Candida albicans endocarditis involving a normal native aortic valve in an immunocompetent patient

2020 ◽  
Vol 13 (11) ◽  
pp. e236902
Author(s):  
Taha Sheikh ◽  
Jeremy C Tomcho ◽  
Mohammed T Awad ◽  
Syeda Ramsha Zaidi
Keyword(s):  
Candida Albicans ◽  
Mortality Rate ◽  
Aortic Valve ◽  
High Mortality ◽  
Treatment Options ◽  
Immunocompetent Patient ◽  
Fungal Endocarditis ◽  
Appropriate Treatment ◽  
Mechanical Valves ◽  
Serious Infection

Fungal endocarditis, specifically from Candida species, is a rare but serious infection with a high mortality rate. Most cases occur in bioprosthetic or mechanical valves and are uncommon in native, structurally normal valves. When Candida endocarditis is detected and appropriate treatment is initiated earlier, there is an improvement in mortality. While the recommendation is usually to treat with a combination of surgery and antifungal medications, patient comorbidities may limit treatment options.

scholarly journals Successful Coronary Protection during TAVI in Heavily Calcified Aortic Leaflets in Patient with Short and Low Left Coronary System

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Mohamad Kabach ◽  
Abdulah Alrifai ◽  
Lawrence Lovitz ◽  
Mark Rothenberg ◽  
Cristiano Faber ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
High Mortality ◽  
Transcatheter Aortic Valve Replacement ◽  
Intermediate Risk ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Coronary Obstruction

Transcatheter aortic valve replacement has been recently approved for patients who are high or intermediate risk for surgical aortic valve replacement. The procedure is associated with several known complications including coronary related complications. Coronary obstruction is rare but disastrous complication, and it is associated with a high mortality rate. Coronary protection technique has emerged as a preemptive technique to avoid this complication. We present a case of successful coronary protection during TAVR in severely calcified left cusp in patient with short and low left ostium.

scholarly journals Mitral-Valve Endocarditis due to Candida albicans: A Case Report

2018 ◽  
Vol 35 (4) ◽  
pp. 345-350
Author(s):  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Mohammad Taghi Salehi Omran ◽  
Zeinab Ahangar Darabi ◽  
Ahmad Karkhah ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Case Report ◽  
Infective Endocarditis ◽  
Mitral Valve ◽  
Blood Culture ◽  
Negative Results ◽  
Fungal Endocarditis ◽  
Serious Infection

Abstract Infective endocarditis (IE) is a serious infection among endovascular infections. Fungal endocarditis, especially caused by Candida albicans, is very rare, and its diagnosis is often difficult due to the negative results of blood culture and the presence of nonspecific symptoms. In this study, a patient who developed endocarditis on a normal valve due to infection with Candida albicans is presented.

scholarly journals Identification of Trichosporon asahii by PCR Based on Sequences of the Internal Transcribed Spacer Regions

1998 ◽  
Vol 36 (9) ◽  
pp. 2742-2744 ◽  
Author(s):  
Takashi Sugita ◽  
Akemi Nishikawa ◽  
Takako Shinoda
Keyword(s):  
Candida Albicans ◽  
Mortality Rate ◽  
Cryptococcus Neoformans ◽  
Causative Agent ◽  
High Mortality ◽  
Internal Transcribed Spacer ◽  
Detection System ◽  
Malassezia Furfur ◽  
Trichosporon Asahii ◽  
Internal Transcribed Spacer Regions

Trichosporon asahii is a major causative agent of deep-seated trichosporonosis, which has a high mortality rate. To detect T. asahii, we have developed specific oligonucleotide primers based on the internal transcribed spacer regions of this organism’s genome. Amplification products were selectively obtained from only T. asahii DNA; the DNAs of other Trichosporon species, as well as those of medically relevant yeasts such as Candida albicans,Cryptococcus neoformans, and Malassezia furfur, were not amplified. This detection system will be useful as a microbiological tool for the diagnosis of trichosporonosis.

