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  1. Article: Schistosomiasis.

    Blanchard, Tom J

    Travel medicine and infectious disease

    2004  Volume 2, Issue 1, Page(s) 5–11

    Abstract: Schistosomiasis is a common intravascular trematode infection. The snail/human lifecycle is illustrated. Travellers who acquire the infection are often asymptomatic, but nearly always give a history of fresh water exposure in endemic countries when asked. ...

    Abstract Schistosomiasis is a common intravascular trematode infection. The snail/human lifecycle is illustrated. Travellers who acquire the infection are often asymptomatic, but nearly always give a history of fresh water exposure in endemic countries when asked. The various manifestations of symptomatic schistosomiasis are described, including the rare but important complication of neuroschistosomiasis. Guidelines for diagnostic tests, treatment with praziquantel and management of complications are given. Prospects for disease control in endemic countries by improvement in public health and mass treatment are discussed. Various vaccines are in development, but none are in clinical use yet.
    Language English
    Publishing date 2004-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2170891-5
    ISSN 1873-0442 ; 1477-8939
    ISSN (online) 1873-0442
    ISSN 1477-8939
    DOI 10.1016/j.tmaid.2004.02.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Hyperinflammation with COVID-19: The key to patient deterioration?

    Haigh, Kathryn / Syrimi, Zoe Joanna / Irvine, Sharon / Blanchard, Tom J / Pervaiz, Muhammad Sajid / Toth, Arpad G / Ratcliffe, Libuse

    Clinical infection in practice

    2020  Volume 7, Page(s) 100033

    Abstract: Background: The potential risk of cytokine storm in patients with coronavirus disease 2019 (COVID-19) has been described [1]; we write to share our experience treating a 17-year-old male with haemophagocytic lymphohistiocytosis (HLH) secondary to COVID- ... ...

    Abstract Background: The potential risk of cytokine storm in patients with coronavirus disease 2019 (COVID-19) has been described [1]; we write to share our experience treating a 17-year-old male with haemophagocytic lymphohistiocytosis (HLH) secondary to COVID-19 infection.
    Case report: This patient presented with cough, sore throat, anorexia and pyrexia. On examination, he had gross cervical lymphadenopathy and palpable splenomegaly. Nose and throat swab for SARS-CoV-2 was positive and blood tests revealed pancytopaenia with very high ferritin, triglyceride and d-dimer levels. The patient's H-Score [2] was calculated at 220, suggesting probability of HLH of 93-96%. Considering Russell and colleagues' [3] comments about potential harm of corticosteroid use in patients with COVID-19 infection, the patient was commenced on treatment with the selective IL-1 receptor antagonist drug, Anakinra, and a two-day course of intravenous immunoglobulin.
    Results: The patient responded rapidly to treatment, becoming apyrexial after 24 h. His lymph nodes and spleen began to normalise after the first 48 h, at which time point the ferritin also started to decrease. He was discharged after 11 days feeling fit and well.
    Conclusion: This case certainly illustrates the importance of hyperinflammation syndromes in COVID-19. It also raises the question - is the severe pneumonitis seen in patients with COVID-19 an immunological phenomenon? We know that the viral load of patients with COVID-19 seems to peak in the early stages of illness [4,5]; however, patients deteriorate later in the disease course, at around days 10-14. This patient, who had risk factors for deterioration (male, pancytopaenic), did not develop an oxygen requirement and clinically and biochemically improved rapidly on Anakinra with no adverse events. We might suggest Anakinra to the scientific community as a treatment option in COVID-19 infection.
    Keywords covid19
    Language English
    Publishing date 2020-05-24
    Publishing country England
    Document type Case Reports
    ISSN 2590-1702
    ISSN (online) 2590-1702
    DOI 10.1016/j.clinpr.2020.100033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Hereditary haemochromatosis, haemophagocytic lymphohistiocytosis and COVID-19.

    Riley, Matthew J / Hicks, Scott R / Irvine, Sharon / Blanchard, Tom J / Britton, Edward / Shawki, Howida / Sajid Pervaiz, Muhammad / Fletcher, Tom E

    Clinical infection in practice

    2020  Volume 7, Page(s) 100052

    Abstract: Background: Syndromes of iron overload have been shown to increase the risk of severe clinical disease in viral infections. Immune dysfunction is similarly described in hereditary haemochromatosis (HH). We present here the case of a 51-year-old man who ... ...

