Ibrutinib-associated necrotic nasal lesion and pulmonary infiltrates

2021 ◽  
Vol 14 (1) ◽  
pp. e237085
Author(s):  
Christopher Saling ◽  
Fionna Feller ◽  
Holenarasipur R Vikram
Keyword(s):  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Blood Culture ◽  
Lymphocytic Leukaemia ◽  
Invasive Pulmonary Aspergillosis ◽  
Necrotic Lesion ◽  
Tissue Necrosis ◽  
Pulmonary Aspergillosis ◽  
Ecthyma Gangrenosum ◽  
First Case

Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grew Pseudomonas aeruginosa. A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. To our knowledge, this is the first case of ecthyma gangrenosum secondary to Pseudomonas sepsis and concurrent invasive pulmonary aspergillosis associated with ibrutinib use.

scholarly journals Putative invasive pulmonary aspergillosis within medical wards and intensive care units: a 4-year retrospective, observational, single-centre study

2021 ◽  
Author(s):  
Silvia Corcione ◽  
Tommaso Lupia ◽  
Stefania Raviolo ◽  
Giorgia Montrucchio ◽  
Alice Trentalange ◽  
...  
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Hospital Admissions ◽  
Invasive Pulmonary Aspergillosis ◽  
Positive Culture ◽  
Lower Airway ◽  
Organ Support ◽  
Pulmonary Aspergillosis ◽  
Medical Wards

AbstractBlot and colleagues have proposed putative invasive pulmonary aspergillosis (PIPA) definitions for troublesome diagnosis in suspected patients outside the classical criteria of immunosuppression. We retrospectively included in the study all admitted patients with an Aspergillus spp. positive culture within lower airway samples. Overall, Aspergillus spp. positivity in respiratory samples was 0.97 every 1000 hospital admissions (HA): 4.94 and 0.28/1000/HA, respectively, in intensive care units (ICUs) and medical wards (MW). 66.6% fulfilled PIPA criteria, and 33.4% were defined as colonized. 69.2% of PIPA diagnosis occurred in the ICU. Antifungal therapy was appropriate in 88.5% of subjects with PIPA and 37.5% of colonized, confirming the comparison between deads and lives. Patients with PIPA in the ICUs had more frequent COPD, sepsis or septic shock, acute kidney injury (AKI), needed more surgery, mechanical ventilation (MV), vasopressors, hemodialysis, blood or platelets transfusions. PIPA in MW had associated with a history of smoking, interstitial lung disease and inhaled steroid therapy. Overall mortality within 21 days was 50%: 54.2% in ICU, 36,8% in MW. Factors associated with death were length of hospitalization, influenza, pneumonia, liver transplant, AKI, ARDS, sepsis and septic shock. PIPA in the ICU had higher disease severity and needed more organ support than MW cases, despite that cases of PIPA in MW are emerging with trends difficult to demonstrate given the problematic diagnosis.

scholarly journals Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia.

2020 ◽  
Author(s):  
huiting xu ◽  
Jie Cheng ◽  
Qinghong Yu ◽  
Qingyuan Li ◽  
Qian Yi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Time To Positivity ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background: Pseudomonas aeruginosa (P. aeruginosa) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia.Methods: From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock.Results: Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 hours. Early TTP (≤18 hours) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P=0.014), higher incidence of septic shock (52.4% vs12.9%, P=0.06), higher Pitt bacteremia scores [3.00 (1.00-5.00) vs 1.00 (1.00-4.00), P=0.046] and more intensive care unit admission (61.9% vs 22.6%, P=0.008) when compared with late TTP (>18 hours) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21-21.96, P=0.035; OR 4.95, 95%CI 1.26-27.50, P=0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18-33.77, P=0.032; OR 8.15, 95%CI 1.15-42.43, P=0.014; OR 6.46, 95% CI 1.19-33.19 P=0.031; respectively).Conclusions: Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.Trial registration: Retrospectively registered. File No. (2019)304

scholarly journals Post‐COVID‐19 co‐morbidity of emerged Lophomonas infection and invasive pulmonary aspergillosis: First case report

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Ali Sharifpour ◽  
Zakaria Zakariaei ◽  
Mahdi Fakhar ◽  
Elham Sadat Banimostafavi ◽  
Maryam Nakhaei ◽  
...  
Keyword(s):  
Case Report ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
First Case ◽  
Co Morbidity

scholarly journals Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Huiting Xu ◽  
Jie Cheng ◽  
Qinghong Yu ◽  
Qingyuan Li ◽  
Qian Yi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Time To Positivity ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background Pseudomonas aeruginosa (P. aeruginosa) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia. Methods From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock. Results Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 h. Early TTP (≤18 h) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P = 0.014), higher incidence of septic shock (52.4% vs12.9%, P = 0.06), higher Pitt bacteremia scores [3.00 (1.00–5.00) vs 1.00 (1.00–4.00), P = 0.046] and more intensive care unit admission (61.9% vs 22.6%, P = 0.008) when compared with late TTP (> 18 h) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21–21.96, P = 0.035; OR 4.95, 95%CI 1.26–27.50, P = 0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18 h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18–33.77, P = 0.032; OR 8.15, 95%CI 1.15–42.43, P = 0.014; OR 6.46, 95% CI 1.19–33.19 P = 0.031; respectively). Conclusions Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.

scholarly journals Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia.

2020 ◽  
Author(s):  
huiting xu ◽  
Jie Cheng ◽  
Qinghong Yu ◽  
Qingyuan Li ◽  
Qian Yi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Time To Positivity ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background Pseudomonas aeruginosa ( P. aeruginosa ) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia. Methods From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. 52 case were analyzed. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock. Results Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 hours. Early TTP (≤18 hours) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P=0.014), higher incidence of septic shock (52.4% vs 12.9%, P=0.06), higher Pitt bacteremia scores [3.00 (1.00-5.00) vs 1.00 (1.00-4.00), P=0.046] and more intensive care unit admission (61.9% vs 22.6%, P=0.008) when compared with late TTP (>18 hours) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21-21.96, P=0.035; OR 4.95, 95%CI 1.26-27.50, P=0.024; respectively). The study also revealed that the independent risk factors for septic shock were as follows: TTP≤18h, Pitt bacteremia scores≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18-33.77, P=0.032; OR 8.15, 95%CI 1.15-42.43, P=0.014; OR 6.46, 95% CI 1.19-33.19 P=0.031; respectively). Conclusions Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.

scholarly journals Pseudomonas aeruginosa septic shock associated with ecthyma gangrenosum in an infant with agammaglobulinemia

2002 ◽  
Vol 44 (3) ◽  
pp. 167-169 ◽  
Author(s):  
João Fernando Lourenço de ALMEIDA ◽  
Jaques SZTAJNBOK ◽  
Eduardo Juan TROSTER ◽  
Flávio Adolfo Costa VAZ
Keyword(s):  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Intravenous Immunoglobulin ◽  
Invasive Infection ◽  
Ecthyma Gangrenosum ◽  
Antibiotic Coverage

Ecthyma gangrenosum (EG) due to Pseudomonas aeruginosa is a rare and invasive infection that can be associated with agammaglobulinemia. The cornerstone of the treatment is based on prompt recognition with appropriate antibiotic coverage and intravenous immunoglobulin. The authors report a case of EG emphasizing the clinical and therapeutic aspects of this condition.

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