Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Fatal Central Nervous System Co-Infection MESHD with SARS-CoV-2 and Tuberculosis MESHD in a Healthy Child TRANS

    Authors: Bishara J. Freij; Bassam M. Gebara; Rabail Tariq; Ay-Ming Wang; John Gibson; Nidal El-Wiher; Graham Krasan; Paul M. Patek; Kelly A. Levasseur; Mitual Amin; Joseph M. Fullmer

    doi:10.21203/rs.3.rs-33272/v1 Date: 2020-06-04 Source: ResearchSquare

    Background. Central and peripheral nervous system symptoms MESHD and complications are being increasingly recognized among individuals with pandemic SARS-CoV-2 infections MESHD, but actual detection of the virus or its RNA in the central nervous system has rarely been sought or demonstrated. Severe or fatal illnesses are attributed to SARS-CoV-2, generally without attempting to evaluate for alternative causes or co-pathogens.Case presentation. A five-year-old girl with fever HP fever MESHD and headache HP headache MESHD was diagnosed with acute SARS-CoV-2-associated meningoencephalitis MESHD based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis, and magnetic resonance imaging findings. Serial serologic tests SERO for SARS-CoV-2 IgG and IgA showed seroconversion, consistent with an acute infection MESHD. Mental status and brain imaging findings gradually worsened despite antiviral therapy and intravenous dexamethasone. Decompressive suboccipital craniectomy for brain herniation with cerebellar biopsy on day 30 of illness, shortly before death, revealed SARS-CoV-2 RNA in cerebellar tissue using the Centers for Disease Control and Prevention 2019-nCoV Real-Time Reverse Transcriptase-PCR Diagnostic Panel. On histopathology, necrotizing granulomas MESHD granulomas HP with numerous acid-fast bacilli were visualized, and Mycobacterium tuberculosis MESHD complex DNA was detected by PCR. Ventricular cerebrospinal MESHD fluid that day was negative for mycobacterial DNA. She had no known exposures to tuberculosis MESHD and no chest radiographic findings to suggest it. All 6 family members TRANS had normal chest radiographs and negative interferon-γ release assay results. The source of her tuberculous infection MESHD was not identified, and further investigations by the local health department were not possible because of the State of Michigan-mandated lockdown for control of SARS-CoV-2 spread.Conclusion. The detection of SARS-CoV-2 RNA in cerebellar tissue and the demonstration of seroconversion in IgG and IgA assays was consistent with acute SARS-CoV-2 infection of the central nervous infection MESHD. However, the cause of death MESHD was brain herniation from her rapidly progressive central nervous system tuberculosis MESHD. SARS-CoV-2 may mask or worsen occult tuberculous infection MESHD infection with severe HP or fatal consequences.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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