderson
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Leah C Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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10
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Beloukas A. Dengue: Another viral infection with mucocutaneous manifestations. J Eur Acad Dermatol Venereol 2024; 38:15-16. [PMID: 38126691 DOI: 10.1111/jdv.19589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
- National AIDS Reference Centre of Southern Greece, School of Public Health, University of West Attica, Athens, Greece
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11
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Fera C, Maillard O, Joly E, Diallo K, Mavingui P, Koumar Y, Cabié A, Bertolotti A. Descriptive and comparative analysis of mucocutaneous manifestations in patients with dengue fever: A prospective study. J Eur Acad Dermatol Venereol 2024; 38:191-196. [PMID: 37611258 DOI: 10.1111/jdv.19453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/06/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Dengue is an arbovirosis affecting nearly 4 billion people worldwide. Since 2018, dengue has been re-emerging in Reunion Island. The incidence of mucocutaneous manifestations varies according to the studies and is generally called 'rash'. OBJECTIVES To assess the prevalence of different mucocutaneous symptoms and describe the characteristics of patients developing these symptoms and the clinical signs associated with severe dengue. METHODS A prospective study was conducted in 2019 at the University Hospital of La Réunion, in patients presenting a positive PCR for dengue. Descriptive analyses were performed. All cases in the prospective study were examined by a dermatologist. RESULTS A total of 163 cases were included. The prevalence of mucocutaneous signs was 80.4%. A pruritus was reported in 33.7% cases, an erythematous rash in 29.4% and a mouth involvement including lip, tongue, cheek, angular cheilitis, pharyngitis, mouth ulcer and gingivitis in 31.3%. Most of symptoms appeared in the first days, but some of them could disappear only after the 3rd week. Mucocutaneous signs were not associated with a severe dengue fever (p = 0.54), but ecchymotic purpura was (p = 0.037). In multivariate analysis, skin involvement was associated with flu-like syndrome (headache, pharyngitis, rachis pain) and patient required rehydration but not invasive reanimation. CONCLUSION This work confirms the high prevalence of skin symptoms in dengue disease, but also their wide diversity. The mucocutaneous involvement of dengue fever appears to be accompanied by a pronounced flu-like syndrome in people without severity, but careful examination to identify ecchymotic purpura or sign of dehydration in the mucous membranes would better identify cases that may worsen.
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Affiliation(s)
- C Fera
- CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - O Maillard
- Inserm CIC1410, CHU Réunion, Saint Pierre, La Réunion, France
| | - E Joly
- CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - K Diallo
- CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - P Mavingui
- UMR PIMIT, CNRS 9192, INSERM 1187, IRD 249, Université de La Réunion, Saint-Denis, France
| | - Y Koumar
- CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - A Cabié
- CHU Martinique, Service des Maladies Infectieuses, Fort de France, Martinique, France
- Inserm CIC1424, CHU de Martinique, Fort-de-France, France
| | - A Bertolotti
- CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
- Inserm CIC1410, CHU Réunion, Saint Pierre, La Réunion, France
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Kawali A, Mahendradas P, Sanjay S, Mohan A, Shetty B. Epidemic Retinitis with Positive or Negative Weil Felix Test - a Comparative Study and Outcome with Doxycycline. Ocul Immunol Inflamm 2022; 30:1582-1587. [PMID: 34003725 DOI: 10.1080/09273948.2021.1909072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare clinical manifestations and disease outcomes in Epidemic Retinitis (ER) with positive or negative Weil Felix Test (WFT). METHODS Retrospective, observational, comparative study. WFT positive or negative patients formed Group 1 and 2, respectively. Patients receiving oral doxycycline monotherapy formed subgroup A and B. Duration of resolution of macular edema and retinitis was compared. RESULTS Novel finding of "ring retinitis" was observed equally in group 1 and 2. Complete resolution of macular edema took 41.3 days (range: 30-60 days) and 43.68 days (range: 20-105 days) (p = .668) and retinitis lesions resolved in 34.3 days (range: 14-65 days) and 34 days (range: 12-60 days) (p = .875) in group A and B, respectively. All (n = 14) eyes with retinitis within 1 disc diameter of fovea improved better than 20/80 except 1. CONCLUSION No significant difference with respect to clinical, imaging findings and the treatment outcome was observed in WFT positive or negative cases.
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Affiliation(s)
- Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ashwin Mohan
- Department of Vitreo-retina, Narayana Nethralaya, Bangalore, India
| | - Bhujang Shetty
- Department of General Ophthalmology, Narayana Nethralaya, Bangalore, India
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13
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Carica papaya L. Leaves: Deciphering Its Antioxidant Bioactives, Biological Activities, Innovative Products, and Safety Aspects. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2451733. [PMID: 35720184 PMCID: PMC9203216 DOI: 10.1155/2022/2451733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 01/02/2023]
Abstract
The prevalence of viral infections, cancer, and diabetes is increasing at an alarming rate around the world, and these diseases are now considered to be the most serious risks to human well-being in the modern period. There is a widespread practice in Asian countries of using papaya leaves (C. papaya L.) as herbal medicine, either alone or in combination with prescribed medications, to treat a variety of ailments. The importance of conducting the necessary descriptive studies in order to determine the safety of papaya leaf consumption is also emphasized in the context of their application in the healthcare sector. Electronic databases such as Google Scholar, Scopus, and PubMed were used to gather information on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The literature was gathered from publications on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The antidengue, anticancer, antidiabetic, neuroprotective, and anti-inflammatory effects of papaya leaves discussed in this article are supported by evidence from preclinical, in vivo, in vitro, and clinical trial studies, as well as from other sources. Leaves have been investigated for their mechanism of action as well as their potential to be used in the development of novel herbal products for the health business. According to the reports gathered, only a small number of research demonstrated that leaf extract at high concentrations was hazardous to certain organs. The collective literature reviewed in this review provides insights into the use of papaya leaves as a cure for epidemic diseases, highlighting the phytochemical composition and pharmacological attributes of papaya leaves, as well as the results of various preclinical and clinical studies that have been conducted so far on the subject. The review clearly demonstrates the successful medical evidence for the use of papaya leaf extracts in the healthcare system as a supplemental herbal medication in a variety of clinical settings.
