scholarly journals Chryseobacterium indologenesperitonitis in a peritoneal dialysis patient

2018 ◽  
Vol 11 (1) ◽  
pp. e227713 ◽  
Author(s):  
Tiago J Carvalho ◽  
Patrícia Quadros Branco ◽  
Ana Rita Martins ◽  
Augusta Gaspar
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Course ◽  
Peritoneal Dialysis Patient ◽  
Underlying Disease ◽  
Immunocompetent Patient ◽  
Tenckhoff Catheter ◽  
First Case ◽  
Intravenous Antibiotics ◽  
Severe Underlying Disease

Peritonitis remains an important complication of peritoneal dialysis. The Gram-negative bacillusChryseobacterium indologenescauses infection mostly in immunocompromised patients with severe underlying disease, mainly in Asia. Herein, we report the first case in Europe and the second case in an immunocompetent patient of peritoneal dialysis-associatedC. indologenesperitonitis. Our patient presented with abdominal pain and a cloudy effluent and was started on intraperitoneal antibiotics. The organism cultured from the peritoneal fluid was later identified asC. indologenesand antibiotic therapy was adjusted accordingly. Despite this, the peritonitis followed a relapsing course, requiring Tenckhoff catheter removal, temporary transfer to haemodialysis and intravenous antibiotics. Subsequently, a new Tenckhoff catheter was inserted and peritoneal dialysis was restarted. The patient remains peritonitis free after 18 months of follow-up. This case highlights the need to consider rare causes of peritonitis in peritoneal dialysis patients as well as the heterogeneous clinical course ofC. indologenesperitonitis.

scholarly journals Development of Bullous Pemphigoid after Tenckhoff Catheter Placement in a Peritoneal Dialysis Patient

2020 ◽  
Vol 12 (1) ◽  
pp. 42-46
Author(s):  
Davide Giunzioni
Keyword(s):  
Peritoneal Dialysis ◽  
Bullous Pemphigoid ◽  
Peritoneal Dialysis Patient ◽  
Catheter Placement ◽  
Peritoneal Dialysis Catheter ◽  
Tenckhoff Catheter ◽  
First Case ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage

Bullous pemphigoid (BP), a chronic autoimmune subepidermal blistering skin disease, has been described in end-stage renal disease patients requiring dialysis after the placement of an artero-venous fistula. We report a case of a novel onset of BP following a peritoneal dialysis abdominal Tenckhoff catheter placement. The 3-month treatment with systemic doxycycline and topical clobetasol propionate allowed a rapid disappearing of the blisters and left the patient free of symptoms in the follow-up. To our knowledge, this is the first case describing a new BP onset after a peritoneal dialysis catheter placement.

Prostatic Abscess in a Patient with Chronic Granulomatous Disease: A Multi-Disciplinary Intervention

2017 ◽  
Vol 84 (4) ◽  
pp. 267-269 ◽  
Author(s):  
Alberto Martini ◽  
Ioannis Katafigiotis ◽  
Sofia Kalantzi ◽  
Ioannis Anastasiou ◽  
Ioannis Adamakis ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Chronic Granulomatous Disease ◽  
Urine Culture ◽  
Underlying Disease ◽  
Multidrug Resistant ◽  
Granulomatous Disease ◽  
Prostatic Abscess ◽  
The Past ◽  
First Case

Introduction Chronic granulomatous disease (CGD) is a rare pathology that increases patients’ susceptibility to infections, given the inability to generate oxygen radicals to fight microorganisms. In the context of CGD, primary prostatic involvement has been described only once in the past, in a pediatric patient. Case Report We report the case of a 35-year old patient with CGD presenting with persistent fever. After hospital admission, blood and urine were sent for culture and antibiotic therapy was initiated. Patient's conditions continued to deteriorate and an aggressive antibiotic therapy was administered to treat the septic scenario. Urine culture grew a multidrug-resistant Escherichia Coli. After patient's condition improved, a CT scan was performed. The depiction showed multiple abscesses within the prostate. A rectal approach was excluded given patient's underlying disease. A TURP was performed and prostatic pathology resolved. Patient was discharged on postoperative day 14. At 6-month follow-up he hasn't experienced major infections. To the best of our knowledge, this is the first case of septic shock originating from a prostatic abscess in an adult patient with CGD. Conclusions Aggressive medical therapy along with TURP resulted curative in our case. A multi-disciplinary approach was mandatory.

