Atypical presentation and nosocomial spread - intensifying the MERS mystery and misery
Identifieur interne : 000589 ( Pmc/Corpus ); précédent : 000588; suivant : 000590Atypical presentation and nosocomial spread - intensifying the MERS mystery and misery
Auteurs : S. Fagbo ; A. M. Hakawi ; M. Mukahal ; L. Skakni ; A. Santos ; M. Garbati ; K. AlaoSource :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2016.
Url:
DOI: 10.1016/j.ijid.2016.02.477
PubMed: NONE
PubMed Central: 7129606
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Atypical presentation and nosocomial spread - intensifying the MERS mystery and misery</title><author><name sortKey="Fagbo, S" sort="Fagbo, S" uniqKey="Fagbo S" first="S." last="Fagbo">S. Fagbo</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Hakawi, A M" sort="Hakawi, A M" uniqKey="Hakawi A" first="A. M." last="Hakawi">A. M. Hakawi</name><affiliation><nlm:aff id="aff0010">KFMC, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Mukahal, M" sort="Mukahal, M" uniqKey="Mukahal M" first="M." last="Mukahal">M. Mukahal</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Skakni, L" sort="Skakni, L" uniqKey="Skakni L" first="L." last="Skakni">L. Skakni</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Santos, A" sort="Santos, A" uniqKey="Santos A" first="A." last="Santos">A. Santos</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Garbati, M" sort="Garbati, M" uniqKey="Garbati M" first="M." last="Garbati">M. Garbati</name><affiliation><nlm:aff id="aff0015">King Fahad Medical City, Riyadh, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Alao, K" sort="Alao, K" uniqKey="Alao K" first="K." last="Alao">K. Alao</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7129606</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129606</idno><idno type="RBID">PMC:7129606</idno><idno type="doi">10.1016/j.ijid.2016.02.477</idno><idno type="pmid">NONE</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000589</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000589</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Atypical presentation and nosocomial spread - intensifying the MERS mystery and misery</title><author><name sortKey="Fagbo, S" sort="Fagbo, S" uniqKey="Fagbo S" first="S." last="Fagbo">S. Fagbo</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Hakawi, A M" sort="Hakawi, A M" uniqKey="Hakawi A" first="A. M." last="Hakawi">A. M. Hakawi</name><affiliation><nlm:aff id="aff0010">KFMC, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Mukahal, M" sort="Mukahal, M" uniqKey="Mukahal M" first="M." last="Mukahal">M. Mukahal</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Skakni, L" sort="Skakni, L" uniqKey="Skakni L" first="L." last="Skakni">L. Skakni</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Santos, A" sort="Santos, A" uniqKey="Santos A" first="A." last="Santos">A. Santos</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Garbati, M" sort="Garbati, M" uniqKey="Garbati M" first="M." last="Garbati">M. Garbati</name><affiliation><nlm:aff id="aff0015">King Fahad Medical City, Riyadh, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Alao, K" sort="Alao, K" uniqKey="Alao K" first="K." last="Alao">K. Alao</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Infectious Diseases</title><idno type="ISSN">1201-9712</idno><idno type="eISSN">1878-3511</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader></TEI><pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7129606</article-id><article-id pub-id-type="publisher-id">S1201-9712(16)30456-8</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2016.02.477</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Atypical presentation and nosocomial spread - intensifying the MERS mystery and misery</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Fagbo</surname><given-names>S.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Hakawi</surname><given-names>A.M.</given-names></name><xref rid="aff0010" ref-type="aff">2</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Mukahal</surname><given-names>M.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Skakni</surname><given-names>L.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Santos</surname><given-names>A.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib><contrib contrib-type="author" id="aut0030"><name><surname>Garbati</surname><given-names>M.</given-names></name><xref rid="aff0015" ref-type="aff">3</xref></contrib><contrib contrib-type="author" id="aut0035"><name><surname>Alao</surname><given-names>K.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib></contrib-group><aff id="aff0005"><label>1</label>King Fahad Medical City, Riyadh, Saudi Arabia</aff><aff id="aff0010"><label>2</label>KFMC, Riyadh, Saudi Arabia</aff><aff id="aff0015"><label>3</label>King Fahad Medical City, Riyadh, Riyadh, Saudi Arabia</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author.</corresp></author-notes><pub-date pub-type="pmc-release"><day>29</day><month>3</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>4</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>29</day><month>3</month><year>2016</year></pub-date><volume>45</volume><fpage>209</fpage><lpage>209</lpage><permissions><copyright-statement>Copyright © 2016 Published by Elsevier Ltd.</copyright-statement><copyright-year>2016</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions></article-meta></front><body><p id="par0005"><bold>Background</bold>: Infection control measures to prevent nosocomial transmission of novel pathogens like the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) require strict adherence to guidelines. However, atypical presentations may mislead unwary Emergency Department (ED) physicians, thus posing challenges. We present the investigation of a MERS case with atypical presentation at the King Fahad Medical City (KFMC) in Riyadh in the summer of 2015.</p><p id="par0010"><bold>Methods & Materials</bold>: The patient's charts and electronic health records covering her two ED visits and subsequent intensive care unit (ICU) admission were reviewed. Adhering to MOH protocols, health care workers (HCWs) exposed to the patient were monitored for possible nosocomial MERS CoV transmission.</p><p id="par0015"><bold>Results</bold>: The patient was a 77-year-old female with Diabetes Mellitus, Hypertension, chronic kidney disease and chronic myelocytic leukemia who presented twice at the ED, within 4 days. On her first visit, she was febrile (37.9<sup>0</sup>C), had abdominal pain and distension (ascites), nausea and vomiting. Four days earlier, she had visited her primary hospital, known to be experiencing a MERS outbreak at that time, for chemotherapy. Biochemical and microbiological testing of drained ascitic fluid were unremarkable. She was discharged the same day after spending 10 hours in the ED. Three days later, she returned to the ED with progressive abdominal distension, worsening fever (38.8<sup>0</sup>C) and deteriorating hepatic and renal function. She developed pulseless electrical activity (PEA) and asystole that required resuscitation for 19 minutes. She survived the arrest but clinically worsened and died 4 days in the ICU. Despite 6 intra-hospital transfers (5 prior to MERS CoV confirmation) during her second visit, none of the exposed HCWs (n = 60) developed MERS; included are those who performed high risk procedures (intubation and CPR) on her. However, epidemiological investigation suggests she infected a post-mastectomy patient that shared the waiting room with her while awaiting triage on her first ED visit. Both patients died.</p><p id="par0020"><bold>Conclusion</bold>: This case of an atypical MERS case with multiple exposures to several HCWs having varying levels of protection on multiple occasions led to only one nosocomial case thus further intensifying the mystery surrounding MERS CoV transmission.</p></body></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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