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14
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Morbilliform Eruptions in the Hospitalized Child. Dermatol Clin 2022; 40:191-202. [PMID: 35366972 PMCID: PMC8896762 DOI: 10.1016/j.det.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Sk M, Raj S, S A, James R, Mc A, Thomas P. Palatal Rash Sign is Reliable Predictor of Severe Thrombocytopenia in Dengue Fever. Trop Doct 2022; 52:298-301. [PMID: 35128994 DOI: 10.1177/00494755221074553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop in platelet count has serious connotations, and is frequently evidenced by a palatal rash.
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Affiliation(s)
- Mathew Sk
- Department of Medicine, 446644Believers Church Medical College and Hospital, Thiruvalla
| | - Shibu Raj
- Department of Medicine, 112884Somervell Memorial Medical College and Hospital, Karakonam, Trivandrum
| | - Aswin S
- Department of Medicine, 446644Believers Church Medical College and Hospital, Thiruvalla
| | - Renjith James
- Department of Medicine, 112884Somervell Memorial Medical College and Hospital, Karakonam, Trivandrum
| | - Aravind Mc
- Department of Medicine, 112884Somervell Memorial Medical College and Hospital, Karakonam, Trivandrum
| | - Pramod Thomas
- Department of community medicine, 446644Believers Church Medical College and Hospital, Thiruvalla
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16
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Clinicopathologic features among different viral epidemic outbreaks involving the skin. Clin Dermatol 2022; 40:573-585. [PMID: 36509508 PMCID: PMC8219845 DOI: 10.1016/j.clindermatol.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The current coronavirus disease 2019 pandemic has exceeded any epidemiologic prevision, but increasing information suggests some analogies with the major viral outbreaks in the last century, and a general warning has been issued on the possibility that coinfections can make the differential diagnosis and treatment difficult, especially in tropical countries. Some reports have noted that the presence of high dengue antibodies can give a false-negative result when testing for severe acute respiratory syndrome coronavirus 2. Mucocutaneous manifestations are very frequent, with an apparent overlap among different pathogens. However, strong clinicopathologic correlation might provide some clues to address differentials. Waiting for laboratory and instrumental results, the timing and distribution of skin lesions is often pathognomonic. Histopathologic findings characterize certain reaction patterns and provide insights on pathogenetic mechanisms. Unfortunately, skin assessment, especially invasive examinations such as biopsy, takes a back seat in severely ill patients. A literature retrieval was performed to collect information from other epidemics to counteract what has become the most frightening disease of our time.
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Key Words
- (covid-19), coronavirus 2019 disease
- (who), world health organization
- (sars), severe acute respiratory syndrome coronavirus
- (sars-cov-2), novel coronavirus
- (mers), middle east respiratory syndrome
- (r0), basic reproductive number
- (mis), multisystem inflammatory syndrome
- (iga), immunoglobulin a
- (ace-2), angiotensin‐converting enzyme 2
- (dengv), dengue virus
- (ttp), thrombotic thrombocytopenic purpura
- (vwf), von willebrand factor
- (cd1a), cluster of diffentiation 1-a
- (rt-pcr), reverse transcription polymerase chain reaction
- (chikv), chikungunya virus
- (e1, e2), envelope glycoprotein
- (ifn-i), interferon-type-i
- (zikv), zika virus
- (ebov), ebola virus
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17
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Atzori L, Ferreli C, Mateeva V, Vassileva S, Rongioletti F. Clinicopathologic features between different viral epidemic outbreaks involving the skin. Clin Dermatol 2021; 39:405-417. [PMID: 34517998 PMCID: PMC8071581 DOI: 10.1016/j.clindermatol.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The current coronavirus disease 2019 pandemic has exceeded any epidemiologic prevision, but increasing information suggests some analogies with the major viral outbreaks of the last century. A general warning has been issued on the possibility that coinfections can make differential diagnosis and treatment difficult, especially in tropical countries. Some reports have pointed out that the presence of high Dengue antibodies can give a false-negative result for severe acute respiratory syndrome coronavirus 2. Mucocutaneous manifestations are very frequent, with an apparent overlap among different pathogens. A strong clinicopathologic correlation, however, may provide some clues to address the differential. Waiting for laboratory and instrumental results, the timing and distribution of skin lesions is often pathognomonic. Histopathologic findings characterize certain reaction patterns and provide insights on pathogenetic mechanisms. Unfortunately, skin assessments, especially invasive exams such as biopsy, are less important in severely ill patients. A literature review was performed to collect information from other epidemics to counteract what has become the most frightening disease of our time.
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Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Valeria Mateeva
- Department of Dermatology, Sofia University of Medicine, Sofia, Bulgaria
| | - Snejina Vassileva
- Department of Dermatology, Sofia University of Medicine, Sofia, Bulgaria
| | - Franco Rongioletti
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Vita-SaluteS.Raffaele University, Milan, Italy
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18
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Adarsh MB, Abraham A, Kavitha P, Nandakumar MM, Vaman RS. Severe Thrombocytopenia in COVID-19: A Conundrum in Dengue-endemic Areas. Indian J Crit Care Med 2021; 25:465-466. [PMID: 34045816 PMCID: PMC8138641 DOI: 10.5005/jp-journals-10071-23778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Thrombocytopenia in coronavirus disease-2019 (COVID-19) can be attributed to multiple factors. Most often it is disease related. It is usually mild and if severe often associated with severe COVID-19 disease. It can also be due to drugs (Remdesivir, Tocilizumab) or coinfection with other viruses. Here we report two cases of severe thrombocytopenia in COVID-19 due to dengue coinfection. Most often the thrombocytopenia in dengue is self-resolving, and a careful “wait and watch” should suffice unlike COVID-19, where steroids can help if the cytopenia is due to cytokine storm or immune-mediated effects.
