scholarly journals Differences inRhodococcus equiInfections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Praveen Gundelly ◽  
Yasuhiro Suzuki ◽  
Julie A. Ribes ◽  
Alice Thornton
Keyword(s):  
Antibiotic Susceptibility ◽  
Immune Status ◽  
Case Series ◽  
Clinical Isolates ◽  
Immunocompromised Patients ◽  
Hiv Patients ◽  
Zoonotic Pathogen ◽  
The Us ◽  
Life Threatening ◽  
Immunocompetent Patients

Rhodococcus equiis an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients withR. equiinfection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P<0.0001). Mortality inR. equi-infected HIV patients was lower in the HAART era (8%) than in pre-HAART era (56%) (P<0.0001), suggesting that HAART improves prognosis in these patients. Most (85–100%) of clinical isolates were susceptible to vancomycin, clarithromycin, rifampin, aminoglycosides, ciprofloxacin, and imipenem. Interestingly, there was a marked difference in susceptibility of the isolates to cotrimoxazole between Europe (35/76) and the US (15/15) (P<0.0001). Empiric treatment ofR. equiinfection should include a combination of two antibiotics, preferably selected from vancomycin, imipenem, clarithromycin/azithromycin, ciprofloxacin, rifampin, or cotrimoxazole. Local antibiograms should be checked prior to using cotrimoxazole due to developing resistance.

scholarly journals COVID-19 in HIV: a Review of Published Case Reports

2020 ◽  
Vol 2 (12) ◽  
pp. 2647-2657
Author(s):  
Zoya Morani ◽  
Saumil Patel ◽  
Sudeshna Ghosh ◽  
Falah Abu Hassan ◽  
Shriya Doreswamy ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Web Of Science ◽  
Case Reports ◽  
Case Series ◽  
Hiv Patients ◽  
High Burden ◽  
Cardiovascular Comorbidities ◽  
Life Threatening ◽  
The Mean ◽  
Immunocompromised State

AbstractPatients with COVID-19 present with a myriad of comorbidities. An immunocompromised state like HIV in patients with COVID-19 can be life-threatening. We searched PubMed/Medline, Scopus, and Web of Science for case reports and case series about COVID-19 in HIV patients. We finally reviewed 20 case reports including cases of 43 patients with HIV and COVID-19. The mean age of 43 adult patients was 51.56 ± 27.56 years (range 24–76 years). Of these, 30 were male (69.77%), 11 were female (25.58%), and 2 were transgender (4.65%). A total of 25 patients (58.14%) were above 50 years of age. The most common cardiovascular comorbidities were hypertension and hyperlipidemia (48.8%), diabetes (20.93%), and morbid obesity (11.63%). Out of 43 HIV patients with COVID-19, 6 resulted in death (13.95%). All the patients who died were elderly above 50 years and required mechanical ventilation. HIV patients infected with COVID-19 had a high mortality rate. A high burden of pre-existing comorbidities and an advanced age in these patients make them prone to disease progression and worse outcomes.

scholarly journals Evaluation of cellular and humoral indicators immunity in the treatment of various types of sepsis in immunocompromised hemoblastosis patients

2019 ◽  
Vol 21 (2) ◽  
pp. 43-47
Author(s):  
A K Yurkin
Keyword(s):  
Myeloid Leukemia ◽  
Immune Status ◽  
Intensive Therapy ◽  
Infectious Complications ◽  
Immunocompromised Patients ◽  
Lymphoproliferative Diseases ◽  
Life Threatening ◽  
Cellular And Humoral Immunity ◽  
Causes Of Deaths ◽  
Acute Myeloid

It was established that the course and development of sepsis in patients with hemoblastosis, are held against the background of complex violations of indicators of cellular and humoral immunity. However, in patients with acute myeloid leukemia, they are more pronounced, which most likely explains the higher mortality rate in this group of patients compared with patients suffering from lymphoproliferative diseases. Some features of the development of post-cytotoxic complications after chemotherapy in patients with hemoblastosis are identified. In addition, the most significant predictors of post-cytotoxic complications in patients with hemoblastosis, who are most susceptible to post-cytotoxic infectious complications and life- threatening emergency conditions, have been identified. The most probable causes of deaths in primary and secondary immunodeficiencies of the cytotoxic type in immunocompromised patients suffering from hemoblastosis with proven sepsis on the background of neutropenia after polychemotherapy are presented. Revealed some post-cytotoxic complications that significantly affect the course and outcome of the disease in patients with hemoblastosis. The nature of these complications and emergency conditions allows you to determine the volume and priority of ongoing proactive intensive therapy after polychemotherapy in the period of neutropenia or agranulocytosis, on the background of a violation of the immune status of patients. An assessment of some humoral and cellular indicators of the immune status of patients with various types of proven sepsis is given.

