Background Brucellosis is a zoonotic disease caused by Brucella spp., namely B. melitensis and B. abortus in humans. Culturing is the gold standard method for diagnosis; however, because Brucella is a slow-growing bacterium, which may delay diagnosis, other faster methods, such as serology, are used. Studies on the correlation between Brucella antibody titers and clinical outcomes are limited. Therefore, this study assessed such correlation and evaluated the correlation between baseline serological results with culture positivity and clinical picture. Methods Patients tested positive for Brucella antibodies at baseline and diagnosed with brucellosis between January 2008 and December 2018 were included. Collected data included clinical outcomes, baseline culture positivity (growth in culture), arthralgia, baseline and end of therapy (EOT) temperature, white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Results Of 695 patients tested for Brucella antibodies, only 94 had positive baseline serology and diagnosed with acute brucellosis, among whom 63 had EOT serology. No significant correlations were found between EOT antibody titers of both Brucella spp. and clinical cure, mortality, length of stay, and duration of therapy. Additionally, no correlations were found between baseline serology and culture positivity, arthralgia, temperature, and other lab values. Conclusion Brucella serology does not correlate with clinical outcomes at EOT nor with culture positivity at baseline. Therefore, healthcare providers are advised to consider the whole clinical picture of a brucellosis patient without relying solely on serological results during follow up and not replace culturing with serology testing alone at the time of diagnosis.

Overuse or misuse of antibiotics is one reason for the emergence of antibiotic resistance. Here, we present four cases where antibiotics were started (or proposed) although they were not needed. The first case was asymptomatic bacteriuria where antibiotic therapy was initiated but then stopped after the case was referred to the infectious diseases (ID) service. The second case was a cholangiocarcinoma patient in whom four antibiotics were continued after completing the treatment for a remote infection. Hence, the ID team discontinued the unneeded therapy after considering that the inflammatory process was due to malignancy. The third case was a patient who was diagnosed with pneumonia in whom both antibiotics and an antiviral were initiated. However, antibiotic therapy was continued despite the lack of bacterial growth in the respiratory culture. Thus, it wasn't until the ID team evaluated the case and decided that the pneumonia was viral in nature that antibiotic therapy was discontinued. The last case was for a patient who presented with dry cough presumed to be a pneumonia and was about to be started on antibiotics. The ID team noticed the patient had a history of decompensated congestive heart failure causing the cough. Antibiotics were not initiated when lack of clinical findings suggestive of pneumonia was also confirmed. These cases represent an example of daily occurrences of antibiotics overuse. Healthcare providers are encouraged to augment their knowledge regarding the safe and judicious use of antibiotics, as well as consulting an ID expert if doubts concerning the necessity of antibiotics arise.

The COVID-19 pandemic has created huge economic and healthcare burdens. In most cases, the virus affects the lungs and causes respiratory symptoms. Additionally, its impact on the cranial nerves remains unclear. We thus aimed to investigate cranial nerve dysfunction in patients with COVID-19 infection.We conducted a systematic literature search of relevant and eligible literature in five databases: PubMed, Web of Science, Medline, EBSCO, and Google Scholar.Our sample included 21 case reports, one case series with 29 patients, and one analytical study with 135 cases. Participant ages ranged from 23 months to 72 years (mean age of 47.5 ± 19.02). The mean time from respiratory symptoms to the onset of neurological signs was (9.6 ± 7.4) days, and the mean recovery time was (16.3 ± 15.3) days.Cranial nerve impairment associated with COVID-19 infection has affected a large population, from infants to the elderly. Facial and abducent nerves were the most commonly affected cranial nerves with reported good prognosis or complete recovery within a few days to weeks. Olfactory dysfunctions were widely detected among COVID-19 patients.

BackgroundBrucellosis is a zoonotic disease caused by Brucella spp., namely B. melitensis and B. abortus in humans. Culturing is the gold standard method for diagnosis; however, because Brucella is a slow-growing bacterium, which may delay diagnosis, other faster methods, such as serology, are used. Studies on the correlation between Brucella antibody titers and clinical outcomes are limited. Therefore, this study assessed such correlation and evaluated the correlation between baseline serological results with culture positivity and clinical picture.MethodsPatients tested positive for Brucella antibodies at baseline and diagnosed with brucellosis between January 2008 and December 2018 were included. Collected data included clinical outcomes, baseline culture positivity (growth in culture), arthralgia, baseline and end of therapy (EOT) temperature, white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate.ResultsOf 695 patients tested for Brucella antibodies, only 94 had positive baseline serology and diagnosed with acute brucellosis, among whom 63 had EOT serology. No significant correlations were found between EOT antibody titers of both Brucella spp. and clinical cure, mortality, length of stay, and duration of therapy. Additionally, no correlations were found between baseline serology and culture positivity, arthralgia, temperature, and other lab values.ConclusionBrucella serology does not correlate with clinical outcomes at EOT nor with culture positivity at baseline. Therefore, healthcare providers are advised to consider the whole clinical picture of a brucellosis patient without relying solely on serological results during follow up and not replace culturing with serology testing alone at the time of diagnosis.