56 research outputs found
Clinical diagnosis challenges in Zika virus infection
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Will Zika virus (ZIKV) infection as a mosquito-borne illness with symptoms similar to flu difficult to diagnose?
To answer this question, we need to know this infectious disease well and its clinical symptoms. So, first we need to point to the mentioned case. ZIKV is an emerging viral infection in the Flaviviridae family, transmitted by Aedes aegypti.
At present according to the reports of health organizations, this infection has spread throughout the USA, the Pacific Islands, and the Southeast Asia. This flu like infection causes mild symptoms resolved in two weeks, like fever, headache, rash, myalgia, redness, and conjunctivitis (1).
Thus, the temperature is usually low grade fever (within 38.0°C) and skin rashes are likely immune-mediated and pruritic in many cases which begin within 1–4 days onset. Definitely, the complicated features comprising Guillain-Barré syndrome (GBS) and fatal encephalitis in adults, an abnormally small head size (microcephaly) in newborn infants, immune thrombocytopenic purpura (ITP) were documented (2).
There are many flu like illnesses, which may make clinicians doubtful in the diagnosis of ZIKV infection. Among these diseases can be referred to such terms as herpes simplex virus (HSV), acquired immune deficiency syndrome (HIV/AIDS), hepatitis C, Lyme disease, Q fever, dengue fever (DF), measles, and so on.
In other words, it is confirmed that these common clinical presentations of ZIKV infection performed to be very similar to some arboviral diseases, like as Chikungunya virus (CHIKV) and Dengue virus (DENV) infection, as a result, a confounding diagnosis. Consequently, a study that was conducted in 2015 revealed 224 dengue cases screened for ZIKV infection, seven patients had positive results for ZIKV infection(3).
Several in vitro studies suggested cross-reactivity between antibody responses in dengue virus (DENV) as an arthropod‑borne virus and a member of the genus Flavivirus, and Zika virus(4). Even few research studies suggest that dengue virus enters to cells with Tyro 3, Axl, and Mertk (TAM) and T-cell immunoglobulin and mucin domain (TIM), and these receptors are engaged in ZIKV infection (5). Although other studies showed the differences between these infections that they are very helpful in solving the misdiagnosed problem.
Rashes in ZIKV infection are more likely to occur in the first week than dengue infection. In the event, rashes regularly appear during recovery phases of dengue disease. Contrary to dengue, hemorrhagic episodes and abnormality in laboratory findings as thrombocytopenia occur less frequently in ZIKV.
It has shown that different types of edema are more common in ZIKV infections than in DENV illness. In general, people with ZIKV infection, unlike dengue fever, less likely develop severe illnesses and need to be hospitalized. As a consequence, it can be concluded that diagnosis of ZIKV infection and the complete and accurate verification is a great challenge due to low-level viremia and cross- reactivity related to immune system functions. On the other hand, detection of this infection is best during the early-phase, though, diagnosis is seriously problematic at this stage because the disease occurs in this phase asymptomatically (3).
As a result, the best and the most reliable things are the careful evaluation of infection regarding clinical and paraclinical (hematologic) parameters alongside the use of RT-PCR with high specificity and sensitivity as the gold standard for ZIKV detection. Meanwhile, RT-PCR is effective in serum, saliva and semen in 1-2 weeks post infection. Moreover, it is recommended to use acute and recuperating samples for better diagnosis (5).