scholarly journals Coexistence of Emphysematous Pyelonephritis and Cystitis in a Patient with COVID-19 Complicated with Spontaneous Pneumomediastinum

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ibrahim Boukhannous ◽  
Anouar El Moudane ◽  
Mehdi Chennoufi ◽  
Mohamed Mokhtari ◽  
Abdelghani Ouraghi ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Clinical Course ◽  
Emphysematous Pyelonephritis ◽  
Perinephric Abscess ◽  
Emphysematous Cystitis ◽  
Spontaneous Pneumomediastinum ◽  
First Case ◽  
Intravenous Antibiotics ◽  
Uremic Syndrome

We report the first case of a 52-year-old nondiabetic male admitted for management of uremic syndrome associated with emphysematous pyelonephritis (EPN), renal and perinephric abscess, and emphysematous cystitis (EC) on a single functional kidney with a large abundance of spontaneous pneumomediastinum (SP) complicating a SARS-CoV-2 pneumonia. The patient has benefited from several dialysis sessions, intravenous antibiotics, and percutaneous drainage. His clinical course was complicated by acute respiratory distress syndrome, and unfortunately, he died nine days following admission.

scholarly journals Siamese twin pregnancy in peritoneal dialysis : first case in the world

2018 ◽  
Vol 1 (1) ◽  
pp. 39-42
Author(s):  
D El Hamssili ◽  
T. Bouattar ◽  
R. Bayahia ◽  
L. Benamar
Keyword(s):  
Peritoneal Dialysis ◽  
Twin Pregnancy ◽  
Antihypertensive Drugs ◽  
Successful Pregnancy ◽  
Dialysis Dose ◽  
Cerebral Malformation ◽  
Emergency Cesarean ◽  
First Case ◽  
Obstetrical Ultrasound

 Introduction: The probability of conception is low in peritoneal dialysis (PD), and the probability of successful pregnancy is even lower. Nearly 60 years after the first reported case of successful pregnancy in a dialysis patient, many questions about pregnancy during dialysis remain unresolved, namely the required dialysis dose, the follow-up rhythm, the choice of the the most appropriate dialysis technique. Case report: We report the first case worldwide of twin Siamese pregnancy in a patient on continuous ambulatory peritoneal dialysis (CAPD). The pregnancy was diagnosed at 7 weeks of amenorrhea (WA). The patient was initially under 2 exchanges per day, with 2-liter bags of Dianealof 1.36% glucose. As soon as the pregnancy was discovered, the prescription was modified, putting the patient under 3 exchanges a day with the same concentrates. The infusion volume was maintained at 2 liters up to 18 WA , and then reduced to 1.5 liters due to patient discomfort and abdominal hyperpressure. Daily ultrafiltration ranged from 180 to 800 ml with 1 liter diuresis. The blood pressure was well controlled, with an average of 125/80 mmHg, without need of  antihypertensive drugs. On a biological level, the Kt / V was 2.2, nPCR was 0.8, and the weekly clearance was 80 L / 1.73 m². The average hemoglobin was 11.5 g / dl under erythropoietin 9000 units per week. At 20 WA, obstetrical ultrasound revealed a mono-chorionic, mono-amniotic twin pregnancy. Due to high maternal and fetal risks, closer obstetrical control was indicated. At 24 WA, morphological obstetrical ultrasound coupled with Doppler examination of the uterine and umbilical arteries favored the diagnosis of mono-amniotic mono-chorionic twin pregnancy with strong suspicion of Siamese contiguous to the pelvis, with a cerebral malformation in one of the fetuses. The patient experienced intense contractions and pelvic pain leading to an emergency cesarean section with two surviving Siamese twins, contiguous to the pelvis, weighing 900g, but who died one day after delivery. Conclusion: Pregnancy during dialysis is at high maternal and fetal risks. It is necessary to prepare and follow this pregnancy to optimize the chances of success. This implies an adaptation of the medical treatment and dialysis prescription, including the volume and modality of exchanges. The same holds true for gynecological and obstetrical follow-up, which must be regular and strict, in order to prevent any maternal-fetal complications.