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Affiliation(s)
- M B Adarsh
- Department of General Medicine, Government Medical College, Kasaragod, Kerala, India
| | - Anitha Abraham
- Department of Community Medicine, Government Medical College, Kasaragod, Kerala, India
| | - P Kavitha
- Department of Anaesthesia, Government Medical College, Kasaragod, Kerala, India
| | | | - Raman S Vaman
- Medical Superintendent, Government Medical College, Kasaragod, Kerala, India
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19
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Sánchez-González L, Venuto M, Poe S, Major CG, Baskara L, Abdiyeva S, Murphy D, Munoz-Jordan JL, Medina FA, Paz-Bailey G, Petersen K, Becker K, Sharp TM. Dengue Virus Infections among Peace Corps Volunteers in Timor-Leste, 2018-2019. Am J Trop Med Hyg 2021; 104:2202-2209. [PMID: 33901000 PMCID: PMC8176509 DOI: 10.4269/ajtmh.21-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Dengue is an ongoing health risk for Peace Corps Volunteers (PCVs) working in the tropics. On May 2019, the Peace Corps Office of Health Services notified the Centers for Disease Control and Prevention (CDC) of a dengue outbreak among PCVs in Timor-Leste. The purpose of this investigation was to identify the clinical, demographic, and epidemiological characteristics of PCVs with dengue and recommend dengue preventive measures. To identify PCVs with dengue and describe disease severity, the medical records of PCVs reporting fever during September 2018–June 2019 were reviewed. To identify factors associated with dengue virus (DENV) infection, we administered a questionnaire on demographics, travel history, and mosquito avoidance behaviors and collected blood specimens to detect the anti-DENV IgM antibody to diagnose recent infection. Of 35 PCVs in-country, 11 (31%) tested positive for dengue (NS1, IgM, PCR), eight requiring hospitalization and medical evacuation. Among 27 (77%) PCVs who participated in the investigation, all reported having been recently bitten by mosquitoes and 56% reported being bitten most often at home; only 16 (59%) reported having screens on bedroom windows. Nearly all (93%) PCVs reported using a bed net every night; fewer (70%) reported using mosquito repellent at least once a day. No behaviors were significantly associated with DENV infection. Raising awareness of dengue risk among PCVs and continuing to encourage mosquito avoidance behavior to prevent dengue is critical. Access to and use of measures to avoid mosquito bites should be improved or implemented. Peace Corps medical officers should continue to receive an annual refresher training on dengue clinical management.
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Affiliation(s)
| | - Margaret Venuto
- 2Epidemiology and Surveillance Unit, Office of Health Services, United States Peace Corps, Washington, District of Columbia
| | - Scott Poe
- 2Epidemiology and Surveillance Unit, Office of Health Services, United States Peace Corps, Washington, District of Columbia
| | - Chelsea G Major
- 1Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Leonardus Baskara
- 3Timor-Leste Country Office, Office of Health Services, U.S. Peace Corps, Washington, District of Columbia
| | - Sevinj Abdiyeva
- 3Timor-Leste Country Office, Office of Health Services, U.S. Peace Corps, Washington, District of Columbia
| | - Daniel Murphy
- 2Epidemiology and Surveillance Unit, Office of Health Services, United States Peace Corps, Washington, District of Columbia
| | - Jorge L Munoz-Jordan
- 1Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Freddy A Medina
- 1Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- 1Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Kyle Petersen
- 2Epidemiology and Surveillance Unit, Office of Health Services, United States Peace Corps, Washington, District of Columbia
| | - Karen Becker
- 2Epidemiology and Surveillance Unit, Office of Health Services, United States Peace Corps, Washington, District of Columbia
| | - Tyler M Sharp
- 1Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico.,4U.S. Public Health Service, Rockville, Maryland
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20
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Tan BH, Stacey S. Case report: An atypical dengue rash involving the soles. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/2010105820941876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The cutaneous manifestation of dengue is a maculopapular blanchable erythema over the body that spares the palms and the soles. We report a case of serologically proven, uncomplicated dengue fever in a lady who developed macular morbilliform erythema with islands of sparing over the plantar regions of the bilateral soles on day 8 of disease. This phenomenon has not yet been reported in dengue literature.
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Affiliation(s)
- Boon Hian Tan
- Department of General Medicine, Geriatric Medicine, Sengkang General Hospital, Singapore
| | - Simon Stacey
- Department of General Medicine, Geriatric Medicine, Sengkang General Hospital, Singapore
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21
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Belaunzarán-Zamudio PF, Mateja A, Guerra-de-Blas PDC, Rincón-León HA, Navarro-Fuentes K, Ruiz-Hernández E, Caballero-Sosa S, Camas-Durán F, Priego-Smith Z, Nájera-Cancino JG, López-Roblero A, del Carmen Trujillo-Murillo K, Powers JH, Hunsberger S, Siddiqui S, Beigel JH, Valdés-Salgado R, Ruiz-Palacios G. Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico. PLoS Negl Trop Dis 2021; 15:e0009133. [PMID: 33591992 PMCID: PMC7909682 DOI: 10.1371/journal.pntd.0009133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/26/2021] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO). METHODS/ PRINCIPAL FINDINGS This was a two-year, multicenter, observational, prospective, cohort study. We collected data from patients meeting the Pan American Health Organization's modified case-definition criteria for probable Zika infection. We identified Zika, dengue chikungunya by RT-PCR in serum and urine. We compared characteristics between patients with confirmed Zika and dengue infections, Zika and AIUO, and Dengue and AIUO at baseline, Days 3,7,28 and 180 of follow-up. Most episodes (67%) consistent with the PAHO definition of probable Zika could not be confirmed as due to any flavivirus and classified as Acute Illnesses of Unidentified Origin (AIUO). Infections by Zika and dengue accounted for 8.4% and 16% of episodes. Dengue patients presented with fever, generalized non-macular rash, arthralgia, and petechiae more frequently than patients with Zika during the first 10 days of symptoms. Dengue patients presented with more laboratory abnormalities (lower neutrophils, lymphocytosis, thrombocytopenia and abnormal liver function tests), with thrombocytopenia lasting for 28 days. Zika patients had conjunctivitis, photophobia and localized macular rash more frequently than others. Few differences persisted longer than 10 days after symptoms initiation: conjunctivitis in Zika infections, and self-reported rash and petechia in dengue infections. CONCLUSIONS Our study helps characterize the variety and duration of clinical features in patients with Zika, dengue and AIUO. The lack of diagnosis in most patients points to need for better diagnostics to assist clinicians in making specific etiologic diagnoses.
