He was vaccinated for SARS-CoV-2 with two doses of Pfizer's BNT162b2 mRNA vaccine (the last in December 2021) and had already contracted COVID-19 in January 2022Cytat:
2022-08-25 08:21:43, cris82 napisał(a):
pisali ze jest niezaszczepiony
“Our patient, an Italian 36-year-old male spent 5
days in Spain from 16 to 20 June 2022 (Figure
1). Nine days after, he developed fever (up to
39°C), accompanied by sore throat, fatigue,
headache and right inguinal
lymphadenomegaly. On 2 July he resulted
positive for SARS-CoV-2. On the afternoon of
the same day a rash started to develop on his
left arm. The following day small, painful
vesicles surrounded by an erythematous halo
appeared on the torso, lower limbs, face and
glutes. On 5 July, due to a progressive and
uninterrupted spread of vesicles that began to
evolve into umbilicated pustules, he went to the
emergency department of the Policlinico "G.
Rodolico - San Marco" University Hospital in
Catania, Italy, and was subsequently transferred
to the Infectious Diseases unit.
On admission, the patient reported being
treated for syphilis in 2019. In September 2021
he performed an HIV test with a negative result.
He suffered from bipolar disorder, for which he
regularly took carbamazepine 200 mg daily.
He was vaccinated for SARS-CoV-2 with two doses of Pfizer's BNT162b2 mRNA vaccine (the last in December 2021) and had already contracted COVID-19 in January 2022 He also reported of
having condomless intercourse with men during
his stay in Spain. Fever (37.5°C),
pharyngodynia, fatigue, headache was still
present. On physical examination his body was
dotted, including the palm of the right hand and
the perianal region, with skin lesions in various
stages of progression, ranging from small
vesicles (Figure 1, Panel A) to reddened haloed
pustules (Fiqure 1, Panel B and Panel C) and
umbilicated plaques (Figure 1, Panel D). The
oral mucosa was normal, except for bilateral
tonsillar hypertrophy. A modest
hepatosplenomegaly and an enlarged (2 cm)hypomobile and painful lymph node in the right inguinal region were found. Laboratory test showed elevated C-reactive protein (69 mg/L, normal values 0.0 - 5.0 mg/L), fibrinogen (713 mg/dL, normal values 170 - 400 mg/dL) and prothrombin time (1.21, normal values 0.8 - 1.2). Chest X-ray revealed a parenchymal hypodiaphany in the right parailary region.
On the second day of admission (July 6, 2022), given the high suspicion of monkeypox supported by suggestive skin lesions and a recent trip to Spain [[1]], swabs of pustule exudate and nasopharynx secretions were sent to the Regional Reference Laboratory hosted at the University Hospital “A.O.U.P. P. Giaccone” of Palermo (Italy) for monkeypox orthopoxvirus detection and SARS-CoV-2 sequencing. To this purpose, monkeypox virus DNA was extracted using Quick-DNA™ Miniprep Plus extraction kit (Zymo Research), whereas SARS-CoV-2 RNA was extracted using QIAamp Viral RNA extraction kit (QIAGEN). Eluted DNA/RNA was stored immediately at -80°C until further use or analysed by means of rt-PCR assays. Three different singleplex rt-PCR assays targeting the TNF receptor gene of monkeypox were used: a monkeypox generic assay and two further rt-PCR assays specifically designed to differentiate monkeypox Congo Basin and West African strains [[8]]. All rt-PCR assays were performed with a QuantStudio™ 7 Flex Real-Time PCR System (Applied Biosystems, Carlsbad, USA) and a test was considered positive when its cycle threshold value was <40. SARS-CoV-2 genome was generated by next-generation sequencing on an Ion GeneStudio™ S5 System (Applied Biosystems, Carlsbad, USA) using the Ion Ampliseq™ SARS-CoV-2 Research Panel and virus lineage was designated using the Pangolin dynamic nomenclature system [[9],[10]]. SARS-CoV-2 genome included in the study was submitted to the Global Initiative on Sharing All Influenza Data (GISAID) repository (https://www.gisaid.org).
The specimens were confirmed positive to monkeypox virus and SARS-CoV-2. The first belonged to the West African clade, the variant responsible for the Spanish outbreak [[1]], while SARS-CoV-2 genome classified by Pangolin as lineage BA.5.1 (GISAID Accession ID: EPI_ISL_13876417). Serology tests for viral hepatitis, herpes simplex, gonorrhoea, chlamydia and lymphogranuloma venereum were negative. However, HIV-1 resulted positive with a viral load of 234,000 copies/mL. The CD4 lymphocyte count was unaltered with 812 cells/μL (normal values within 410-1590 cells/μL).
The third day almost all skin lesions began to turn to crusts. Sotrovimab 500 mg was infused intravenously. On day 5 (July 9, 2022), almost all constitutional symptoms were resolved and previously altered laboratory test values normalized. On day 6 (July 11, 2022), nasopharyngeal swabs for SARS-CoV-2 and monkeypox virus were still positive, despite the absence of new skin lesions. Since symptoms had resolved, the patient was discharged to home isolation. On 19 July 2022 he returned to our institute to underwent a new oropharyngeal swab for monkeypox virus, which was still positive. The crusts had healed almost completely, leaving a small scar (Figure 2, Panels E to H). A triple combination of dolutegravir, abacavir and lamivudine was initiated for HIV treatment.”
…no ale w gazecie to cisza.
Zdjec nie doklekalam.
[ Ostatnio edytowany przez: Maat17 25-08-2022 22:53 ]