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Case Reports
. 2020 Jul 4;12(7):e9000.
doi: 10.7759/cureus.9000.

COVID-19 as a Possible Cause of Functional Exhaustion of CD4 and CD8 T-cells and Persistent Cause of Methicillin-Sensitive Staphylococcus aureus Bacteremia

Ivana Choudhury  1   2 , Haowei Han  2 , Kaushik Manthani  2 , Sandeep Gandhi  3 , Rameshchandra Dabhi  3
Affiliations
Case Reports

COVID-19 as a Possible Cause of Functional Exhaustion of CD4 and CD8 T-cells and Persistent Cause of Methicillin-Sensitive Staphylococcus aureus Bacteremia

Ivana Choudhury et al. Cureus. .

Abstract

We report a case of a 73-year-old male with a history of diabetes mellitus, osteomyelitis, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who recently completed an extended intravenous course of cefazolin eight days back, and presented with MSSA bacteremia complicated by epidural abscess, endocarditis, and aortic root abscess. Meanwhile, the patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription-polymerase chain reaction (RT-PCR). Even with aggressive antibiotic treatment, the patient remained bacteremic and developed endocarditis with a worsening aortic root abscess. We suspect coronavirus disease 2019 (COVID-19) as a cause for the infectious paradox and will discuss the possible mechanisms in this case report.

Keywords: aortic root abscess; covid 19; infectious endocarditis; mssa bacteremia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Transthoracic echocardiogram, parasternal, short axis view, aortic valve
Leftmost image: increased echogenicity of the annulus of the bioprosthetic aortic valve, but no definite abscess (arrow). Middle image: development of paravalvular abscess. Rightmost image: echolucent area, suggestive of an increase in the abscess size.
Figure 2
Figure 2. MRI of the L-spine
Coronal view (left) and transverse view (right) of the spinal epidural abscess.
Figure 3
Figure 3. Aortic valve endocarditis as seen on the transthoracic echocardiogram
See this image and copyright information in PMC

References

    1. Cardiovascular disease and COVID-19. Bansal M. Diabetes Metab Syndr. 2020;14:247–250. - PMC - PubMed
    1. COVID-19 and kidney failure in the acute care setting: our experience from seattle. Durvasula R, Wellington T, Mcnamara E, Watnick S. Am J Kidney Dis. 2020;76:4–6. - PMC - PubMed
    1. COVID-19 update: Covid-19-associated coagulopathy. Becker RC. J Thromb Thrombolysis. 2020;50:54–67. - PMC - PubMed
    1. The pathogenesis and treatment of the 'Cytokine Storm' in COVID-19. Ye Q, Wang B, Mao J. J Infect. 2020;80:607–613. - PMC - PubMed
    1. A case of extensive epidural abscess concomitant with intracranial involvement due to Staphylococcus aureus successfully treated with ceftriaxone in combination with linezolid and rifampin. Saito K, Fukazawa R, Ogura S, Kasai T, Mizuno T. ENeurologicalSci. 2019;14:1–3. - PMC - PubMed

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