The use of molecular tests such as Trioplex Real-Time RT-PCR (rRT-PCR) by the Centers for Disease Control and Prevention (CDC) is recommended specially for those who have recently traveled to regions with risk of Zika and even show some symptoms of a disease such as Chikungunya virus (CHIKV) and DENV(5)
Comments on Successful Treatment of a High‐Risk Diabetic Foot Ulcer by Ozone Therapy and Collagen Powder: A Case Report
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The role of regulatory T cells in immunopathogenesis and immunotherapy of viral infections
No full textSever hepatitis induced by Epstein-Barr virus: case series
No full textAbstract
Epstein-Barr virus (EBV) is a causative agent of infectious mononucleosis syndrome. This infection often resolves over a period of several months without outcomes, but may occasionally be complicated by a great variety of neurologic, hepatic, hematologic and respiratory complications. In the current report, we present the case histories of three patients with acute hepatitis following EBV infection when previously healthy. The patients showed fever, nausea, weakness, as well as yellowing of the skin, and then in the course of examination, sore throat. They were managed supportively and their clinical condition improved. Liver function tests such as ALT, AST, ALP, were undertaken and bilirubin were elevated. The serological tests for EBV infection were consistent with the acute phase of infection. The monospot test was also positive. The patients were managed supportively, and their critical condition was improved.</jats:p
Clinical and laboratory findings of patients with the possible diagnosis of influenza hospitalized in affiliated hospitals of Babol University of Medical Sciences, 2015-2016
No full textThe clinical and para clinical manifestations of influenza in various patients have range from an autoimmune disease to a life-threatening respiratory infection. In addition, the severity of the disease is influenced by factors such as demographic factors, underlying diseases, and immune response. Therefore, in this study, we evaluated the clinical, laboratory and epidemiological characteristics of patients with this type of influenza in Babol (north of Iran). This study was conducted as a descriptive cross-sectional study from October 2015 to March 2016. Subsequently, in this study, records of 123 patients with clinical signs of the influenza-like disease who have undergone the clinical sign in hospitals affiliated to Babol University of Medical Sciences were reviewed. Of 123 patients admitted to a possible diagnosis of influenza, 58 patients (47.2%) were PCR positive for H1N1, while seventy nine (64.2%) participants were women and 21 (17.1%) had diabetes or underlying lung disease. Most of the involved age groups were of individuals above the age of 50. These were followed by the 21-35 years-old. Fever (78%), cough (65.9%), shivering (58.5%) and myalgia (56.1%) were the most common clinical symptoms. Increased levels of transaminases (43.1%), leukocytosis (35.8%) and thrombocytopenia (34.2%) were as well reported in patients as the most frequently reported para clinical findings. In the present study, the most usual clinical symptoms were fever, cough, chill, and myalgia, while gastrointestinal symptoms were also noticeably observed in patients. In an experimental study, a significant number of patients showed leukocytosis and thrombocytopenia and increased transaminases
Commentary on “Association of Plasma Homocysteine With Peripheral Arterial Disease in Hypertensive Adults: A Cross‐Sectional Study”
No full textComments on “Non‐classical monocytes frequency and serum vitamin D3 levels are linked to diabetic foot ulcer associated with peripheral artery disease”
No full textClinical and Laboratory Presentations of Leptospirosis Patients in North of Iran
No full textLeptospirosis is a zoonosis that common in warm and tropical regions with global spread and it is an occupational disease. The aim of recent study was to evaluate the clinical and Para clinical findings of leptospirosis patients in Babol, northern of Iran. In this cross-sectional study, 118 patients with high suspicion to leptospirosis admitted to hospitals of Babol University of Medical Sciences, Babol, Iran, during 2009 -2011. Thirty one cases with positive finding (IFA) were enrolled as definitive Patients. Clinical and Para clinical data for all patients were recorded. The mean age of the confirmed patients (male: 71%, rural: 90.5%) was 48.5 years (range 18-80 years old). The commonest chief complaints were fever (71%) and ichter (19%) and among the clinical features of them fever (90.5%), gastro intestinal signs (80.5%), ichter (71%) and headache(68%) was the most prevalent ones. Weil's syndrome occurred in 10 (32%) patients. Thrombocytopenia and leukocytosis were noticed in 80.5% and 42% of the patients respectively. Transaminases in 80.5% of cases were above the normal upper limit. Based on current study, the most of leptospirosis patients were farmers and presented in hot seasons. The commonest clinical and laboratory pattern of this disease in our region was fever, ichter, myalgia and headache in conjunction with Mild elevations in levels of transaminases and thrombocytopenia that can be used as a good marker in early clinical diagnosis and treatment.</jats:p
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