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Cureus May 2024A 34-year-old male, with no history of known previous disease, employed at a ginger farm in South India, presented with a four-day history of high-grade fever and...
A 34-year-old male, with no history of known previous disease, employed at a ginger farm in South India, presented with a four-day history of high-grade fever and headache. Initially, he received symptomatic treatment but was referred due to hypotension and persistent fever. Investigations showed leucocytosis, thrombocytopenia, abnormal liver function tests, renal dysfunction, and elevated C-reactive protein. Positive results were obtained for immunoglobulin M (IgM) and scrub typhus IgM tests, indicating a coinfection, reported rarely from this region. Timely clinical suspicion, prompt laboratory diagnosis, and early treatment with doxycycline and broad-spectrum antibiotics are crucial to prevent complications and fatal outcomes in such coinfections.
PubMed: 38903293
DOI: 10.7759/cureus.60732 -
World Journal of Clinical Cases Jun 2024In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis....
BACKGROUND
In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis. Here, we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids.
CASE SUMMARY
A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes, with no facial erythema. Initial management done were application of steroid eye ointment on both eyelids, hot compresses, and eyelid margin cleaning; noting that there was no relief of symptoms. Surgical excision of the chalazion was done on both eyes, however, bilateral recurrence occurred post-operatively. The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells. Immunohistochemistry studies were positive for LL-37. Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin.
CONCLUSION
Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.
PubMed: 38898849
DOI: 10.12998/wjcc.v12.i17.3253 -
Veterinaria Italiana Mar 2024The aim of this study was to determine the concentration of TNF-alpha (TNF-α) in dogs naturally infected with Dirofilaria immitis (D. immitis) and to assess whether...
The aim of this study was to determine the concentration of TNF-alpha (TNF-α) in dogs naturally infected with Dirofilaria immitis (D. immitis) and to assess whether there are any changes in TNF-α concentration and their dependence during therapy for heartworm disease (HWD). For this study, 14 client-owned dogs with HWD were selected. Clinical and parasitological examinations (modified Knott test for circulating microfilariae and SNAP Test IDEXX for circulating D. immitis antigen) had been used for diagnosing D. immitis and HWD. All dogs were treated with an alternative therapy for HWD (oral doxycycline 10 mg/kg b.w., once daily for 6 weeks, then alternately 4 weeks without and 2 weeks with the medication, and oral ivermectin 6-14 µg/kg b.w., every 2 weeks). The dogs blood sera at the moment of HWD diagnosis, during and at the end of therapy were frozen for further quantifying of TNF-α (Canine TNF-alpha ELISA kit, Thermo scientific). At the moment of HWD diagnosis TNF-α was detected in 9 dogs (7.21±12.44 pg/ml). Concentration of TNF-α was not significantly change during the therapy, neither related to the level of D. immitis antigen nor to antigen level changes. The alternative therapy for HWD has no influence on TNF-α concentration dynamics.
Topics: Animals; Dogs; Dirofilariasis; Dog Diseases; Tumor Necrosis Factor-alpha; Dirofilaria immitis; Male; Female; Doxycycline; Ivermectin
PubMed: 38898794
DOI: 10.12834/VetIt.2662.22847.2 -
BMC Infectious Diseases Jun 2024Q fever, caused by the zoonotic pathogen Coxiella burnetii, exhibits a worldwide prevalence. In China, Q fever is not recognized as a notifiable disease, and the disease...
BACKGROUND
Q fever, caused by the zoonotic pathogen Coxiella burnetii, exhibits a worldwide prevalence. In China, Q fever is not recognized as a notifiable disease, and the disease is overlooked and underestimated in clinical practice, leading to diagnostic challenges.
CASE PRESENTATION
We present a case series of three patients diagnosed with persistent Q fever between 2022 and 2023. The average age of our three cases was 63.33 years old, consisting of two males and one female. The medical history of the individuals included previous valve replacement, aneurysm followed by aortic stent-graft placement and prosthetic hip joint replacement. At the onset of the disease, only one case exhibited acute fever, while the remaining two cases were devoid of any acute symptoms. The etiology was initially overlooked until metagenomic next-generation sequencing test identified Coxiella burnetii from the blood or biopsy samples. Delayed diagnosis was noted, with a duration ranging from three months to one year between the onset of the disease and its confirmation. The epidemiological history uncovered that none of the three cases had direct exposure to domestic animals or consumption of unpasteurized dairy products. Case 1 and 2 resided in urban areas, while Case 3 was a rural resident engaged in farming. All patients received combination therapy of doxycycline and hydroxychloroquine, and no recurrence of the disease was observed during the follow-up period.