    Abstract Background: Syndromes of iron overload have been shown to increase the risk of severe clinical disease in viral infections. Immune dysfunction is similarly described in hereditary haemochromatosis (HH). We present here the case of a 51-year-old man who developed severe coronavirus disease 2019 (COVID-19) complicated by suspected haemophagocytic lymphohistiocytosis (HLH). He was found to have HH post-mortem and we propose a link between his iron overload and the development of severe COVID-19.
    Case report: The initial clinical presentation consisted of cough, shortness of breath and fever. Pancytopenia, markedly elevated ferritin and d-dimer were present. Computed tomography (CT) showed bilateral ground glass changes consistent with COVID-19, widespread lymphadenopathy and splenomegaly. A subsequent combined nose and throat swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). HLH was suspected based upon the H-score and Anakinra, an IL-1 receptor antagonist, was commenced. Liver function acutely worsened and magnetic resonance cholangiopancreatography (MRCP) revealed hepatic haemosiderosis. Intense splenic and cervical lymph node uptake were seen on a positron emission tomography (PET) scan and high doses of intravenous steroids were administered due to concerns over haematological malignancy.
    Results: Day fourteen of admission heralded the start of progressive clinical deterioration with rapid increase in oxygen demands. Continuous positive airway pressure (CPAP) was trialled without success and the patient unfortunately died seventeen days into admission. Results returned after his death showed homozygous C282Y mutation of the HFE gene consistent with a diagnosis of HH. Post-mortem examination revealed widespread haemosiderin deposition in the liver along with lung pathology in keeping with severe COVID-19 and widespread splenic infarctions.
    Conclusion: An association between HH and COVID-19 is not currently described in the literature. What does exist, however, is an evidence base for the detrimental impacts iron overload has on viral infections in general and the negative effects of HH on the immune system. We therefore postulate that the underlying metabolic and immune disturbances seen in HH should be considered a potential risk factor for the development of severe COVID-19. This case also adds to the evidence that hyperinflammation appears to be a unique and interesting characteristic of this novel viral disease.
    Keywords covid19
    Language English
    Publishing date 2020-11-01
    Publishing country England
    Document type Case Reports
    ISSN 2590-1702
    ISSN (online) 2590-1702
    DOI 10.1016/j.clinpr.2020.100052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Pneumocystis

    Kelly, Sophie / Waters, Laura / Cevik, Muge / Collins, Simon / Lewis, Joe / Wu, Meng-San / Blanchard, Tom J / Geretti, Anna M

    Clinical medicine (London, England)

    2020  Volume 20, Issue 6, Page(s) 590–592

    Abstract: While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the ... ...

    Abstract While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the fungus
    MeSH term(s) AIDS-Related Opportunistic Infections/diagnosis ; AIDS-Related Opportunistic Infections/pathology ; AIDS-Related Opportunistic Infections/physiopathology ; AIDS-Related Opportunistic Infections/therapy ; COVID-19 ; Coronavirus Infections ; Diagnosis, Differential ; Fatal Outcome ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Male ; Middle Aged ; Pandemics ; Pneumocystis carinii ; Pneumonia, Pneumocystis/diagnosis ; Pneumonia, Pneumocystis/pathology ; Pneumonia, Pneumocystis/physiopathology ; Pneumonia, Pneumocystis/therapy ; Pneumonia, Viral
    Keywords covid19
    Language English
    Publishing date 2020-11-13
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.2020-0565
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5439: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: Pneumocystis pneumonia, a COVID-19 mimic, reminds us of the importance of HIV testing in COVID-19

    Kelly, Sophie / Waters, Laura / Cevik, Muge / Collins, Simon / Lewis, Joe / Wu, Meng-San / Blanchard, Tom J / Geretti, Anna M

    Clin Med (Lond)

    Abstract: While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the fungus Pneumocystis jirovecii, are emerging. Given the uncertain spectrum of COVID-19 ...