scholarly journals Epidemiological Survey of Head and Neck Injuries and Trauma in the United States

2014 ◽  
Vol 151 (5) ◽  
pp. 776-784 ◽  
Author(s):  
Rosh K. V. Sethi ◽  
Elliott D. Kozin ◽  
Peter J. Fagenholz ◽  
Daniel J. Lee ◽  
Mark G. Shrime ◽  
...  
Keyword(s):  
Head And Neck ◽  
Case Series ◽  
The United States ◽  
Epidemiological Survey ◽  
Common Procedure ◽  
Weighted Estimates ◽  
Patient Disposition ◽  
Depth Analysis ◽  
The Us ◽  
Life Threatening

Objective Head and neck trauma results in a range of injuries, spanning minor lacerations to life-threatening airway compromise. Few studies provide in-depth analysis of injuries to the head and neck (HN). We aim to (1) describe HN injury prevalence in the US and (2) investigate patient disposition and the outcome of mortality. Study Design Case series with chart review. Setting Nationwide emergency department (ED) sample. Methods The 2011 database was queried for encounters with a primary diagnosis of HN injury, as categorized by the Barell Injury Matrix. Weighted estimates for demographics, injury category, and mechanism were extracted. Predictors of mortality and admission were determined by multivariable regression. Results We identified 131 million ED encounters. A weighted total of 5,418,539 visits were related to primary HN injuries. Average age was 30 (SE = 0.4), and 56.8% were male. Sixty-four percent of injuries were attributed to fall or blunt trauma. Open wounds comprised 41.8% of injuries. The most common procedure was laceration repair (70%). The majority of patients (97%) were discharged home. Mortality rate was less than 1%. Predictors of admission and mortality ( P < .05) included multiple trauma, vessel trauma, and burns. Other risk factors included foreign-body, older age, and male gender. Conclusions Primary HN injuries commonly present to emergency rooms in the US. The majority of HN injuries are non–life threatening and do not require admission to the hospital or result in death. These data have implications for HN injury surveillance and may be used to risk-stratify patients who present with injuries in the acute care setting.

scholarly journals Invasive Saprochaete Infections: An Emerging Threat to Immunocompromised Patients

Pathogens ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 922
Author(s):  
Said El Zein ◽  
Joya-Rita Hindy ◽  
Souha S. Kanj
Keyword(s):  
Fungal Pathogens ◽  
Case Reports ◽  
Antifungal Susceptibility ◽  
Case Series ◽  
Source Control ◽  
Immunocompromised Patients ◽  
Tissue Samples ◽  
Flight Mass Spectrometry ◽  
Life Threatening

Saprochaete clavata and Saprochaete capitata are emerging fungal pathogens that are responsible for life threatening infections in immunocompromised patients, particularly in the setting of profound neutropenia. They have been associated with multiple hospital outbreaks mainly in Europe. In this article, we present a comprehensive review of the epidemiology, clinical presentation, diagnosis, antifungal susceptibility and treatment of these organisms. The diagnosis of invasive Saprochaete disease is challenging and relies primarily on the isolation of the fungi from blood or tissue samples. Both species are frequently misidentified as they are identical macroscopically and microscopically. Internal transcribed spacer sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry are useful tools for the differentiation of these fungi to a species level. Saprochaete spp. are intrinsically resistant to echinocandins and highly resistant to fluconazole. Current literature suggests the use of an amphotericin B formulation with or without flucytosine for the initial treatment of these infections. Treatment with extended spectrum azoles might be promising based on in vitro minimum inhibitory concentration values and results from case reports and case series. Source control and recovery of the immune system are crucial for successful therapy.