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Affiliation(s)
- Pablo F. Belaunzarán-Zamudio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Allyson Mateja
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | | | - Héctor A. Rincón-León
- Unidad de Medicina Familiar No.11, Instituto Mexicano del Seguro Social, Tapachula, Chiapas, Mexico
| | - Karla Navarro-Fuentes
- Unidad de Medicina Familiar No.11, Instituto Mexicano del Seguro Social, Tapachula, Chiapas, Mexico
| | | | - Sandra Caballero-Sosa
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | - Francisco Camas-Durán
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | - Zoila Priego-Smith
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | | | | | | | - John H. Powers
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Sally Hunsberger
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Sophia Siddiqui
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - John H. Beigel
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | | | - Guillermo Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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22
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Palhares D. Exanthematic dengue fever mimicking rubella. An Bras Dermatol 2020; 96:88-90. [PMID: 33288365 PMCID: PMC7838086 DOI: 10.1016/j.abd.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 06/04/2020] [Indexed: 11/08/2022] Open
Abstract
The authors present a case of dengue fever mimicking rubella. Male patient, in the second episode of dengue fever, presented afebrile, with diffuse morbilliform rash and craniocaudal progression, having subsequently affected his palms and soles. On the third day of clinical evolution, serologies did not indicate IgM, IgG, or NS1, but on the sixth day of evolution, IgM and IgG were reactive for dengue fever. Previous episodes of dengue are a risk factor for the development of more severe conditions, but this was atypical because the patient was afebrile and had a rubelliform rash. The case also illustrates an early IgG anamnestic response, as it was a reinfection.
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23
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Garduño-Soto M, Choreño-Parra JA, Cazarin-Barrientos J. Dermatological aspects of SARS-CoV-2 infection: mechanisms and manifestations. Arch Dermatol Res 2020; 313:611-622. [PMID: 33159236 PMCID: PMC7646711 DOI: 10.1007/s00403-020-02156-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/11/2020] [Accepted: 10/17/2020] [Indexed: 02/08/2023]
Abstract
The human infection caused by the novel SARS-CoV-2 is a public health emergency of international concern. Although the disease associated to this virus, named COVID-19, mainly affects the lungs, the infection can spread to extrapulmonary tissues, causing multiorgan involvement in severely ill patients. The broad infective capacity of SARS-CoV-2 is related to the pattern of expression of the viral entry factors ACE2 and TMPRSS2 in human tissues. As such, the respiratory and gastrointestinal tracts are at high risk for SARS-CoV-2 infection due to their high expression of ACE2 and TMPRSS2, which explains the clinical phenotype described in the vast majority of infected patients that includes pneumonia and diarrhea. Recently, preoccupation about the potential of the virus to infect the skin has been raised by dermatologists due to the increasing observations of cutaneous manifestations in patients with SARS-CoV-2 infection. Although there is little evidence of the expression of ACE2 and TMPRSS2 in the normal skin, the dermatological findings observed among COVID-19 patients warrants further investigation to delineate the mechanisms of skin affection after SARS-CoV-2 infection. Here, we provide a summary of the dermatological findings observed among patients with laboratory-confirmed SARS-CoV-2 infection based on recent reports. In addition, we analyze possible mechanisms of skin injury in COVID-19 patients and discuss about the risk of individuals with chronic skin conditions for SARS-CoV-2 infection. The present review constitutes a useful informative tool to improve our understanding of the pathophysiological mechanisms of COVID-19 and the possible implications of the current pandemic in dermatology.
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Affiliation(s)
- Myriam Garduño-Soto
- Department of Dermatology, Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148, Doctores, Cuauhtémoc, 06720, Mexico City, Mexico.
| | | | - Jorge Cazarin-Barrientos
- Department of Dermatology, Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148, Doctores, Cuauhtémoc, 06720, Mexico City, Mexico
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24
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Srinivas SM, Dhar S. Linear and confluent erythema over the extremities in an infant. Pediatr Dermatol 2020; 37:1147-1148. [PMID: 33283922 DOI: 10.1111/pde.14279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sahana M Srinivas
- Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, India
| | - Sandipan Dhar
- Department of Pediatric Dermatology, Institute of Child Health, Kolkata, India
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25
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Mascitti H, Bonsang B, Dinh A, Assan F, Perronne V, Leblanc T, Duran C, Bouchand F, Matt M, Le Gal A, N'guyen Van Thanh J, Lanore A, Jacob L, Kiavue N, Siméon S, Bessis S, de Truchis P, Landowski S, Davido B, Moreau F, Rameix-Welti MA, Gault E, Gaillard JL, Roux AL, Sivadon-Tardy V, Salomon E, El Sayed F, Carlier R, Emile JF, Perronne C, Bourgault-Villada I. Clinical Cutaneous Features of Patients Infected With SARS-CoV-2 Hospitalized for Pneumonia: A Cross-sectional Study. Open Forum Infect Dis 2020; 7:ofaa394. [PMID: 33204745 PMCID: PMC7650967 DOI: 10.1093/ofid/ofaa394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/25/2020] [Indexed: 12/29/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a current pandemic worldwide. This virus can reach all organs and disturbs the immune system, leading to a cytokine storm in severe forms. We aimed to report cutaneous features among coronavirus disease 2019 (COVID-19) hospitalized patients. Methods We performed a cross-sectional study on 1 given day among all patients hospitalized in acute care for COVID-19 and included all patients with cutaneous features. Follow-up 48 hours later was obtained. Results Among 59 adult patients hospitalized on the day of the study in an infectious diseases ward for SARS-CoV-2 infection who were confirmed by molecular assay and/or radiological findings (computed tomography scan), 40 were included. Several cutaneous manifestations were found: macular exanthema (80%), face edema (32%), livedo (13%), urticarial rash (8%), purpura (5%), oral lichenoid lesions (33%), and conjunctivitis (18%). Cutaneous biopsy was performed in 17 patients. Histological findings showed mast cell hyperplasia (100%), superficial perivascular infiltrate of lymphocytes (94%), and superficial edema (47%) consistent with capillary leak. Conclusions Various dermatological signs can be encountered during COVID-19. A macular rash was the most frequent. All cutaneous features could be related to a vascular leak process.
