1/7. scrub typhus during pregnancy: a case report and review of the literature.scrub typhus is a rickettsial disease that is uncommon during pregnancy. We report a case of a 33-year-old woman, G1P0, 29 weeks pregnancy who presented to hospital with high fever, chill and headache for two weeks. Her diagnosis of scrub typhus was confirmed by serum immunofluorescent assay. She was successfully treated with chloramphenicol, but preterm delivery occurred. Her infant died from respiratory distress syndrome. No vertical transmission was demonstrated in this case. scrub typhus should be listed in the differential diagnosis of acute febrile illness in pregnant women, who either live in, or return from, endemic areas. chloramphenicol can be used safely during pregnancy if it is not circulating at the time of delivery.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
2/7. daptomycin cure after cefazolin treatment failure of methicillin-sensitive staphylococcus aureus (MSSA) tricuspid valve acute bacterial endocarditis from a peripherally inserted central catheter (PICC) line.Right-sided acute bacterial endocarditis (ABE) is an infrequent complication of central intravenous (IV) lines. We report a case of methicillin-sensitive staphylococcus aureus tricuspid valve (TV) ABE related to a peripherally inserted central catheter line (PICC). patients with right-sided ABE present with symptoms of fever and chills, and symptoms and signs of pulmonary emboli. In the patient presented, the PICC line was removed and high-dose cefazolin therapy, 2 g (IV) every 8 hours, was initiated. Although the patient's blood cultures became negative during the third week of cefazolin therapy, her erythrocyte sedimentation rate and teichoic acid antibody titers remained high. Pulmonary emboli developed. A large TV vegetation (1 x 2 cm) remained unchanged after 4 weeks of cefazolin therapy. For these reasons, cefazolin treatment was considered a treatment failure. Therapy with daptomycin was initiated at a dose of 6 mg/kg (IV) every 24 hours. During daptomycin therapy, the patient's erythrocyte sedimentation rate and teichoic acid antibody titers gradually returned to normal. Repeat transthoracic echocardiograph revealed the TV vegetation was gone and the methicillin-sensitive staphylococcus aureus ABE was cured with daptomycin. We conclude daptomycin is a rapidly bactericidal antistaphylococcal antibiotic reliably effective even when other usually effective antistaphylococcal antibiotics have failed.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
3/7. Transfusion reactions due to bacterial contamination of blood and blood products.bacterial infections transmitted by blood or blood products, although rare, remain a serious threat to the recipient of a transfusion. We report on five cases of adverse reactions due to bacterial contamination of blood products, and we review 76 similar cases reported in the English-language literature. Most cases (70%) have been reported from the united states. Various sources of contamination have been suggested, including infection in the donor and invasion of the blood product during the process of collection, preparation, and storage. Frequent clinical manifestations are fever (80%), chills (53%), hypotension (37%), and nausea or vomiting (26%). The overall mortality is 35% (28 of 81 patients). In 38 patients (47%) the adverse reactions have appeared during transfusion; in the others the interval between completion of the transfusion and appearance of symptoms has ranged from 15 minutes to 17 days. A wide spectrum of bacteria have been implicated as causes of adverse reactions, with pseudomonas species involved in 28% of episodes. Many such reactions are probably misdiagnosed or overlooked, the result being underestimation of the extent of the problem.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
4/7. Transplacental passage of influenza A/Bangkok (H3N2) mimicking amniotic fluid infection syndrome.Influenza virus infection complicating pregnancy remains a matter of concern because of the frequency of these infections and possible associated increased maternal and perinatal risks. Influenza A/Bangkok (H3N2) infection occurred in a gravid woman in association with fever, chills, and uterine tenderness and contractions together with maternal and fetal tachycardia. Initial evaluations led to consideration of amniotic fluid infection syndrome with planned termination of the pregnancy. Examination of amniotic fluid obtained by amniocentesis showed neither microorganisms nor neutrophils, and close monitoring and supportive measures were continued. amniotic fluid and maternal nasopharyngeal washing both yielded influenza A/Bangkok (H3N2). Mother and fetus were closely monitored until term. Cord blood samples demonstrated hemagglutination inhibition and complement fixation antibody titers of 1:32 and greater than 1:512, respectively. Cord blood IgM and IgA hemagglutination inhibition antibody concentrations were 6,400 and 3,200 micrograms/ml, respectively, consistent with transplacental infection. This is the first confirmation of transplacental influenza infection. This generally self-limited viral infection may mimic the amniotic fluid infection syndrome and put mother and fetus at risk for potentially harmful untimely delivery.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
5/7. Disseminated neonatal echovirus 11 disease following antenatal maternal infection with a virus-positive cervix and virus-negative gastrointestinal tract.An infant girl was born apparently well one week after her mother had had a mild illness with chills, fever, and diarrhea. On the third day of life, the infant became ill and died four days later with necrotizing hepatitis. On the same day, echovirus type 11 was recovered from the throat, rectum, and buffy coat of the infant and from the cervix of the mother. At this time, the mother had an IgM neutralizing antibody titer to echovirus type 11 and 1:128, but no IgG antibodies. The infant had no echovirus type 11 antibodies. The virus was also isolated from the baby's liver and adrenal at autopsy. These findings raise the possibility of enterovirus infection at delivery from a contaminated cervix.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
6/7. Systemic malassezia furfur infection in an adult receiving total parenteral nutrition.malassezia furfur sepsis developed in a woman with hyperemesis gravidarum while she was receiving total parenteral nutrition supplemented with lipids. fever, chills, dyspnea, pleuritic chest pain, and multiple bilateral pulmonary nodular infiltrates were the primary clinical manifestations. Lysis-centrifugation fungal blood cultures supplemented with olive oil grew M furfur. Treatment included removal of the central venous catheter line, discontinuation of the lipid emulsion, and antifungal chemotherapy. malassezia furfur sepsis complicating total parenteral nutrition may be more common in adults than once suspected. A high index of suspicion is required to diagnose this infection, and the addition of olive oil to the fungal culture medium will provide the necessary growth factors to isolate this fungus.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
7/7. pregnancy with scrub typhus and vertical transmission: a case report.scrub typhus is a rickettsian disease which is seldom found in pregnancy. A 31-year-old, 34 weeks pregnant woman presented with fever, chill and cough for 6 weeks. Fetal jeopardy was found then a cesarean section was performed to deliver a 2,200 g male with hepatosplenomegaly. The mother's diagnosis was confirmed by positive Weil-Felix (OXK titer 1:320) and scrub typhus (titer 1:1600) tests. Vertical transmission was also demonstrated by a positive scrub typhus IgM in her child.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |