Microbiology/Infectious Disease

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29933

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    Acute Acalculous Cholecystitis caused by the Epstein-Barr Virus in a Young Woman
    (2020) Siadati, Mohammad; Mandal, Prasun
    Background: The Epstein-Barr Virus (EBV) is a common virus that causes infectious mononucleosis, which typically includes symptoms such as fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and elevated liver enzymes. However, acalculous cholecystitis has been reported as a rare complication of EBV. Acute acalculous cholecystitis only accounts for 10% of all acute cholecystitis cases. Case information: Here, we report a case of acalculous cholecystitis caused by EBV, which was treated successfully by medical treatment without surgery. An 18-year-old woman presented to the office for a four-day history of abdominal pain, nausea, vomiting, and dark urine. Physical exam showed scleral icterus and tenderness in the epigastric and right upper quadrant abdominal regions. Lab results indicated elevated LFTs, alkaline phosphatase, reactive lymphocytes, and hyperbilirubinemia. An ultrasound showed gallbladder wall thickening with no gallstones. Next, she was admitted and underwent an abdominopelvic CT, MRCP, viral hepatitis serology testing, and gastroenterology consultation. CT and MRCP showed hepatomegaly, splenomegaly, and gallbladder wall edema. Serology showed a positive EBV IgM. At this point, we diagnosed her with an acute EBV infection, causing acute acalculous cholecystitis. Subsequently, she improved with supportive care and was discharged home. Conclusion: Though acalculous cholecystitis rarely accompanies EBV, clinicians should be aware of this complication to avoid an unnecessary cholecystectomy.
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    Blue Green neutrophilic inclusions - poor prognostic indicator in patients presenting with Septic Shock(multiorgan) and DIC
    (2020) Pham, Thien; Mohanaselvan, Arvindselvan
    Intracytoplasmic blue green granules have been nicknamed Crystals of Death and have been seen as signs of impending fatality. It has been reported in cases that have a complex presentation including, but not limited to, Septic shock, multiorgan failure, multidrug resistant bacteremia resulting in shock, shock liver, shock kidneys etc. Most of the cases that are reported having hepatic failure as one of the main comorbids in the patients. A recent study discussed two similar cases but totally different outcomes and concluded that the presence of comorbidities including ICU stay and multisystem failure lead to a fatal prognosis. Green Neutrophilic Inclusions are frequently associated with liver injury and may portend short-term mortality in critically ill patients. Patients presenting with Septic Shock from multiorgan failure including shock liver tend to develop DIC as a complication. One of the most common hematological findings in DIC is the presence of Schiztocytes. The crystals, if present in patients presenting with Septic Shock, require a complete workup for DIC including D-dimer levels, Fibrin monomers, Fibrin degradation products and Fibrinogen, if there is sufficient time. As most of the patients pass away within hours to days of this peripheral smear presentation, depending on the comorbidities the patient is presenting with, decision has to be made to work up DIC and treat if found. Usually patients presenting with a mild hepatic injury, mild metabolic/lactic acidosis have a better chance at survival compared to patients presenting with full blown shock liver and severe metabolic/lactic acidosis.
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    Socio-economic predictors of dengue fever at the municipality level in Mexico
    (2020) Trevino, Jesus; Haque, Ubydul; Reeves, Caitlynn
    Purpose: The dengue virus is an arbovirus of increasing global concern. Both the disease and its vector, Aedes mosquitos, have spread extensively over the past 30 years. This is often attributed to climate change and urbanization. However, there is evidence that socio-economic factors may also impact the risk of dengue infection. This study sought to identify socio-economic factors that contribute to the burden of dengue fever in Mexico. Methods: Monthly dengue fever reports were compiled by municipality health departments in Mexico from 2012 through 2019. These reports were then combined with census tract data containing socio-economic variables for each municipality. Negative binomial regression was carried out using SAS 9.4 to produce relative risks. Results: The percentage of households without indoor plumbing, toilets, or access to health services within each municipality were examined as covariates. Lack of indoor plumbing increased the risk of dengue 1.03 times (95% CI 1.030, 1.034). Lack of health services increased the risk for dengue 1.01 times (95% CI 1.013, 1.017). Homes without toilets increased the risk of dengue 1.04 times (95% CI 1.03, 1.04). Conclusion: Socioeconomic factors at the municipality level are significant predictors of dengue fever. Municipalities with greater percentage of access to health services, indoor plumbing and toilets had decreased risk of dengue; the burden of dengue fever in Mexico may be reduced by improving access to these key services.
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    Chronic sleep restriction association with oral microbiome profile
    (2020) Trinh, Heather
    Reduced sleep quality is a common problem in the United States. Inadequate sleep is linked to increased risk for several conditions, such as cardiovascular disease and Alzheimer's disease. Current evidence indicates an association between the gut microbiome and sleep modulation. Based on this relationship, we investigated whether changes in the gut microbiome of chronically sleep-restricted subjects were reflected in their oral microbiome. With the ease of access to the oral cavity for examination and sampling, correlations between the gut and oral microbiome have clinical implications for developing screening tools. Mice models were placed on chronic sleep restriction for six weeks via the Modified Multiple Platform Method. Oral swabs and tissue samples were collected at the end of this scheduled period and characterized using Miseq for sequencing the V4 region of the 16S rRNA gene.