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Affiliation(s)
- Hélène Mascitti
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Benjamin Bonsang
- Department of Pathological Anatomy and Cytology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Aurélien Dinh
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Florence Assan
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Véronique Perronne
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Thibault Leblanc
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Clara Duran
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Frédérique Bouchand
- Department of Pharmacy, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Morgan Matt
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Aurélie Le Gal
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Julia N'guyen Van Thanh
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Aymeric Lanore
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Louis Jacob
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Nicolas Kiavue
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Soline Siméon
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Simon Bessis
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Pierre de Truchis
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Stéphanie Landowski
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Benjamin Davido
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Frédérique Moreau
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Marie-Anne Rameix-Welti
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Elyanne Gault
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Jean-Louis Gaillard
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Anne-Laure Roux
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Valérie Sivadon-Tardy
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Elsa Salomon
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Faten El Sayed
- Department of Microbiology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Robert Carlier
- Department of Radiology, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Jean-François Emile
- Department of Pathological Anatomy and Cytology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Christian Perronne
- Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France
| | - Isabelle Bourgault-Villada
- Department of Dermatology and Immunology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
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26
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Kamolratanakul S, Thungthong P, Nakhakes C, Kittiyanpanya C, Chonsawat P, Chamnanchanunt S. False-positive dengue IgM test result in a patient with systemic lupus erythematosus: a case report. ASIAN BIOMED 2020; 14:209-213. [PMID: 37551268 PMCID: PMC10373403 DOI: 10.1515/abm-2020-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Dengue virus infection most commonly has mild-to-moderate nonspecific clinical presentations that overlap with other diseases. Dengue-specific tests are commonly used for those patients with acute febrile illness in dengue-endemic areas. There is one study in vitro that showed a false-positive dengue-immunoglobulin M (dengue IgM) test for blood from a patient with systemic lupus erythematosus (SLE). Here, we demonstrated a false-positive dengue IgM test in a patient with SLE. The patient had fever, cytopenia, and a skin rash, but her clinical variables more closely matched with the criteria for SLE than the dengue infection. Vasculitis-like-lesions supported prednisolone administration and her clinical symptoms improved. This case highlights that some patients with SLE can be misdiagnosed as having a viral infection. These two diseases have similar clinical findings, such as acute febrile illness, but they are different in terms of their treatments and disease prognosis.
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Affiliation(s)
- Supitcha Kamolratanakul
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok10400, Thailand
| | - Pravinwan Thungthong
- Division of Hematology, Department of Medicine, Rajavithi Hospital, Bangkok10400, Thailand
| | - Chajchawan Nakhakes
- Division of Hematology, Department of Medicine, Rajavithi Hospital, Bangkok10400, Thailand
| | | | - Putza Chonsawat
- Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok10400, Thailand
| | - Supat Chamnanchanunt
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok10400, Thailand
- Division of Hematology, Department of Medicine, Rajavithi Hospital, Bangkok10400, Thailand
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27
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Bothra A, Maheswari A, Singh M, Pawar M, Jodhani K. Cutaneous manifestations of viral outbreaks. Australas J Dermatol 2020; 62:27-36. [PMID: 32895964 DOI: 10.1111/ajd.13421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 12/13/2022]
Abstract
As the world tries to grapple with the COVID-19 pandemic, dermatologists are left in a lurch as there is a lacuna in dermatologic literature as well as training regarding the cutaneous manifestations of varied viral agents capable of causing epidemics/pandemics or the potential to be bio-weaponised. Such outbreaks have the potential to become a pandemic given this age of globalisation. The quote by George Santayana stands true 'Those who cannot remember the past are condemned to repeat it'. Thus, this article lends a perspective to the recent viral outbreaks and is aimed at summarising these agents and their clinical features to serve as a quick reference for dermatologists.
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Affiliation(s)
- Atul Bothra
- Department of Dermatology, Gauhati Medical College & Hospital, Guwahati, India
| | - Anshu Maheswari
- Consultant Dermatologist, Private Practice, New Delhi, India
| | - Mehak Singh
- Department of Dermatology, JK Medical College & LN Hospital, Bhopal, India
| | - Manoj Pawar
- Department of Dermatology, MVP's Dr.V.P Medical College & Hospital & Research center, Nashik, India
| | - Kirti Jodhani
- Department of Dermatology, Gauhati Medical College & Hospital, Guwahati, India
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Mohan K, Malaiyan J, Nasimuddin S, Devasir RS, Meenakshi-Sundaram P, Selvaraj S, Krishnasamy B, Gnanadesikan S, Karthikeyan M, Kandasamy M, Jayakumar N, Elumalai D, Ra GG. Clinical profile and atypical manifestation of dengue fever cases between 2011 and 2018 in Chennai, India. J Family Med Prim Care 2020; 9:1119-1123. [PMID: 32318478 PMCID: PMC7113926 DOI: 10.4103/jfmpc.jfmpc_926_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 11/14/2022] Open
Abstract
Introduction: Dengue fever is a common mosquito-borne viral disease which has reached alarming size in the past few years. It is endemic in more than 100 countries and significant differences were found in clinical profile and atypical manifestation. Aim of the Study: A retrospective observational study of clinical profile and atypical manifestations in patients with dengue fever. Materials and Methods: Serum samples were collected from clinically suspected cases of dengue fever and it was confirmed by NS1 antigen, IgM, and IgG antibody by ELISA. Clinical details and atypical manifestations were recorded. Observation: During the study period, a total of 2502 patients were suspected to have dengue infection, of which 464 (18.5%) samples were found to be positive for dengue viral infection. A majority of the cases were males [268 (57%)] when compared with females [196 (42%)]. Fever was the most common clinical presentation seen in all the patients, followed by headache (78.4%), myalgia (61%), body pain (49.3%), vomiting (40%), joint pain (31.5%), dry cough (19%), nausea (14%), abdominal pain (8%), diarrhea (5.6%), retro-orbital pain (04%), burning micturition (2.4%), and rashes (0.6%). Among atypical manifestations, hepatomegaly [32 (7%)] was the most common, followed by splenomegaly [23 (5%)], bradycardia [18 (4%)], meningitis [6 (1.2%)], hemoptysis [5 (1%)], acalculous cholecystitis [4 (0.8%)], and acute pancreatitis [2 (0.4%)]. The study of hematological parameters showed thrombocytopenia was present in 179 (38.5%) patients, followed by leukopenia [77 (17%)] and raised hematocrit [29 (6.2%)]. Conclusion: During ongoing epidemics, the clinical profile and atypical manifestations in clinically suspected dengue patients should be investigated early so that severe forms can be treated promptly.