Emamectin benzoate is a safe and effective anthelmintic against coelomic nematode Philometra rubra in striped bass Morone saxatilis

2020 ◽  
Vol 142 ◽  
pp. 47-53
Author(s):  
K Béland ◽  
G Séguin ◽  
S Lair
Keyword(s):  
Mortality Rate ◽  
Striped Bass ◽  
High Mortality ◽  
Morone Saxatilis ◽  
Treatment Results ◽  
Emamectin Benzoate ◽  
Once Daily ◽  
Fish Hatchery ◽  
Parasitic Burden

An unusually high mortality rate due to verminous (Philometra rubra) coelomitis was documented in wild-hatched striped bass Morone saxatilis raised in a fish hatchery as part of a stock restoration program. To decrease the parasitic burden and therefore potentially minimize mortality, the effectiveness of 2 different anthelmintics was evaluated. Two trials were conducted on wild-collected fingerlings naturally infected by P. rubra. In 2006, 144 yearling fish were randomly assigned to 4 experimental groups: (1) levamisole (Levasol®) at 2 mg l-1 via immersion for 8 h once weekly for 3 wk; (2) levamisole at a dose of 2.5 mg kg-1 biomass via feed once daily for 7 d; (3) emamectin benzoate (Slice®) at a dose of 0.05 mg kg-1 biomass via feed once daily for 7 d; and (4) control. Emamectin successfully eliminated live nematodes in 84.9% of the fish, whereas the administration of levamisole, either via immersion or feed, was not successful in significantly reducing the number of live P. rubra. In 2007, the administration of the same dosage of emamectin to approximately 1000 naturally infected yearling striped bass was associated with a 100% mortality rate of P. rubra in the 30 fish randomly examined 5 wk after the beginning of the treatment. Results of these trials indicate that, at the dosage used, the administration of emamectin at the end of the summer is safe for striped bass yearlings and considerably reduces the prevalence and intensity of the infection by this parasite.

Candida albicans Endocarditis and a Review of Fungal Endocarditis: Case Report

2004 ◽  
Vol 7 (4) ◽  
pp. E312-E314 ◽  
Author(s):  
Ugur Filizcan ◽  
Sebnem Cetemen ◽  
Yavuz Enç ◽  
Mahmut Çakmak ◽  
Onur Göksel ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Case Report ◽  
Fungal Endocarditis

Inovasi Teknologi Pembuatan Pakan Udang dengan Penambahan Tepung Kopasanda (Chromolaena odorata L.) di Desa Tamangapa Kecamatan Ma’rang Kab. Pangkep

2019 ◽  
Vol 3 (2) ◽  
pp. 140
Author(s):  
Harlina Harlina ◽  
Hadijah Hadijah ◽  
Kamaruddin Kamaruddin ◽  
Ernaningsih Ernaningsih
Keyword(s):  
Mortality Rate ◽  
Community Service ◽  
High Mortality ◽  
Raw Materials ◽  
Development Program ◽  
Chromolaena Odorata ◽  
Farmed Fish ◽  
Counseling Training ◽  
Shrimp Feed ◽  
Simple Technology

Tamangapa village, Ma’rang district is part of the community development program conducted by Universitas Muslim Indonesia in Pangkajene Kepulauan regency. The local shrimp farmers of Tamangapa village have been facing major issue due to expensive artificial feed and high mortality rate. In order to solve the needs of feed and high mortality rate for farmed fish or shrimp, the source of the natural ingredients using kopasanda leaves Chromolaena odorata L is required. The use of a natural ingredient is also used to prevent the vibriosis using simple technology such as the utilization of local raw materials which is affordable and locally available. The present community service aimed to provide the proper knowledge and skills to members of the fish/shrimp farmer’s group through counseling, training and mentoring. This community service program encouraged the local farmers to be able to utilize the local raw materials as a source of shrimp feed, use the feed pellet machine, and packaging leading to independent feed production. The participatory training method, lectures, forum group discussions, and practices of making shrimp feed and packaging were applied. The Implementation of the Community Partnership Program of Shrimp and Fish Cultivation Groups is independently able to produce organic fish or shrimp feed for farmer’s group leading to higher productivity of aquaculture.