Tinea nigra palmaris-associated peritonitis, caused by Hortaea werneckii: The first case report in a peritoneal dialysis patient

2020 ◽  
pp. 089686082094477
Author(s):  
Tamonwan Chamroensakchai ◽  
Chadarat Kleebchaiyaphum ◽  
Sajja Tatiyanupanwong ◽  
Somchai Eiam-Ong ◽  
Talerngsak Kanjanabuch
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Ribosomal Rna ◽  
Internal Transcribed Spacer ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Ribosomal Rna Gene ◽  
Hortaea Werneckii ◽  
First Case ◽  
Tinea Nigra

We report the first case of peritoneal dialysis (PD) patients with peritonitis from Hortaea werneckii, a halotolerant black yeast-like fungus. The pathogen was confirmed by nucleotide sequences of internal transcribed spacer regions of the ribosomal RNA gene. A potential cause of this infection was tinea nigra on the patient’s palm. Therefore, gloving might be advised during PD bag exchange in patients or caregivers who have an obvious lesion of the palm.

Peritonitis Caused by Monilia sitophila in a Patient Undergoing Peritoneal Dialysis

1996 ◽  
Vol 19 (4) ◽  
pp. 218-220 ◽  
Author(s):  
A.E. Radix ◽  
V.M. Bieluch ◽  
C.W. Graeber
Keyword(s):  
Peritoneal Dialysis ◽  
Amphotericin B ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Fungal Peritonitis ◽  
Common Cause ◽  
Tenckhoff Catheter ◽  
First Case ◽  
Etiologic Agents ◽  
Oral Itraconazole

Fungi have become an increasingly important cause of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. The most common cause of fungal peritonitis is Candida. However, in recent years unusual and “nonpathogenic” fungi have been reported as etiologic agents of CAPD-associated peritonitis. We are reporting the first case of CAPD-associated peritonitis caused by Monilia sitophila. This organism had previously been considered to be non-pathogenic, and a troublesome laboratory contaminant. Our patient was successfully managed with intravenous and intraperitoneal amphotericin B, followed by oral itraconazole, without removal of her Tenckhoff catheter.

Apolipoprotein(a) Phenotype and Lipoprotein(a) Level Predict Peritoneal Dialysis Patient Mortality

2002 ◽  
Vol 22 (4) ◽  
pp. 492-499 ◽  
Author(s):  
Eduard A. Iliescu ◽  
Santica M. Marcovina ◽  
Alexander R. Morton ◽  
Miu Lam ◽  
Marlys L. Koschinsky
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Tertiary Care ◽  
Inverse Correlation ◽  
Peritoneal Dialysis Patient ◽  
Lipoprotein A ◽  
Apolipoprotein A ◽  
Size Number ◽  
Care Health

♦ Objective To examine the associations between lipoprotein(a) [Lp(a)] level, apolipoprotein(a) [apo(a)] phenotype, and patient mortality in peritoneal dialysis (PD) patients. ♦ Design Observational prospective study of prevalent PD patients. ♦ Setting Tertiary-care health sciences center. ♦ Patients 54 prevalent PD patients were followed prospectively for 24 months. ♦ Main Outcome Measures The exposures were Lp(a) level and apo(a) phenotype, designated by the apo(a) isoform size (number of kringle 4 repeats). Outcome was death from any cause. ♦ Results There were 24 deaths in 77.9 patient–years’ follow-up. The independent predictors of death in the multivariate survival analysis were age [relative risk (RR) = 1.03, p = 0.23], diabetes (RR = 3.00, p = 0.03), diastolic blood pressure ≤ 70 mmHg (RR = 2.94, p = 0.03), serum albumin (RR = 0.87, p < 0.01), and Lp(a) level (RR = 1.004, p < 0.01). There was strong inverse correlation of Lp(a) with apo(a) isoform size ( r = –0.62, p < 0.01). With Lp(a) removed from the model, apo(a) isoform size was a significant predictor of death (RR = 0.91, p = 0.0497). ♦ Conclusions Lipoprotein(a) level and apo(a) phenotype are associated with PD patient mortality. Measurement of Lp(a) level and apo(a) phenotype may be useful in clinical practice to identify patients at high risk for cardiovascular disease. Large prospective studies are needed to determine if a reversal of the increase in Lp(a) level associated with renal disease and dialysis is feasible and beneficial in reducing the risk of cardiovascular disease and mortality.