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Affiliation(s)
- Kamalraj Mohan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Jeevan Malaiyan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Sowmya Nasimuddin
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Ravin Sathyaseelan Devasir
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - PradeepRaj Meenakshi-Sundaram
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Santhiya Selvaraj
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Bharathi Krishnasamy
- Institute of Microbiology, Madurai Medical College, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Madurai, Tamil Nadu, India
| | - Sumathi Gnanadesikan
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Muthulakshmi Karthikeyan
- Department of Microbiology, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kancheepuram, Tamil Nadu, India
| | - Mohanakrishnan Kandasamy
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Nithyalakshmi Jayakumar
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Dhevahi Elumalai
- Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
| | - Gokul G Ra
- Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India
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Gautam G, Khera D, Singh K. Isles of white in a sea of red: an underdiagnosed entity? BMJ Case Rep 2020; 13:13/2/e234154. [DOI: 10.1136/bcr-2019-234154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
The "chik sign" is considered to be one of the most common cutaneous features of chikungunya fever and has been considered unique to this disorder. It consists of brownish hyperpigmentation involving the nose. We report a case of a 3-year-old boy with dengue infection who presented with macular hyperpigmentation of nose simulating the chik sign. Hyperpigmentation is an unusual cutaneous manifestation in cases of dengue.
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Affiliation(s)
- Shibani S Bhatia
- Department of Dermatology, Kasturba Medical College, MAHE, Manipal, India
| | | | - Shrikiran A Hebbar
- Department of Paediatrics, Kasturba Medical College, MAHE, Manipal, India
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Lucero JA, Sacdalan DB. White islands in a sea of red: A tropical rash. Eur J Intern Med 2019; 66:e3-e4. [PMID: 31200995 DOI: 10.1016/j.ejim.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/15/2019] [Accepted: 05/08/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Josephine Anne Lucero
- Section of Hematology, Department of Medicine, Philippine General Hospital and University of the Philippines Manila, Philippines
| | - Danielle Benedict Sacdalan
- Section of Medical Oncology, Department of Medicine, Philippine General Hospital and University of the Philippines Manila, Philippines.
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Abstract
Chikungunya and Zika virus infections are emerging diseases in the Americas, and dengue continues to be the most prevalent arthropod-borne virus in the world. These arbovirus diseases may spread by endemic transmission or as travel-related infections and have rapidly expanded their geographic distribution secondary to vector spread. All 3 share a similar clinical picture that includes a maculopapular rash. Zika is characterized by pruritic rash, low-grade fever, and arthralgia. Congenital nervous system malformations are a growing public-health concern. Chikungunya distinctive dermatologic manifestations include facial melanosis and bullous eruption. Dengue bleeding complications may be life-threatening and require inpatient management.
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Affiliation(s)
- Jose Dario Martinez
- Department of Internal Medicine, University Hospital "Dr. José E. González", UANL, Mitras Centro, Avenida Gonzalitos y Madero S/N, Monterrey 64460, Mexico.
| | - Jesus Alberto Cardenas-de la Garza
- Department of Dermatology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Mitras Centro, Avenida Gonzalitos y Madero S/N, Monterrey 64460, Mexico
| | - Adrian Cuellar-Barboza
- Department of Dermatology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Mitras Centro, Avenida Gonzalitos y Madero S/N, Monterrey 64460, Mexico
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Abstract
Endothelins were discovered more than thirty years ago as potent vasoactive compounds. Beyond their well-documented cardiovascular properties, however, the contributions of the endothelin pathway have been demonstrated in several neuroinflammatory processes and the peptides have been reported as clinically relevant biomarkers in neurodegenerative diseases. Several studies report that endothelin-1 significantly contributes to the progression of neuroinflammatory processes, particularly during infections in the central nervous system (CNS), and is associated with a loss of endothelial integrity at the blood brain barrier level. Because of the paucity of clinical trials with endothelin-1 antagonists in several infectious and non-infectious neuroinflammatory diseases, it remains an open question whether the 21 amino acid peptide is a mediator/modulator rather than a biomarker of the progression of neurodegeneration. This review focuses on the potential roles of endothelins in the pathology of neuroinflammatory processes, including infectious diseases of viral, bacterial or parasitic origin in which the synthesis of endothelins or its pharmacology have been investigated from the cell to the bedside in several cases, as well as in non-infectious inflammatory processes such as neurodegenerative disorders like Alzheimers Disease or central nervous system vasculitis.
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Rose E. Other Potentially Life-Threatening Conditions with Mucocutaneous Findings (Leptospirosis, Typhoid Fever, Dengue, Diphtheria, Murine Typhus). LIFE-THREATENING RASHES 2018. [PMCID: PMC7123152 DOI: 10.1007/978-3-319-75623-3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
There are several conditions with mucocutaneous findings that are potentially life-threatening, particularly in certain vulnerable populations. In this chapter, leptospirosis, typhoid fever, dengue, diphtheria, and murine typhus are reviewed. The disease time course of classic and atypical presentations is detailed to assist making the diagnosis in subtle cases. Associated symptoms are discussed as well as a comparison with disease mimics and differential diagnoses. Key diagnostic features are emphasized, and evidence-based management of each condition is detailed in this chapter.
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Affiliation(s)
- Emily Rose
- Keck School of Medicine, University of Southern California, Los Angeles, CA USA
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35
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Soe HJ, Khan AM, Manikam R, Samudi Raju C, Vanhoutte P, Sekaran SD. High dengue virus load differentially modulates human microvascular endothelial barrier function during early infection. J Gen Virol 2017; 98:2993-3007. [PMID: 29182510 DOI: 10.1099/jgv.0.000981] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Plasma leakage is the main pathophysiological feature in severe dengue, resulting from altered vascular barrier function associated with an inappropriate immune response triggered upon infection. The present study investigated functional changes using an electric cell-substrate impedance sensing system in four (brain, dermal, pulmonary and retinal) human microvascular endothelial cell (MEC) lines infected with purified dengue virus, followed by assessment of cytokine profiles and the expression of inter-endothelial junctional proteins. Modelling of changes in electrical impedance suggests that vascular leakage in dengue-infected MECs is mostly due to the modulation of cell-to-cell interactions, while this loss of vascular barrier function observed in the infected MECs varied between cell lines and DENV serotypes. High levels of inflammatory cytokines (IL-6 and TNF-α), chemokines (CXCL1, CXCL5, CXCL11, CX3CL1, CCL2 and CCL20) and adhesion molecules (VCAM-1) were differentially produced in the four infected MECs. Further, the tight junctional protein, ZO-1, was down-regulated in both the DENV-1-infected brain and pulmonary MECs, while claudin-1, PECAM-1 and VE-cadherin were differentially expressed in these two MECs after infection. Non-purified virus stock was also studied to investigate the impact of virus stock purity on dengue-specific immune responses, and the results suggest that virus stock propagated through cell culture may include factors that mask or alter the DENV-specific immune responses of the MECs. The findings of the present study show that high DENV load differentially modulates human microvascular endothelial barrier function and disrupts the function of inter-endothelial junctional proteins during early infection with organ-specific cytokine production.
