SM Journal of Infectious Diseases

Current Issue

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Successful Treatment of Psoriasis Flare-Up Following COVID-19 Vaccination with Traditional Chinese Medicine: A Case Report

This report documents the case of a 28-year-old male who developed widespread psoriasis following getting the second dose of the Pfizer-BioNTech COVID-19 vaccine in 2022. Despite half a year of treatment with Western medicine, there was no improvement in symptoms. In 2023, the patient sought Traditional Chinese Medicine (TCM) treatment. The initial examination by the Chinese medicine practitioner revealed that the psoriasis affected 17% of the Body Surface Area with a PASI (Psoriasis Area and Severity Index) score of 16.4. The TCM diagnosis identified the condition as predominated by dampness with spleen deficiency. The treatment plan involved the internal administration of Chinese herbal formulas, including Chai Hu Gui Zhi Gan Jiang Tang and Wu Ling San, along with the topical application of Indigo Naturalis gel. After six months of treatment, his psoriasis condition significantly improved, with the PASI score decreasing to 2.9. By January 2024, the condition had fully recovered. Globally, approximately 125 million adults are affected by psoriasis, and there has been an increase in cases of psoriasis worsening or emerging post-vaccination. This case demonstrates the effectiveness of TCM and herbal treatments in managing vaccine-induced psoriasis and COVID-19-related psoriasis. It also opens new avenues for research into applying alternative treatment in modern medical practices.

Po Hsuan Chiu1,2, Ta Chen Chen1,3, Hui Yu Chung1 , Peng Yuan Li1 , Shigeharu Tanei1 , Ichiro Arai1 and Fu Shih Chen1*


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Complex Management of Spinal Tuberculosis in an 8-Year-Old Child: A Case Report

A previously healthy 8-year-old girl presented at our hospital with cervical pain and walking difficulty. Initial evaluation was unremarkable, but magnetic-resonance-imaging revealed extensive vertebral involvement. Surgery confirmed Mycobacterium tuberculosis infection and a nine-month antitubercular regimen was started. Early diagnosis, multi-drug therapy and surgery led to a favorable outcome, emphasizing the importance of a multidisciplinary approach in managing pediatric spinal tuberculosis.

Marco Caruso1*, Samantha Bosis2 , Claudia Tagliabue2 , Raffaella Pinzani2 , Paola Marchisio1,2, Francesco Maria Lo Russo2 , Mauro Pluderi2 and Giada Maria Di Pietro2


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COVID-19 in Haemodialysis Patients: Identifying Key Risk Factors for Adverse Outcomes

Background: Haemodialysis (HD) patients are particularly vulnerable to SARS-CoV-2 due to frequent healthcare exposure and multiple comorbidities. This study examines outcomes of HD patients infected with SARS-CoV-2 and evaluates risk factors for hospital admission, Intensive Care Unit (ITU) admission, length of stay, and 30-day mortality.

Methods: A retrospective cohort study was conducted in four HD centres at a major London hospital, including 249 SARS-CoV-2-positive HD patients from March 2020 to August 2021. Data on demographics, comorbidities, deprivation, and COVID-19 wave were collected. PCR was used for nasopharyngeal swabs, with genotypic analysis in waves 2 and 3. Logistic regression models assessed risk of hospital and ITU admissions, while a Cox proportional hazards model was applied for 30-day mortality.

Results: Of the HD population, 28.9% contracted SARS-CoV-2, 96% had at least one comorbidity, 40% required hospital admission, 11% needed ITU care, and 11% died within 30 days (median time-to-death: 14 days). Mortality was significantly higher in the second wave (p = 0.038), coinciding with the Alpha variant. Age was the only factor associated with hospital admission (OR 1.03, 95% CI 1.01–1.06, p = 0.008). In multivariate analysis, age, comorbidities, deprivation, and wave 2 infection were linked to increased mortality hazard, with lower deprivation significantly reducing risk (HR 0.50, 95% CI 0.26–0.95, p = 0.036).

Discussion: The findings underscore the increased vulnerability of HD patients to COVID-19, particularly with emerging variants. Although age was the main predictor of hospital admission, mortality was also influenced by comorbidities and deprivation, indicating socio-economic disparities despite uniform healthcare access.

Caitlin Norris Grey1 , Shiv Raj Sharma1 , Cate Goodlad2 , Andrew Davenport2 , Tabitha Mahungu1 and Tanzina Haque1*