IDCases
-
A 65-year-old woman with chronic osteoarthritis of the knees presented with a one-week history of acutely worsening right knee pain and swelling. Arthrocentesis was performed and synovial fluid was indicative of septic arthritis with a negative Gram stain for bacteria. Magnetic Resonance Imaging (MRI) was obtained, revealing a large anterior periarticular abscess with concomitant septic arthritis. ⋯ Synovial fluid culture grew Kingella kingae and the patient was treated with four weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. Kingella kingae is a common cause of pediatric bone and joint infection but remains an exceedingly rare cause of native joint septic arthritis among immunocompetent adults. Kingella spp are largely susceptible to beta-lactam antimicrobials.
-
Case Reports
Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report.
We report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and had large pulmonary involvement. Seven days later, he desaturated but was without any signs of respiratory distress. ⋯ A second G6PD test was ordered at the 5-month follow-up appointment and revealed decreased levels. Clinicians should thus be aware of possible false negative tests when testing for G6PD during hemolytic crisis. In addition, whether the COVID-19 infection alone would be responsible for this chain of events remains a challenging question.
-
The ongoing outbreak of COVID-19 poses an unprecedented global health challenge. With its variety of clinical manifestations including, but not limited to, fever, cough, diarrhea, vomiting, headache, myalgia and fatigue, it may be challenging to distinguish COVID-19 from a spectrum of diseases with similar presentations, such as malaria, especially in endemic areas. ⋯ We present the first reported case of confirmed COVID and malaria co-infection. In this case, we emphasize the need for vigilance from frontline clinicians for timely diagnosis and appropriate clinical management of potential co-infections in the COVID era.
-
There remains diagnostic uncertainty regarding the sensitivity of reverse transcription polymerase chain reaction in detection of SARS-CoV-2 from nasopharyngeal specimens. We present a case where two nasopharyngeal specimens were negative, followed by a positive sputum sample. Serial testing for COVID-19 is indicated in patients with high pretest probability of disease.
-
SARS-Cov2 coinfection with other respiratory viruses is very rare. Adenovirus coinfection is even more unusual. We report the case of a patient with poorly controlled diabetes, and he was admitted to the emergency department because of severe COVID-19 infection. ⋯ Hydroxychloroquine was administered as suggested by the national guidelines. The symptoms resolved, and hospital discharge was indicated. COVID-19 association with another respiratory virus is related with adverse clinical outcomes, such as shock, ventilatory support requirement and greater lymphopenia and thrombocytopenia.