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Affiliation(s)
- Hui Jen Soe
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Asif M Khan
- Centre for Bioinformatics, School of Data Sciences, Perdana University, Serdang, Selangor, Malaysia
| | - Rishya Manikam
- Trauma and Emergency (Academic), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chandramathi Samudi Raju
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Paul Vanhoutte
- State Key Laboratory of Pharmaceutical Biotechnology and Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Hong Kong SAR
| | - Shamala Devi Sekaran
- Department of Medical Microbiology, Faculty of Medicine, MAHSA University, Selangor, Malaysia.,Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Chatterjee SS, Sharma A, Choudhury S, Chumber SK, Bage R, Parkhe N, Khanduri U. Dengue fever in a south Asian metropolis: a report on 219 cases. IRANIAN JOURNAL OF MICROBIOLOGY 2017; 9:174-185. [PMID: 29225757 PMCID: PMC5719512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Yearly epidemics of Dengue fever occur post-monsoon in India's capital, Delhi. A prospective observational study was conducted during the outbreak months to understand the epidemiology and outcome of this infection and its economic impact. MATERIALS AND METHODS Febrile hospitalized (n=219) patients with dengue fever diagnosed by a combination of MAC-ELISA, GAC-ELISA and NS1Antigen-ELISA were enrolled. Epidemiologic (including economic) parameters, clinical, radiological and laboratory manifestations were noted and patients followed up over the period of hospital stay. Patient management means and outcome were recorded and analysed. RESULTS As per WHO-2009, 153 (69.9%) and 27 (12.3%) patients were classified as dengue with warning signs and Severe Dengue respectively while according to WHO-1997 guidelines 39 (17.8%) and 18 (8.2%) patients were classified as DHF and DSS respectively. 216 patients were from the city while three were travellers; hospitalization was more frequent among the young and male gender. Fever, vomiting, aches and abdominal pain were the most common troublesome manifestations; classical dengue triad was present in 55 (25.1%) patients; hemorrhagic, neurologic and mucocutaneous manifestations were present in 44 (20.1%), 8 (3.7%) and 70 (32%) patients. Ascitis, pleural effusion, and Gall bladder wall oedema was found in 53 (24.2%), 31 (14.1%) and 45 (20.5%) patients respectively. Mortality was 1.4% (3 deaths); in addition there was an intra-uterine fetal death; mean expenditure per patient during the illness was US$ 377.25. CONCLUSION Dengue virus infection results in immense morbidity and substantial mortality.
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Affiliation(s)
- Shiv Sekhar Chatterjee
- Department of Laboratory Diagnostic Services, St Stephen Hospital, Delhi, India,Corresponding author: Dr. Shiv Sekhar Chatterjee, Assistant Professor, Department of Laboratory Diagnostic Services, St Stephen Hospital, Delhi, India. Tel: +9103325644070, +919748732366,
| | - Ankush Sharma
- Department of Laboratory Diagnostic Services, St Stephen Hospital, Delhi, India
| | | | | | - Ras Bage
- Department of Medicine, St Stephen Hospital, Delhi, India
| | - Nittin Parkhe
- Department of Radiology, St Stephen Hospital, Delhi, India
| | - Uma Khanduri
- Department of Laboratory Diagnostic Services, St Stephen Hospital, Delhi, India
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37
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Srivastava A. Dengue fever rash: white islands in a sea of red. Int J Dermatol 2017; 56:873-874. [PMID: 28439894 DOI: 10.1111/ijd.13627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/14/2017] [Accepted: 03/16/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ankita Srivastava
- Jaipur National University Institute for Medical Sciences and Research Centre, Jagatpura, Jaipur, Rajasthan, India
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38
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Fernandes CIR, Perez LEDC, Perez DEDC. Uncommon oral manifestations of dengue viral infection. Braz J Otorhinolaryngol 2016; 86 Suppl 1:3-5. [PMID: 27836645 PMCID: PMC9422683 DOI: 10.1016/j.bjorl.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/13/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Luciano Elias da Cruz Perez
- Universidade Federal de Pernambuco (UFPE), Departamento de Clínica e Odontologia Preventiva, Recife, PE, Brazil
| | - Danyel Elias da Cruz Perez
- Universidade Federal de Pernambuco (UFPE), Departamento de Clínica e Odontologia Preventiva, Recife, PE, Brazil.
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Viral exanthems: An update on laboratory testing of the adult patient. J Am Acad Dermatol 2016; 76:538-550. [PMID: 28413059 DOI: 10.1016/j.jaad.2016.08.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 12/24/2022]
Abstract
Although classic viral exanthems of childhood are well described, they are rarely differentiated in adults. Laboratory techniques for viral identification have advanced without substantial literature to suggest how a dermatologist ought to conduct a cost-effective and diagnostic viral panel. Certain clinical features such as petechiae, vesicles, and dusky macular or morbilliform exanthems point strongly toward a viral exanthem. Differentiation of drug and viral causes of morbilliform eruptions has proven difficult. It is possible that with further diagnostic refinement that unnecessary and fruitless workups of an exanthem and unneeded discontinuation of drugs can be avoided. We review viral exanthems based on clinical features and discuss the available and optimal laboratory techniques to assist the dermatologist in a targeted workup.
