Mycoplasma pneumoniae is a common causative agent for childhood pneumonia. However, empyema is a rare presentation. We report a case of a previously well child who presented with a right-sided empyema. M. pneumoniae was confirmed serologically with evidence of a four-fold rise in Mycoplasma IgM titre. The empyema required drainage procedures for more than two weeks. The infection resolved with a course of six weeks of treatment with erythromycin.
We report a case of an 8-year-old aborigine boy referred to our hospital for respiratory insufficiency with skin eruptions over the trunk and limbs. The skin condition was diagnosed as acquired ichthyosis. He also had a non-bleeding form of disseminated intravascular coagulopathy. Radiograph of the lungs showed bilateral perihilar opacities with bilateral pleural effusion. The diagnosis of leptospirosis was confirmed by a 4-fold rise in microagglutinating titre and polymerase chain reaction assay.
A 7-year-old boy, referred with lymphoma, presented with prolonged fever and intra-abdominal lymphadenopathy demonstrated on computed tomography (CT) of the abdomen. Blood culture isolated Penicillium marneffei. The patient was subsequently proven serologically to be positive for human immunodeficiency virus (HIV). Treatment with amphotericin B followed by itraconazole was successful. A high level of clinical suspicion and awareness is necessary for early diagnosis of penicilliosis, especially in an era of an increasing prevalence of HIV in this region.
The COVID-19 pandemic has plunged the world into uncharted territory, leaving people feeling helpless in the face of an invisible threat of unknown duration that could adversely impact the national economic growths. According to the World Health Organization (WHO), the SARS-CoV-2 spreads primarily through droplets of saliva or discharge from the mouth or nose when an infected person coughs or sneezes. However, the transmission of the SARS-CoV-2 through aerosols remains unclear. In this study, computational fluid dynamic (CFD) is used to complement the investigation of the SARS-CoV-2 transmission through aerosol. The Lagrangian particle tracking method was used to analyze the dispersion of the exhaled particles from a SARS-CoV-2-positive patient under different exhale activities and different flow rates of chilled (cooling) air supply. Air sampling of the SARS-CoV-2 patient ward was conducted for 48-h measurement intervals to collect the indoor air sample for particulate with diameter less than 2.5 μm. Then, the reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted to analyze the collected air sample. The simulation demonstrated that the aerosol transmission of the SARS-CoV-2 virus in an enclosed room (such as a hospital ward) is highly possible.
The rapid spread of the SARS-CoV-2 in the COVID-19 pandemic had raised questions on the route of transmission of this disease. Initial understanding was that transmission originated from respiratory droplets from an infected host to a susceptible host. However, indirect contact transmission of viable virus by fomites and through aerosols has also been suggested. Herein, we report the involvement of fine indoor air particulates with a diameter of ≤ 2.5 µm (PM2.5) as the virus's transport agent. PM2.5 was collected over four weeks during 48-h measurement intervals in four separate hospital wards containing different infected clusters in a teaching hospital in Kuala Lumpur, Malaysia. Our results indicated the highest SARS-CoV-2 RNA on PM2.5 in the ward with number of occupants. We suggest a link between the virus-laden PM2.5 and the ward's design. Patients' symptoms and numbers influence the number of airborne SARS-CoV-2 RNA with PM2.5 in an enclosed environment.