    Abstract While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the fungus Pneumocystis jirovecii, are emerging. Given the uncertain spectrum of COVID-19 presentations and variable sensitivity of laboratory tests for SARS-CoV-2, there is a risk that, without a high index of suspicion, alternative aetiologies may be overlooked while pursuing a diagnosis of COVID-19. The British HIV Association has been calling for the inclusion of HIV testing in all patients admitted to hospital with suspected COVID-19. In this article we reflect on the importance of including HIV testing to prevent avoidable morbidity and mortality in our patients.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #927855
    Database COVID19

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  6. Article: Hyperinflammation with COVID-19: The key to patient deterioration?

    Haigh, Kathryn / Syrimi, Zoe Joanna / Irvine, Sharon / Blanchard, Tom J / Pervaiz, Muhammad Sajid / Toth, Arpad G / Ratcliffe, Libuse

    Clin Infect Pract

    Abstract: Background: The potential risk of cytokine storm in patients with coronavirus disease 2019 (COVID-19) has been described [1]; we write to share our experience treating a 17-year-old male with haemophagocytic lymphohistiocytosis (HLH) secondary to COVID- ... ...

    Abstract Background: The potential risk of cytokine storm in patients with coronavirus disease 2019 (COVID-19) has been described [1]; we write to share our experience treating a 17-year-old male with haemophagocytic lymphohistiocytosis (HLH) secondary to COVID-19 infection. Case report: This patient presented with cough, sore throat, anorexia and pyrexia. On examination, he had gross cervical lymphadenopathy and palpable splenomegaly. Nose and throat swab for SARS-CoV-2 was positive and blood tests revealed pancytopaenia with very high ferritin, triglyceride and d-dimer levels. The patient's HScore [2] was calculated at 220, suggesting probability of HLH of 93-96%. Considering Russell and colleagues' [3] comments about potential harm of corticosteroid use in patients with COVID-19 infection, the patient was commenced on treatment with the selective IL-1 receptor antagonist drug, Anakinra, and a two-day course of intravenous immunoglobulin. Results: The patient responded rapidly to treatment, becoming apyrexial after 24 h. His lymph nodes and spleen began to normalise after the first 48 h, at which time point the ferritin also started to decrease. He was discharged after 11 days feeling fit and well. Conclusion: This case certainly illustrates the importance of hyperinflammation syndromes in COVID-19. It also raises the question - is the severe pneumonitis seen in patients with COVID-19 an immunological phenomenon? We know that the viral load of patients with COVID-19 seems to peak in the early stages of illness [4,5]; however, patients deteriorate later in the disease course, at around days 10-14. This patient, who had risk factors for deterioration (male, pancytopaenic), did not develop an oxygen requirement and clinically and biochemically improved rapidly on Anakinra with no adverse events. We might suggest Anakinra to the scientific community as a treatment option in COVID-19 infection.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #343694
    Database COVID19

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  7. Article: Hereditary haemochromatosis, haemophagocytic lymphohistiocytosis and COVID-19

    Riley, Matthew J / Hicks, Scott Rory / Irvine, Sharon / Blanchard, Tom J / Britton, Edward / Shawki, Howida / Sajid Pervaiz, Muhammad / Fletcher, Tom

    Clin Infect Pract

    Abstract: Background: Syndromes of iron overload have been shown to increase the risk of severe clinical disease in viral infections. Immune dysfunction is similarly described in hereditary haemochromatosis (HH). We present here the case of a 51-year-old man who ... ...

