Mortality and Morbidity of Human Metapneumovirus Infection in the Pre-COVID-19 Era: The Value of the Charlson Comorbidity Index on Outcome Prediction.

Introduction: Human metapneumovirus (HMPV) is an important cause of seasonal respiratory tract infections, mainly in children and immunocompromised adults. The use of the Charlson Comorbidity Index (CCI) to predict outcomes in hospitalized patients has been validated in several settings.

Objective: This study aims to describe the clinical characteristics of adult patients with HMPV infection and evaluate the value of the CCI in predicting outcomes in patients with acute HMPV infections requiring hospitalization.

The Impact of Post-COVID-19 Syndrome in Adolescents: A Pilot Study.

Background:  Post-COVID-19 syndrome has emerged as a long-term complication in adults and children; its effect on adolescents' performance in school is not well studied.

Objectives: To study the physical/psychological impact of prolonged post-COVID-19 symptoms on school performance.

Methods:  This is a cross-sectional study using Google Forms, a web-based fully anonymized survey of children in grades 10-12.

Significant increase in mortality and risk of acute ischemic stroke in infective endocarditis patients with subarachnoid hemorrhage secondary to mycotic aneurysms.

Infective Endocarditis (IE) patients are known to have a variety of complications with one of the rarest, but serious being cerebral mycotic aneurysm, which can result in subarachnoid hemorrhage (SAH). Using the National In-Patient Sample database, we sought to determine the rate of acute ischemic stroke (AIS) and outcomes in IE- patients with and without SAH. In total, we identified 82,844 IE-patients from 2010 to 2016, of which 641 had a concurrent diagnosis of SAH.

Acute myopericarditis due to human granulocytic anaplasmosis.

We present a case of a 54-year-old gentleman with a history of hypertension and chronic HIV who presented with fever and epigastric pain, found to have elevated troponin-I levels and diffuse ST-segement elevations on ECG without clinical evidence of ischemia concerning for myopericarditis. Initial laboratory findings also included thrombocytopenia and elevated aminotransferases as well as computed tomography imaging revealing splenic infarcts. Given plausible exposure to ticks, this led to the eventual diagnosis of anaplasmosis confirmed on PCR assay.

Mpox in the New York metropolitan area, Summer 2022.

Early in the 2022 Mpox (MPX) global outbreak, caseloads in the New York Metropolitan area climbed rapidly before other US urban areas. This case series summarizes the authors' clinical experience detecting and treating MPX, during a quickly evolving outbreak. Clinical outcomes were recorded with a focus on varied clinical presentation and outcomes such as complications and response to experimental tecovirimat therapy.

Corynebacterium Jeikeium Endocarditis: A Review of the Literature.

Corynebacterium jeikeium is a gram-positive, aerobic, pleomorphic, nonspore forming bacillus, commonly present on the skin surface. Infective endocarditis secondary to C. jeikeium most commonly affects left-sided heart valves and has a higher likelihood to require valve replacement compared to other Corynebacterium endocarditis.

Clostridium septicum aortitis: A kiss of the devil.

Background: Clostridium septicum aortitis is a lethal infection. C. septicum has a strong association with an underlying malignancy, most commonly in the colon.

Co-infections in Persons with Early Lyme Disease, New York, USA.

In certain regions of New York state, USA, Ixodes scapularis ticks can potentially transmit 4 pathogens in addition to Borrelia burgdorferi: Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi, and the deer tick virus subtype of Powassan virus. In a prospective study, we systematically evaluated 52 adult patients with erythema migrans, the most common clinical manifestation of B. burgdorferi infection (Lyme disease), who had not received treatment for Lyme disease.

Babesiosis as a cause of acute respiratory distress syndrome: a series of eight cases.

Objectives: The characteristics of patients with Acute Respiratory Distress Syndrome (ARDS) as a complication of Babesia microti infection have not been systematically described.

Methods: Adult patients admitted to the medical intensive care unit (MICU) of a tertiary care hospital in the Lower Hudson Valley of New York from 1/1/2008 to 8/1/2016 were evaluated for ARDS complicating babesiosis.

Results: Of 22 patients with babesiosis in the MICU, eight (36.

Primary Osteomyelitis with Bacteremia and Sepsis in a Patient with Cirrhosis.

Osteomyelitis is commonly caused by , , , and anaerobes. There have been cases of rare organisms like () being initially overlooked as causes of osteomyelitis. We report a case of an elderly cirrhotic adult male transferred for further management of liver failure, who was subsequently diagnosed with osteomyelitis and sepsis.

Potential role of deer tick virus in Powassan encephalitis cases in Lyme disease-endemic areas of New York, U.S.A.

Powassan virus, a member of the tick-borne encephalitis group of flaviviruses, encompasses 2 lineages with separate enzootic cycles. The prototype lineage of Powassan virus (POWV) is principally maintained between Ixodes cookei ticks and the groundhog (Marmota momax) or striped skunk (Mephitis mephitis), whereas the deer tick virus (DTV) lineage is believed to be maintained between Ixodes scapularis ticks and the white-footed mouse (Peromyscus leucopus). We report 14 cases of Powassan encephalitis from New York during 2004-2012.

Diagnostic challenges in Balamuthia mandrillaris infections.

Balamuthia mandrillaris is an emerging cause of subacute granulomatous amebic encephalitis (GAE). The diagnosis of this infection has proven to be difficult and is usually made postmortem. Early recognition and treatment may offer some benefit.

Diagnosis of acute deer tick virus encephalitis.

Background: Deer tick virus (DTV) is a tick-borne flavivirus that has only recently been appreciated as a cause of viral encephalitis. We describe the clinical presentation of a patient who had DTV encephalitis diagnosed before death and survived for 8 months despite severe neurologic dysfunction.

Methods: Diagnosis was made from a cerebrospinal fluid specimen, using a flavivirus-specific polymerase chain-reaction assay followed by sequence confirmation, and the phylogeny was analyzed.

Aspergillus osteomyelitis of the lumbar spine complicated with orbital apex syndrome: A potential role of the Batson's plexus in disease propagation.

We report a rare case of orbital apex syndrome following epidural steroid injections of the lumbar spine in an immunocompetent individual with osteomyelitis and discitis caused by Aspergillus fumigatus. We suspect that the craniospinal venous system, also known as the Batson's plexus, was the main route for steroid-facilitated disease propagation from the spine to intracranial structures.

Non-surgical management of spontaneous splenic rupture due to Babesia microti infection.

Babesiosis is an emerging tick-borne infection. We describe 2 hospitalized patients from the United States with spontaneous splenic rupture attributable to Babesia microti infection. The first patient was a 36-year-old previously healthy man with a low-grade splenic rupture not requiring surgical intervention.

Babesiosis as a cause of fever in patients undergoing a splenectomy.

Babesiosis is an emerging infection most commonly acquired from a tick bite. We describe three hospitalized patients with fever attributable to babesiosis after a splenectomy. Splenectomy was done because of splenic enlargement due to unsuspected babesia infection in one patient and because of splenic perforation due to babesiosis in a second patient.

Value of the PaO₂:FiO₂ ratio and Rapid Shallow Breathing Index in predicting successful extubation in hypoxemic respiratory failure.

Purpose: We sought to determine the predictive value of the PaO₂:FiO₂ ratio (PFR), both independently and in combination with the standard Rapid Shallow Breathing Index (RSBI), for successful extubations in patients with primary hypoxemic respiratory failure (HRF).

Materials And Methods: A retrospective chart review of 154 patients with HRF requiring mechanical ventilation for ≥24 hours was performed. The primary outcome was reintubation within 48 hours.