CONCLUSION
Q fever is rarely diagnosed and reported in clinical practice in our country. We should be aware of persistent Q fever in high-risk population, even with unremarkable exposure history. Metagenomic next-generation sequencing holds great potential as a diagnostic tool for identifying rare and fastidious pathogens such as Coxiella burnetii.
Topics: Q Fever; Humans; Male; Middle Aged; Female; China; Coxiella burnetii; Aged; Delayed Diagnosis; Anti-Bacterial Agents; Doxycycline; High-Throughput Nucleotide Sequencing
PubMed: 38886677
DOI: 10.1186/s12879-024-09484-w -
Journal of Pharmacy & Bioallied Sciences Apr 2024In this study, we synthesized and characterized a novel starch glutaraldehyde cross-linked hydrogel for drug release. The hydrogel exhibited excellent properties such as...
In this study, we synthesized and characterized a novel starch glutaraldehyde cross-linked hydrogel for drug release. The hydrogel exhibited excellent properties such as absorption capacity and drug release. By optimizing the cross-linking reaction using varying concentrations of glutaraldehyde and reaction time, we obtained a hydrogel with a three-dimensional network structure, superior swelling properties, and mechanical strength. The results revealed doxycycline sustained and controlled drug release over a prolonged period, which could be adjusted by altering the cross-linking density of the hydrogel. Overall, the starch glutaraldehyde cross-linked hydrogel shows great promise as a drug delivery system with controlled release properties, applicable in pharmaceuticals and tissue engineering.
PubMed: 38882769
DOI: 10.4103/jpbs.jpbs_538_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Delayed wound healing is one of the most common problems associated with diabetic patients. There are several factors associated with delayed wound healing. It has been...
Delayed wound healing is one of the most common problems associated with diabetic patients. There are several factors associated with delayed wound healing. It has been observed that if not cured the wound healing takes a long time. This is the reason that researchers are engaged in developing sustainable, biodegradable, biocompatible, and effective wound-healing dressings. However, it has been observed that the traditional wound-healing bandages have drawbacks such as allergies and less efficiency in the absorption of wound exudate. To fill the gap, hydrogels have been developed recently which have higher absorption capacity. In addition, they pose slow drug release properties. Therefore, the present study was conducted to prepare an effective and promising hydrogel that has high drug absorption and release properties.
PubMed: 38882755
DOI: 10.4103/jpbs.jpbs_541_23 -
SAGE Open Medical Case Reports 2024Rocky Mountain spotted fever, a potentially fatal tick-borne disease thought to be confined to specific climates and geographic locations, is expanding its reach due to...
Rocky Mountain spotted fever, a potentially fatal tick-borne disease thought to be confined to specific climates and geographic locations, is expanding its reach due to climate change. This is demonstrated by a 73-year-old woman who contracted Rocky Mountain spotted fever outside endemic areas during travel in Canada. Presenting with fevers, arthralgia, weakness, non-bloody diarrhea, conjunctivitis, mild cough, and a rash, this patient was initially started on moxifloxacin (400 mg PO/day) for suspected pneumonia. Treatment was changed to doxycycline (100 mg PO twice daily for 7 days) after dermatology was consulted, and Rocky Mountain spotted fever was thought to be higher on the differential. Rocky Mountain spotted fever was confirmed, and the patient responded well to antibiotics, improving by discharge. The disease's expansion into previously thought nonendemic areas is thought to be linked to milder winters and more extreme dry summers, facilitating pathogen development and tick lineage expansion.
PubMed: 38881973
DOI: 10.1177/2050313X241260980 -
The Journal of Clinical and Aesthetic... Jun 2024Mantle cell lymphoma (MCL) can, in a few reported cases, create an exaggerated mosquito bite response, leading to numerous bullae and significant edema. The phenomenon...
