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Acute Rhinosinusitis
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
In a few children, the viral infection is complicated by bacterial superinfection. This is typically with pyogenic organisms such as Streptococcus pneumoniae, Haemophilus influenzae, Strep. Milleri and Moraxella catarrhalis and is termed acute bacterial rhinosinusitis (ABRS). Clinically, this presents as a change in the nature of the rhinorrhea, which may become thickened, purulent and greatly discoloured, with increased pyrexia and systemic upset, raised inflammatory markers such as C-reactive protein (CRP) and ‘double sickening’. This is when the child’s symptoms suddenly worsen following a period of apparent improvement.
Answers
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
As the name suggests, eczema herpeticum is mostly caused by herpes simplex virus type 1 or 2 and is a potentially fatal complication of atopic eczema in children. Its alternative name, Kaposi’s varicelliform eruption, was coined on Kaposi’s observations that it looked rather like a chickenpox infection. Other viruses, such as Coxsackie, may also be the underlying cause of the sudden eruption. The child usually presents with fever and systemic unwellness. Glands may be swollen and a blistery rash is seen in areas of eczematous skin. New blisters continue to appear over a period of 7–10 days while old ones crust over. Superinfection with bacteria is not uncommon and can complicate treatment. Eczema herpeticum should be considered a dermatological emergency necessitating referral of the child to specialist paediatric dermatology services. Oral or intravenous antiviral treatment is used depending on response and general condition of the child. Recurrences in children are rare (Liddle, 1990). Preceding treatment of topical steroids is unlikely to be a causative factor. Eczema herpeticum may also be a complication in other conditions in which the skin barrier is faulty (David and Longson, 1985).
Fever In Oncology
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
All granulocytopenic cancer patients with fever deserve prompt empiric antibiotic management. Since 85% of the initial pathogens are bacterial, it is essential that the antibiotics cover the range of the potentially life-threatening organisms typical of the given institution. This has usually necessitated two or three drug combinations. Whenever the initial antibiotic therapy must take into account a bacterial pathogen, extended therapy should focus on superinfection, particularly due to fungi. Infection in the non-neutropenic cancer patients should focus on the suspected causative organism.25,26
Hypopyon after Periocular Corticosteroid Injection: A Case Series
Published in Ocular Immunology and Inflammation, 2023
Long-term corneal ulceration has been associated with a higher risk of local superinfection, and Superinfection in HSK may cause the presence of hypopyon, especially bacterial and fungal infection.36 In case 1, we performed corneal scraping, bacterial and fungal cultural, and IVCM to rule out superinfection. However, negative of germ in scraping and culture cannot fully confirm the absence of bacterial or fungal infections.37 But this patient fully recovered without prophylactic antibacterial and antifungal treatment. So, we think superinfection can be ruled out in this case. In case 2, hypopyon appeared following the presence of corneal epithelial erosion and defects. Superinfection should be considered. But the patient did not have any infiltrates on the cornea and fully recovered with only oral and intravitreal antiviral treatment. We suggest that superinfections is also probably not the reason of hypopyon in this case.
COVID-19 and oral diseases: Assessing manifestations of a new pathogen in oral infections
Published in International Reviews of Immunology, 2022
Afsar R. Naqvi, Joel Schwartz, Daniela Atili Brandini, Samantha Schaller, Heba Hussein, Araceli Valverde, Raza Ali Naqvi, Deepak Shukla
Patel and Woolley [54], reported a case of female patient with intense gingival pain, and bleeding. Based on the symptoms authors suspected COVID-19, however, no molecular diagnostic tests were performed to confirm the viral presence. The patient presented gingival bleeding with no attachment loss and was diagnosed with necrotizing gingivitis. These oral presentations corroborates with that reported by Biadsee et al. [51]. Antibiotic regimen (metronidazole thrice/day for 5 days) resolved oral symptoms suggesting biofilm-mediated periodontal inflammation. These findings indicate bacterial superinfection in COVID-19 subjects with even mild symptoms. Depending on the patients’ intraoral symptoms, antibacterial and antiviral regimens can mitigate oral manifestation suggesting significance of controlling bacteria/virus in COVID-19 patients.
Local Bacteriotherapy – a promising preventive tool in recurrent respiratory infections
Published in Expert Review of Clinical Immunology, 2020
Giorgio Ciprandi, Ignazio La Mantia, Valerio Damiani, Desiderio Passali
Moreover, viral infections may per se represent a cause of RRI as they lower the immune defense [18]. Bacterial super-infections may be frequently associated with viral infections and entail overuse/misuse of antibiotics by primary care doctors [19]. As a consequence, antibiotic resistance is a significant problem, even though it is not generalizable to all bacteria and antibiotics; in fact, penicillin resistance with Streptococcus pyogenes has not been described, and resistance with other antibiotics is absent or low. Instead, resistance with H. influenzae and S. pneumoniae is more problematic with some antibiotics and not with others, and the prevalence of resistance varies geographically [20–22]. Moreover, bacteria create a biofilm, such as thinly layered colonies, which cause antibiotic unsuccess and need surgery [23,24]. Biofilm has been considered an ‘influencer of infections’ as it increases pathogens’ survival and promotes unfavorable host-bacteria interactions [25].