No abstract

West Nile virus is a neurotropic virus transmitted to humans via an infected mosquito bite. The increase in the incidences and fatalities of West Nile virus disease has made West Nile virus an important pathogen. Here we describe a case of a 65-year-old man with fever and diplopia presenting to the emergency department during a fall season and who was later diagnosed with West Nile virus infection. Diplopia is an uncommon manifestation of West Nile virus and recognition of the different modes of presentation, especially the uncommon ones like diplopia, will aid in the diagnosis of this emerging infectious disease.

Mucormycosis is a rare infection caused by the ubiquitous filamentous fungi of the order Mucorales and class Zygomycetes. These species are vasotropic, causing rapid onset of tissue infarctions and necrosis and subsequent thrombosis by invading vascular bed. The disease spectrum ranges from involvement of skin, sinuses, lung, and brain to disseminated and mostly fatal infections, especially in immunocompromised hosts. Here, we present a case of a fatal disseminated mucormycosis in a 56-year-old female who had deceased donor renal allograft transplantation ~2 weeks prior to presentation. She presented with shortness of breath and dry cough. Despite being on broad-spectrum antibiotics/antifungals and proper management by transplant, infectious disease, and primary team, she died within 3 weeks of admission. Autopsy showed disseminated mucormycosis of lungs and thyroid. Disseminated infection within 2 weeks of solid organ transplantation in this patient was one of the rare features of mucormycosis.

Background:Children with physical disabilities are at greater risk of health problems including oral health. Dental caries is the most common among the aforementioned group and requires special dental treatments procedures. However, it is less clear on the severity of oral health problems among children with disabilities when compared to the general population. This study aimed to determine the current oral health status of children with disabilities aged 11-13 years and compared with general public schoolchildren of the same age. In this study, special needs children are referred to as children who have various physical disabilities and need specialized services or help.Methods: A cross-sectional study was conducted among 158 children (79 special needs and 79 general public schoolchildren) aged 11-13 years studying in special needs and general public schools in Kathmandu and Lalitpur Districts, Nepal. Dental examination was performed by using a mouth mirror and a probe according to WHO criteria and methods (1997).Results: Among the 79 special needs children, there were visually impaired (16.5%), hearing and speech impaired (25.3%), and orthopedically challenged (58.2%). Prevalence of dental caries among special needs children was high (75.9%) as compared to that of general public schoolchildren (65.8%). The means DMFT of special needs and others were 3.07 and 2.59 respectively. The means of Missing teeth between special needs and others were statistically significant (p<0.05). Only 8.8% of special needs children had good oral hygiene while 32.9% of the others had good oral hygiene. Moreover, untreated caries among special needs children was also higher than that of general children 62% compared with 54.4%. Conclusions: Nepalese special needs children are at higher risk of oral health problems due to their physical limitation in maintaining oral health care. They have poorer oral health compared to general children. Moreover, dental treatment for the group is limited to simple tooth extraction, and most caries is left untreated. It is imperative the policy that extends oral health preventions for children with disabilities into their community be implemented.