Mantle cell lymphoma (MCL) can, in a few reported cases, create an exaggerated mosquito bite response, leading to numerous bullae and significant edema. The phenomenon is further complicated by the observance of a concurrent Epstein-Barr virus (EBV) reactivation. The current literature provides general information on treatment that most practitioners would consider when attempting to treat an arthropod hypersensitivity reaction, such as topical or systemic corticosteroids. However, no information has been published to date that details a preventive and steroid-sparing approach to treating this phenomenon, without simultaneously treating the MCL. MCL can be indolent in nature and does not always require prompt treatment. The purpose of this case report is to discuss the successful treatment of a rare disorder with a steroid-sparing regimen. The steroid-sparing regimen used consisted of oral doxycycline 100mg twice daily, cetirizine 20mg once daily, and valacyclovir 1g daily, which resulted in sustained reduction in bullous eruptions.
PubMed: 38872927
DOI: No ID Found -
Scientific Reports Jun 2024Transplantation of stem cell-derived β-cells is a promising therapeutic advancement in the treatment of type 1 diabetes mellitus. A current limitation of this approach...
Transplantation of stem cell-derived β-cells is a promising therapeutic advancement in the treatment of type 1 diabetes mellitus. A current limitation of this approach is the long differentiation timeline that generates a heterogeneous population of pancreatic endocrine cells. To address this limitation, an inducible lentiviral overexpression system of mature β-cell markers was introduced into human induced-pluripotent stem cells (hiPSCs). Following the selection of the successfully transduced hiPSCs, the cells were treated with doxycycline in the pancreatic progenitor induction medium to support their transition toward the pancreatic lineage. Cells cultured with doxycycline presented the markers of interest, NGN3, PDX1, and MAFA, after five days of culture, and glucose-stimulated insulin secretion assays demonstrated that the cells were glucose-responsive in a monolayer culture. When cultured as a spheroid, the markers of interest and insulin secretion in a static glucose-stimulated insulin secretion assay were maintained; however, insulin secretion upon consecutive glucose challenges was limited. Comparison to human fetal and adult donor tissues identified that although the hiPSC-derived spheroids present similar markers to adult insulin-producing cells, they are functionally representative of fetal development. Together, these results suggest that with optimization of the temporal expression of these markers, forward programming of hiPSCs towards insulin-producing cells could be a possible alternative for islet transplantation.
Topics: Humans; Insulin-Secreting Cells; Homeodomain Proteins; Trans-Activators; Induced Pluripotent Stem Cells; Basic Helix-Loop-Helix Transcription Factors; Nerve Tissue Proteins; Cell Differentiation; Maf Transcription Factors, Large; Insulin; Glucose; Insulin Secretion; Cells, Cultured; Doxycycline
PubMed: 38871849
DOI: 10.1038/s41598-024-64346-4 -
Open Forum Infectious Diseases Jun 2024Identifying and treating patients with acute Q fever who are at an increased risk of progressing to persistent disease is crucial for preventing future complications. In...
BACKGROUND
Identifying and treating patients with acute Q fever who are at an increased risk of progressing to persistent disease is crucial for preventing future complications. In this study, we share our decade-long clinical experience with acute Q fever, highlighting the challenges that clinicians encounter from making an initial diagnosis and performing risk stratification to determining the appropriate prophylaxis regimen and duration.
METHODS
We retrieved records of adult Mayo Clinic patients (≥18 years) with positive serology results between 1 January 2012 and 31 March 2022. Patients with Q fever anti-phase II immunoglobulin G ≥1:256 by indirect immunofluorescence were further analyzed.
RESULTS
Thirty-one patients were included. Their median age was 58 years (IQR, 50-64), and the majority were men (84%). Acute hepatitis (29%), flu-like illness (25.8%), and pneumonia (16%) were the most common presentations. Thirteen patients (42%) received antibiotic prophylaxis to prevent disease progression, with significant variation in the indications and duration across physicians. The combination of doxycycline and hydroxychloroquine was the preferred regimen. Prophylaxis was administered for a median 333 days (IQR, 168-414). Four patients (13%) progressed to Q fever native valve infective endocarditis, with elevated anticardiolipin immunoglobulin G levels being the sole risk factor in 2 cases. The small sample size precluded drawing conclusions on the impact of prophylaxis in preventing disease progression.
CONCLUSIONS
Management of acute Q fever is complicated by the lack of comprehensive clinical guidelines leading to varied clinical practices. There is a critical need for randomized trials to establish robust evidence-based protocols for management.
PubMed: 38868311
DOI: 10.1093/ofid/ofae277