scholarly journals Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette–Guérin for Treatment of Bladder Cancer

2021 ◽  
Vol 13 (3) ◽  
pp. 611-618
Author(s):  
Elsa Alves Branco ◽  
Raquel Duro ◽  
Teresa Brito ◽  
António Sarmento
Keyword(s):  
Bladder Cancer ◽  
Hepatitis A ◽  
Adverse Reactions ◽  
Superficial Bladder Cancer ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Bacillus Calmette Guerin ◽  
Granulomatous Hepatitis ◽  
Appropriate Treatment

Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.

scholarly journals 1186. Cefazolin inoculum effect predicts reduced susceptibility to other antibiotics and patient outcomes in MSSA endovascular infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S617-S617
Author(s):  
Dan Smelter ◽  
Sue McCrone ◽  
Warren Rose
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
Patient Outcomes ◽  
Treatment Options ◽  
Fold Increase ◽  
Specific Mechanism ◽  
Research Support ◽  
High Burden ◽  
Low Toxicity ◽  
Inoculum Effect

Abstract Background MSSA Infective endocarditis (IE) is inherently a high-burden infection with up to a 30% mortality rate. Cefazolin is an appealing treatment option for IE with low toxicity and a favorable dosing scheme. However, cefazolin has been associated with treatment failure in IE, attributed to an inoculum effect. The specific mechanism underlying the cefazolin inoculum effect (CIE) remains undetermined, but CIE has been linked to both blaZ expression and agr dysfunction. This study aims to determine whether CIE is linked to reduced susceptibility to other antibiotics and worse outcomes regardless of therapy in MSSA endovascular infections. Methods Sixty-four MSSA strains were collected from patients with endovascular infections not treated with cefazolin. To determine CIE phenotype, strains were cultured and MICs assayed for cefazolin, nafcillin, and vancomycin at 107 CFU/mL for high-inocula (HI) and 105 CFU/mL for standard-inocula (SI). This study defined CIE as a ≥ 4-fold increase in MIC at HI compared to SI, with at least an MIC of 4 mg/L at HI. Nitrocefin disks identified blaZ expression, and beta lysin disks were used to determine hemolysin type and agr function. Patient outcomes of mortality and bacteremia duration were assessed across cohorts. Results Twenty-four strains exhibit a CIE (38%), with 10 strains having an MIC of ≥ 32mg/L at HI. Nafcillin and vancomycin also had an inoculum effect, uncoupled from the CIE and occurring at a lower frequency and amplitude at HI. Presence of CIE had a greater association with blaZ expression (71% vs 25%) than agr dysfunction (38% vs 20%). 50% (9/18) of CIE infections were cleared within 48 hours while 77% (20/26) of CIE-negative infections were cleared within 48 hours (P=0.106). However, presence of CIE was not associated with increased mortality (25% CIE-positive vs 35%; P=0.578) Conclusion Previous studies for CIE failed to enrich for isolates from endovascular sources, where inocula are known to be high. This study presents one of the largest endovascular source cohorts for CIE evaluation. It identifies that CIE prevalence (38%) is higher than reports from diverse infection sources (10-36%). CIE appears to predict bacteremia duration with other MSSA treatment options, suggesting mechanisms independent of blaZ and agr function for this phenomenon. Disclosures Warren Rose, PharmD, MPH, Merck (Grant/Research Support)Paratek (Grant/Research Support)

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Bowel necrosis in patient with severe case of COVID-19: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Ardian Soeselo ◽  
Wirawan Hambali ◽  
Sandy Theresia
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Critically Ill ◽  
High Mortality ◽  
Severe Case ◽  
Bowel Necrosis ◽  
Case Presentation ◽  
Gastrointestinal Manifestations ◽  
Emergent Laparotomy

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.

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