scholarly journals Special Issue: Mucorales and Mucormycosis

2019 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Eric Dannaoui ◽  
Michaela Lackner
Keyword(s):  
Immunocompromised Patients ◽  
Special Issue ◽  
Traumatic Injuries ◽  
Life Threatening ◽  
Immunocompetent Patients

Mucormycosis is a life-threatening infection, occurring mainly in immunocompromised patients, but also in immunocompetent patients after traumatic injuries [...]

scholarly journals Evaluation of the corticosteroid dose at Pneumocystis pneumonia onset in non-HIV patients receiving steroids and the period from the discontinuation of trimethoprim-sulfamethoxazole prophylaxis to the onset of Pneumocystis pneumonia

2021 ◽  
Author(s):  
Daiki Inoue ◽  
Hirotaka Tamesada ◽  
Tomoki Maetani ◽  
Sho Yamada ◽  
Yujiro Kikuchi ◽  
...  
Keyword(s):  
Clinical Information ◽  
Pneumocystis Pneumonia ◽  
Equivalent Dose ◽  
Immunocompromised Patients ◽  
Hiv Patients ◽  
Corticosteroid Dose ◽  
Immunodeficiency Virus ◽  
Median Period ◽  
Life Threatening ◽  
Prophylactic Use

Abstract Background Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection among non-human immunodeficiency virus (non-HIV) immunocompromised patients. The prophylactic use of trimethoprim-sulfamethoxazole (TMP-SMX) reduces PCP incidence. However, it remains unclear when TMP-SMX can be safely discontinued among patients for whom corticosteroid tapering is underway, and occasionally, PCP develops after TMP-SMX discontinuation despite tapering of corticosteroids to considerably lower dose. Methods We retrospectively reviewed non-HIV immunocompromised patients who were diagnosed with PCP in our institution during a 12-year period (January 2007 to December 2018). We analysed the clinical information including corticosteroid doses when PCP developed and the period from TMP-SMX discontinuation to PCP onset for these patients. Results In all, 39 patients were included. The median patient age was 70 years (range: 27–92 years), and 18 patients (46.2%) were female. Thirty-two patients (82.1%) were administered corticosteroids. The median daily corticosteroid dose converted to the prednisolone equivalent dose was 14 mg (range: 2–60 mg). Further, six (15.4%) patients were treated with a dose of 5 mg or less. Twenty-eight patients (71.8%) were never administered TMP-SMX, and TMP-SMX was discontinued before PCP development in the remaining 11 patients. The median period from TMP-SMX discontinuation to PCP development was 95 days (range: 44–175 days), and in nine patients, PCP developed 14 ± 2 weeks after TMP-SMX discontinuation. Conclusions PCP developed in non-HIV patients treated with corticosteroids at doses considerably lower than the daily 20 mg prednisolone equivalent dose. Non-HIV immunocompromised patients are more likely to develop PCP approximately 3 months after TMP-SMX discontinuation.

scholarly journals Case Series of Three Patients with Rifampicin-Induced Thrombocytopenia

2020 ◽  
Author(s):  
Chandramouli M.T
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Effective Drug ◽  
Antitubercular Drugs ◽  
Short Course ◽  
Life Threatening

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Macrophage Activation Syndrome in Adults: A Retrospective Case Series

2021 ◽  
Vol 9 ◽  
pp. 232470962110264
Author(s):  
Taylor Warmoth ◽  
Malvika Ramesh ◽  
Kenneth Iwuji ◽  
John S. Pixley
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Pediatric Patients ◽  
Inflammatory Diseases ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Case Series ◽  
Adult Patients ◽  
Retrospective Case ◽  
Life Threatening ◽  
Activation Syndrome

Macrophage activation syndrome (MAS) is a form of hemophagocytic lymphohistocytosis that occurs in patients with a variety of inflammatory rheumatologic conditions. Traditionally, it is noted in pediatric patients with systemic juvenile idiopathic arthritis and systemic lupus erythematous. It is a rapidly progressive and life-threatening syndrome of excess immune activation with an estimated mortality rate of 40% in children. It has become clear recently that MAS occurs in adult patients with underlying rheumatic inflammatory diseases. In this article, we describe 6 adult patients with likely underlying MAS. This case series will outline factors related to diagnosis, pathophysiology, and review present therapeutic strategies.

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