scholarly journals Citalopram intoxication in four week old infant

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jo-Anne Janson ◽  
Arthur T. M. Wasylewicz ◽  
Marianne Eijkemans ◽  
Marieke Kerskes
Keyword(s):  
Case Report ◽  
Cardiac Rhythm ◽  
Clinical Course ◽  
Screening Methods ◽  
Pharmacokinetic Data ◽  
Pediatric Practice ◽  
Case Presentation ◽  
Young Infants ◽  
First Case

Abstract Background In contrast to intoxications in toddlers which can be due to accidental ingestions, many intoxications in infants are due to medication errors. To our knowledge, this is the first case report of a citalopram intoxication in an infant, and may offer new insight on possible screening methods for intoxication as well as pharmacokinetics of citalopram in small infants. Case presentation This case report describes an unintentional citalopram intoxication in a 4 week old infant due to a vitamin D drops ‘look alike’ error. The infant showed extreme jitteriness and opisthotonus at presentation, as well as prolonged signs of gastro-oesophageal reflux. No cardiac rhythm disturbances or convulsions were seen. The clinical course combined with Finnegan scores was correlated to and supported by pharmacokinetic and pharmacokinetic data of citalopram in the patient. Conclusions Using Finnegan scores in general pediatric practice could help objectify follow-up of acute intoxications in young infants with neurological symptoms.

Successful Laser-assisted Excision of a Metastatic Midbrain Tumor

Neurosurgery ◽  
1986 ◽  
Vol 18 (6) ◽  
pp. 795-797 ◽  
Author(s):  
William D. Tobler ◽  
Raymond Sawaya ◽  
John M. Tew
Keyword(s):  
Radiation Therapy ◽  
Case Report ◽  
Clinical Course ◽  
Metastatic Adenocarcinoma ◽  
Computed Tomographic ◽  
Metastatic Lesions ◽  
First Case ◽  
Autopsy Series ◽  
Solitary Brain Metastases

Abstract Metastatic lesions to the midbrain are rare. They are found in 1 to 3% of autopsy series of solitary brain metastases. The consensus of opinion in the current literature is that they are inoperable lesions and should be treated by radiation therapy alone. This is the first case report of a completely excised metastatic adenocarcinoma to the midbrain. The patient's clinical course has been stable, and there is no computed tomographic evidence of recurrence at 18 months follow-up. (18:795-797, 1986)

scholarly journals Cryptococcal empyema treated with tube thoracostomy and intrapleural fibrinolysis

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Akshay Kohli ◽  
Ashutosh Sachdeva ◽  
Edward M. Pickering
Keyword(s):  
Underlying Disease ◽  
Tube Thoracostomy ◽  
Pleuritic Chest Pain ◽  
First Case ◽  
Breath Sounds ◽  
Severe Underlying Disease ◽  
History Of ◽  
Dornase Alpha ◽  
The Right ◽  
Repeat Imaging

A 55-year old woman with a history of relapsed T-cell ALL presented with right pleuritic chest pain and decreased breath sounds over the right hemithorax. Imaging of the chest showed loculated effusions. Tube thoracostomy was performed with intrapleural application of alteplase and dornase alpha over a 3-day period. Repeat imaging demonstrated a marked decrease in the volume of the effusion. In most prior published cases of pleural cryptococcosis, surgical drainage was required in addition to prolonged antifungal agents. More than 50% of patients with cryptococcal infection have severe underlying disease or immunodeficiency state making them high risk for surgery. This is the first case to our knowledge of cryptococcal empyema successfully treated with tube thoracostomy and intrapleural fibrinolysis.

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