Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Neaterour P[original query] |
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Incidence and outcome of severe and nonsevere thrombocytopenia associated with Zika virus infection - Puerto Rico, 2016
Van Dyne EA , Neaterour P , Rivera A , Bello-Pagan M , Adams L , Munoz-Jordan J , Baez P , Garcia M , Waterman SH , Reyes N , Richardson LC , Rivera-Garcia B , Sharp TM . Open Forum Infect Dis 2019 6 (1) ofy325 Background: Zika virus (ZIKV) infection has been associated with severe thrombocytopenia. We describe the incidence, clinical manifestations, and outcomes of patients with ZIKV infection and thrombocytopenia. Methods: We reviewed medical records of patients with ZIKV infection and thrombocytopenia (platelet count <100 x10(9) cells/L) in Puerto Rico during 2016. Severe thrombocytopenia was defined by platelet count <20 x10(9)/L or a platelet count <50 x10(9)/L and treatment for immune thrombocytopenia (ITP). Results: Of 37 878 patients with ZIKV infection, 47 (0.1%) had thrombocytopenia in the absence of an alternative etiology (1.4 cases/100 000 population), including 12 with severe thrombocytopenia. Most patients with thrombocytopenia were adult (77%) and male (53%). Platelet nadir occurred a median (range) of 6 (1-16) and 5 (0-34) days after symptom onset for patients with severe and nonsevere thrombocytopenia, respectively. Among patients with severe thrombocytopenia, all had bleeding, 33% were admitted to the intensive care unit, and 8% died; 50% were treated for ITP. Among 5 patients with severe thrombocytopenia who received intravenous immunoglobulin, the median platelet count increase (range) was 112 (65-202) x10(9)/L. In contrast, among 4 patients who received platelet transfusion, the median increase in platelet count (range) was 8.5 (-6 to 52) x10(9)/L. Conclusions: Patients with severe thrombocytopenia and ZIKV infection experienced prominent acute morbidity. Consistent with recommended management, administration of ITP treatments to such patients may be more efficacious than platelet transfusion in resolving thrombocytopenia. Severe thrombocytopenia should be considered a rare outcome of ZIKV infection. |
Fatal Leptospira spp./Zika virus coinfection - Puerto Rico, 2016
Neaterour P , Rivera A , Galloway RL , Negron MG , Rivera-Garcia B , Sharp TM . Am J Trop Med Hyg 2017 97 (4) 1085-1087 Coinfection with pathogens that cause acute febrile illness (AFI) can complicate patient diagnosis and management. This report describes a fatal case of Leptospira spp./Zika virus (ZIKV) coinfection in Puerto Rico. The patient presented with a 5-day history of AFI; reported behavioral risk factors for leptospirosis; was diagnosed with possible leptospirosis, dengue, chikungunya, or ZIKV disease; and received appropriate treatment of leptospirosis and dengue. Following a 3-day hospitalization, the patient died due to acute gastrointestinal hemorrhage, and kidney and liver failure. Serologic diagnostic testing for leptospirosis and ZIKV disease was both negative; however, molecular diagnostic testing performed postmortem was positive for detection of Leptospira spp. and ZIKV nucleic acid. This case demonstrates the need for continued clinical awareness of leptospirosis in areas experiencing outbreaks of pathogens that cause AFI and the need for evaluation of coinfection with AFI-causing pathogens as a risk factor for increased severity of disease. |
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