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Prakash N, Prakash J, Prakash A. Dengue fever: Diagnosis may be skin deep. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2016. [DOI: 10.1016/j.injms.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- Yin Mo
- Ministry of Health Holdings, University Medicine Cluster, National University Health System, 1 Maritime Square, Singapore 099253, Singapore Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Road, Level 10, 119228, Singapore
| | - Brenda Mae Alferez Salada
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Road, Level 10, 119228, Singapore
| | - Paul Anantharajah Tambyah
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Road, Level 10, 119228, Singapore Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd 119228, NUHS Tower Block, Level 11, Singapore 117597, Singapore
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42
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Clinical significance of skin rash in dengue fever: A focus on discomfort, complications, and disease outcome. ASIAN PAC J TROP MED 2016; 9:713-8. [DOI: 10.1016/j.apjtm.2016.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 05/16/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022] Open
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Roopashri G, Vaishali MR, David MP, Baig M, Navneetham A, Venkataraghavan K. Clinical and oral implications of dengue Fever: a review. J Int Oral Health 2015; 7:69-73. [PMID: 25859113 PMCID: PMC4377157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 12/27/2014] [Indexed: 10/25/2022] Open
Abstract
Dengue is a viral infection with fatal potential complications. It is also called as break-bone fever. Worldwide dengue infection is the most common mosquito-borne viral disease. It is caused by vector Aedesa egypti and represents a major public health issue in more than 100 tropical countries. The word dengue is obtained from Swahili phrase Ka-dinga pepo meaning "cramplikeseizure." Dengue viral infections are characterized by abrupt febrile illness, but can also lead to significant morbidity and mortality. Hence, it requires an early and correct diagnosis. Gingival bleeding is the most common oral manifestation of dengue infection. Although oral lesions are uncommon in dengue infections and if manifested, may be mistaken for bleeding disorders. This review emphasizes the significance of oral lesions as it may be the early indicators of dengue hemorrhagic fever.
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Affiliation(s)
- G Roopashri
- Reader, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India,Correspondence: Dr. Roopashri G. Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India.
| | - M R Vaishali
- Reader, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Maria Priscilla David
- Professor & Head, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Muqeet Baig
- Reader, Department of Oral and Maxillofacial Surgery, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anuradha Navneetham
- Professor & Head, Department of Oral and Maxillofacial Surgery, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Karthik Venkataraghavan
- Professor & Head, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujrat, India
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Bolivar-Mejia A, Alarcón-Olave C, Rodriguez-Morales AJ. Skin manifestations of arthropod-borne infection in Latin America. Curr Opin Infect Dis 2014; 27:288-94. [DOI: 10.1097/qco.0000000000000060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Ravi Banavar S, G S V. Diagnostic efficacy of saliva for dengue - a reality in near future? A piloting initiative. J Clin Diagn Res 2014; 8:229-32. [PMID: 24783144 DOI: 10.7860/jcdr/2014/7521.4169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/17/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dengue, a mosquito-transmitted viral infection presents variable symptoms, including death. Due to their increasing incidences, early detection and improved diagnoses of severe cases are of prime importance. Currently, viral antigens and antibodies are detected by traditional serological tests. However, the introduction of oral fluid as an alternative, has led to many researches. Hence, this prompted us to carry out a pilot study to evaluate the diagnostic efficacy of saliva in detecting dengue antibody by using Enzyme Linked Immunosorbent Assay (ELISA). AIM AND OBJECTIVES To evaluate the presence of Dengue antibody in saliva and its sensitivity and specificity through ELISA. METHODOLOGY AND RESULTS Twenty seropositive patients and twenty seronegative patients of Dengue were considered individually. Saliva samples collected from these patients were subjected to ELISA test for detection of Dengue antibody. A sensitivity of 100% and a specificity of 100% were obtained for making a diagnosis of Dengue infection. CONCLUSION Many studies have been conducted by utilizing saliva as a diagnostic tool, especially in western population. Its advantages over venipuncture are many, especially as it is less invasive, safe, less expensive and as it allows large numbers of samples to be collected easily for screening and epidemiological purposes. In a developing tropical country like India, such a diagnostic tool has to be encouraged. Further research necessitates the implementation of saliva as a diagnostic tool.
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Affiliation(s)
- Spoorthi Ravi Banavar
- Reader, Department of Oral Pathology, MS Ramaiah Dental College and Hospital , Bangalore, India
| | - Vidya G S
- Post graduate Student, Department of Oral pathology, MS Ramaiah Dental College and Hospital , Bangalore, India
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Chhavi N, Venkatesh C, Soundararajan P, Gunasekaran D. Unusual ocular manifestations of dengue fever in a young girl. Indian J Pediatr 2013; 80:522-3. [PMID: 22961056 DOI: 10.1007/s12098-012-0871-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 08/06/2012] [Indexed: 11/24/2022]
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48
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Dubey P, Kumar S, Bansal V, Kumar KVA, Mowar A, Khare G. Postextraction bleeding following a fever: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:e27-31. [PMID: 22999964 DOI: 10.1016/j.oooo.2012.03.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 02/11/2012] [Accepted: 03/31/2012] [Indexed: 11/29/2022]
Abstract
Postoperative hemorrhage is one of the few serious complications that can occur as a result of dental procedures. We report a case of an elderly patient with postextraction bleeding caused by dengue hemorrhagic fever (DHF). Although a major sequel of DHF is bleeding secondary to thrombocytopenia, prolonged hemorrhage as a result of extraction of tooth has not been reported. In the current scenario of emerging and reemerging infections worldwide, dengue is gaining global prominence. This case documents the course and progression of this disease from a dental perspective and highlights the as yet unreported capacity of causing oral complications after dental treatment.
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Affiliation(s)
- Prajesh Dubey
- Department of Oral and Maxillofacial Surgery, Subharti Dental College and Hospital, Subharatipuram, Meerut, India.
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Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res 2012; 136:373-90. [PMID: 23041731 PMCID: PMC3510884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dengue virus belongs to family Flaviviridae, having four serotypes that spread by the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. Dengue disease presents highly complex pathophysiological, economic and ecologic problems. In India, the first epidemic of clinical dengue-like illness was recorded in Madras (now Chennai) in 1780 and the first virologically proved epidemic of dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India in 1963-1964. During the last 50 years a large number of physicians have treated and described dengue disease in India, but the scientific studies addressing various problems of dengue disease have been carried out at limited number of centres. Achievements of Indian scientists are considerable; however, a lot remain to be achieved for creating an impact. This paper briefly reviews the extent of work done by various groups of scientists in this country.
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Affiliation(s)
| | | | - Amita Jain
- Department of Microbiology, KG Medical University, Lucknow, India
| | - Umesh C. Chaturvedi
- Indian Council of Medical Research, New Delhi, India,Reprint requests: Prof. U.C. Chaturvedi, 201-Annapurna Apartments, No.1, Bishop Rocky Street, Faizabad Road, Lucknow 226 007, India e-mail:
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