    Abstract Background: Syndromes of iron overload have been shown to increase the risk of severe clinical disease in viral infections. Immune dysfunction is similarly described in hereditary haemochromatosis (HH). We present here the case of a 51-year-old man who developed severe coronavirus disease 2019 (COVID-19) complicated by suspected haemophagocytic lymphohistiocytosis (HLH). He was found to have HH post-mortem and we propose a link between his iron overload and the development of severe COVID-19. Case report: The initial clinical presentation consisted of cough, shortness of breath and fever. Pancytopenia, markedly elevated ferritin and d-dimer were present. Computed tomography (CT) showed bilateral ground glass changes consistent with COVID-19, widespread lymphadenopathy and splenomegaly. A subsequent combined nose and throat swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). HLH was suspected based upon the H-score and Anakinra, an IL-1 receptor antagonist, was commenced. Liver function acutely worsened and magnetic resonance cholangiopancreatography (MRCP) revealed hepatic haemosiderosis. Intense splenic and cervical lymph node uptake were seen on a positron emission tomography (PET) scan and high doses of intravenous steroids were administered due to concerns over haematological malignancy. Results: Day fourteen of admission heralded the start of progressive clinical deterioration with rapid increase in oxygen demands. Continuous positive airway pressure (CPAP) was trialled without success and the patient unfortunately died seventeen days into admission. Results returned after his death showed homozygous C282Y mutation of the HFE gene consistent with a diagnosis of HH. Post-mortem examination revealed widespread haemosiderin deposition in the liver along with lung pathology in keeping with severe COVID-19 and widespread splenic infarctions. Conclusion: An association between HH and COVID-19 is not currently described in the literature. What does exist, however, is an evidence base for the detrimental impacts iron overload has on viral infections in general and the negative effects of HH on the immune system. We therefore postulate that the underlying metabolic and immune disturbances seen in HH should be considered a potential risk factor for the development of severe COVID-19. This case also adds to the evidence that hyperinflammation appears to be a unique and interesting characteristic of this novel viral disease.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #893696
    Database COVID19

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  8. Article ; Online: Hyperinflammation with COVID-19

    Haigh, Kathryn / Syrimi, Zoe Joanna / Irvine, Sharon / Blanchard, Tom J. / Pervaiz, Muhammad Sajid / Toth, Arpad G. / Ratcliffe, Libuse

    Clinical Infection in Practice

    The key to patient deterioration?

    2020  Volume 7-8, Page(s) 100033

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2590-1702
    DOI 10.1016/j.clinpr.2020.100033
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Hereditary haemochromatosis, haemophagocytic lymphohistiocytosis and COVID-19

    Riley, Matthew J. / Hicks, Scott Rory / Irvine, Sharon / Blanchard, Tom J. / Britton, Edward / Shawki, Howida / Sajid Pervaiz, Muhammad / Fletcher, Tom

    Clinical Infection in Practice

    2020  , Page(s) 100052

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2590-1702
    DOI 10.1016/j.clinpr.2020.100052
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  10. Article: Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient.

    Wingfield, Tom / Baxter, Jo / Herwadkar, Amit / du Plessis, Daniel / Blanchard, Tom J / Javier Vilar, F / Varma, Anoop

    Case reports in neurological medicine

    2014  Volume 2014, Page(s) 164826

    Abstract: Background. HIV-positive people starting combined antiretroviral therapy may develop immune reconstitution to latent or treated opportunistic infections. Immune reconstitution to cerebral Cryptococcus is poorly understood and can be fatal. Case ... ...

    Abstract Background. HIV-positive people starting combined antiretroviral therapy may develop immune reconstitution to latent or treated opportunistic infections. Immune reconstitution to cerebral Cryptococcus is poorly understood and can be fatal. Case Presentation. A 33-year-old Zimbabwean female presented with cryptococcal meningitis and newly diagnosed HIV with a CD4 count of 51 cells/ μ L (4%). She was treated with amphotericin and flucytosine. Combined antiretroviral therapy was started four weeks later and she showed early improvement. However, over the ensuing 18 months, her clinical course was marked by periodic worsening with symptoms resembling cryptococcal meningitis despite having achieved CD4 counts ≥400 cells/ μ L. Although initially treated for relapsing cryptococcal immune reconstitution syndrome, a brain biopsy taken 17 months after initial presentation showed budding Cryptococci. Conclusion. This unusually protracted case highlights the difficulties in differentiating relapsing cryptococcal meningitis from immune reconstitution and raises questions concerning the optimum timing of initiation of combined antiretroviral therapy in such patients.
    Language English
    Publishing date 2014-03-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2629909-4
    ISSN 2090-6676 ; 2090-6668
    ISSN (online) 2090-6676
    ISSN 2090-6668
    DOI 10.1155/2014/164826
    Database MEDical Literature Analysis and Retrieval System OnLINE

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