Though pain is a frequent symptom of long COVID-19, little attention has been paid to vertebral algic syndrome. Therefore, we present the cases reports of two precisely selected physically active patients where vertebral algic syndrome and radiculopathy dramatically worsened in acute SARS-CoV-2 infections. The vertebral pain with radicular irritation was resistant to conservative treatment in chronic post-COVID syndrome. The neurological difficulties corresponded to the radiologic imaging presented on MRI scans. Due to the absence of standard therapeutic guidelines in literature sources, it was decided to provide routine therapeutic procedures. Spinal surgery with radicular decompression was performed within 6 months after acute SARS-CoV-2 infection. This led to the improvement of their neurological status and was in corroboration with decreases of VAS (from 9 to 0 in Patient 1 and from 7 to 1 in Patient 2). Our experience indicates that these patients benefited from the standard neurosurgical radicular decompression, and sufficient pain relief was achieved; nevertheless, the initial trigger of neurological worsening was acute SARS-CoV-2 infection.
Introduction.
Exophiala dermatitidisis a relatively common environmental black yeast with worldwide distribution and is a rare cause of fungal infection, mostly in patients with certain predisposing factors. Due to the rarity of the infection, little is known about the specific predisposing factors, way of infection or treatment.
Case presentation. Here, we report what is to our knowledge the first case of E. dermatitidis infection in a child after allogeneic stem cell transplantation. We also review all paediatric cases reported in the literature since 1993.
Conclusion. This is, to our knowledge, the first reported case of E. dermatitidis infection in a child after allogeneic stem cell transplantation. This report should increase the awareness of E. dermatitidis in immunocompromised paediatric patients, particularly after stem cell transplantation.
Pain is one of the most common complaints among patients infected by SARS-CoV-2. While headache and chest pain are reported widely among COVID-19 presentations, there are only scarce reports about vertebral pain. This study aims to describe cases of four healthy and physically active adults, in whom the new onset of back pain was the early or only sign of COVID-19 and the reason for seeking medical outpatient care. The vertebral pain showed great variability and changed dramatically during the course of disease. Pseudoradicular symptoms were present inconstantly and variably; in some patients they varied through the day from left to right side and irradiated from various sensory root segments. Clinical symptoms did not correspond with minor morphological changes presented on MRI scans. Our experience indicates that new onset of vertebral algic syndrome should be considered as an initial indicator of novel coronavirus infection in healthy and physically active adults. There is a pressing need for attention to be paid in the examination of patients with new vertebral pain onset in the coronavirus pandemic.
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