HISTOPLASMOSIS IN CHILDREN

PEDIATRICS ◽  
1964 ◽  
Vol 33 (6) ◽  
pp. 894-903
Author(s):  
Robert B. Tesh ◽  
Martha H. Shacklette ◽  
Fred H. Diercks ◽  
Daniel Hirschl
Keyword(s):  
Blood Culture ◽  
Amphotericin B ◽  
Positive Blood Culture ◽  
Clinical Studies ◽  
Blood Stream ◽  
Sulfa Drugs ◽  
Serologic Tests ◽  
Disseminated Histoplasmosis ◽  
Pulmonary Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis

Two cases of children with disseminated histoplasmosis and four with acute pulmonary histoplasmosis are presented. The unreliability of basing a diagnosis on the skin and serologic tests early in the course of the disease is stressed. A plea for cultures in those cases clinically suspected of having histoplasmosis is made. A positive blood culture obtained from one child with the acute pulmonary form of the disease lends evidence to the belief that in many cases of acute histoplasmosis, the organism is temporarily disseminated by the blood stream. Two cases of progressive, disseminated histoplasmosis, treated with sulfonamides are presented. This suggests that certain of the sulfa drugs are effective in the treatment of disseminated histoplasmosis, and that controlled clinical studies comparing the effectiveness of sulfa with Amphotericin B are needed.

scholarly journals Comparison of the Fully Automated FilmArray BCID Assay to a 4-Hour Culture Test Coupled to Mass Spectrometry for Day 0 Identification of Microorganisms in Positive Blood Cultures

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Paul O. Verhoeven ◽  
Cyrille H. Haddar ◽  
Josselin Rigaill ◽  
Nathalie Fonsale ◽  
Anne Carricajo ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Bacterial Identification ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Negative Results ◽  
Culture Identification ◽  
Tof Ms

Rapid bacterial identification of positive blood culture is important for adapting the antimicrobial therapy in patients with blood stream infection. The aim of this study was to evaluate the performance of the multiplex FilmArray Blood Culture Identification (BCID) assay by comparison to an in-house protocol based on MALDI-TOF MS identification of microcolonies after a 4-hour culture, for identifying on the same day the microorganisms present in positive blood culture bottles. One hundred and fifty-three positive bottles from 123 patients were tested prospectively by the 3 techniques of bacterial identification: 11 bottles yielding negative results by the 3 tests were considered false positive (7.2%). The reference MALDI-TOF MS technique identified 134 monomicrobial (87.6%) and 8 double infections (5.2%), which resulted in a total of 150 microorganisms. Globally, 137 (91.3%) of these 150 pathogens were correctly identified by the fully automated multiplex FilmArray BCID system at the species or genus level on day of growth detection, versus 117 (78.8%) by MALDI-TOF MS identification on nascent microcolonies after a 4-hour culture (P < 0.01). By combining the two approaches, 140 (93.5%) of the positive bottles were identified successfully at day 0. These results confirm the excellent sensitivity of the FilmArray BCID assay, notably in case of multimicrobial infection. Due to the limited number of targets included into the test, it must be coupled to another identification strategy, as that presented in this study relying on MALDI-TOF MS identification of microcolonies obtained after a very short culture period.

scholarly journals Enhanced detection ofCandidain blood cultures with the BACTEC 460 system by use of the aerobic-hypertonic (8B) medium

1990 ◽  
Vol 105 (3) ◽  
pp. 553-558 ◽  
Author(s):  
P. Yagupsky ◽  
F. S. Nolte ◽  
M. A. Menegus
Keyword(s):  
Candida Albicans ◽  
Blood Culture ◽  
Amphotericin B ◽  
Positive Blood Culture ◽  
Blood Cultures ◽  
Superior Performance ◽  
Torulopsis Glabrata ◽  
Radiometric Detection

SUMMARYThe blood culture records during the 6-year period 1984–9 were reviewed to compare the performance of the BACTEC aerobic (6B) and aerobic-hypertonic (8B) media for the recovery ofCandidaspp. andTorulopsis glabratafrom blood. There were 137 positive blood culture sets that contained both a 6B and an 8B bottle. Sixty-eight different yeasts were recovered from 65 patients including 35Candida albicans, 19C. tropicalis, 6C. parapsilosis, 4C. krusei, 1C. pseudotropicalisand 3Torulopsis glabrata. The 8B medium detected 120 of the positive cultures (87·6%) and was the only positive medium in 35 (25·6%) sets, while the 6B medium detected 102 positive cultures (74·4%) and was the only positive medium in 17 (12·4%) sets (P < 0·04). For those sets in which both bottles were positive, radiometric detection occurred first in the 8B bottle in 39 sets and first in the 6B bottle in 11 sets (P < 0·001). The superior performance of the 8B bottle was not related to the administration of amphotericin B. Cultures of stock strains ofC. albicans,C. tropicalis, andC. parapsilosisin 6B and 8B media with and without added blood confirmed the finding that 8B was substantially superior to 6B for the detection of candidaemia. It is concluded that an 8B bottle should be included in the blood culture set whenever candidaemia is suspected.

Procalcitonin Level as a Surrogate for Catheter-Related Blood Stream Infection among Hemodialysis Patients

2017 ◽  
Vol 18 (6) ◽  
pp. 498-502 ◽  
Author(s):  
Mahmoud Hamada Imam ◽  
Eman Gamal
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Positive Culture ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Spearman Correlation Test ◽  
Time Of Presentation

Introduction Catheter-related bloodstream infection (CRBSI) is a frequent complication among hemodialysis patients who usually are presented with nonspecific signs such as fever, rigors, and hypotension. Blood culture will take up to 5 days and antimicrobials will be started. Procalcitonin (PCT) is a valid marker in sepsis. Our goal in this study is to evaluate its usefulness as a diagnostic marker in detecting CRBSI among hemodialysis patients who present with suspected CRBSI. Patients and methods Thirty-one hemodialysis patients with suspected CRBSI were enrolled in this study. PCT level was measured at the time of presentation. Patients were divided into two groups according to blood culture results: positive and negative groups. PCT level and other markers for inflammation: white blood cell count (WBC), C-reactive protein (CRP), and ferritin were compared between the two groups. Statistical analysis of variables was performed using the t-test or Mann-Whitney test together with Spearman correlation test. Results Thirty-one patients had median age 44.7 ± 2.1 years. They comprised 16 males (52%) and 15 females (48%). Sixteen patients had a positive blood culture result while in 15 it was negative. PCT level was significantly higher in the positive blood culture group (40.0 ± -21.9) (95% confidence interval [CI] 28.4-51.8) while its level was 1.1 ± 1 (95% CI 0.54-1.8) in the negative blood culture group [t(15) = -7, p<0.001). In the positive culture group, there was a correlation between CRP and ferritin (r = -0.58, p = 0.01, n = 16), while no correlation between PCT and other markers of inflammation. Conclusions PCT is a useful marker for diagnosis of CRBSI among hemodialysis patients.

scholarly journals Multi-drug resistance bacteria predict mortality in blood stream infection in a tertiary setting in Tanzania

2019 ◽  
Author(s):  
Joel Manyahi ◽  
Upendo Kibwana ◽  
Edna Mgimba ◽  
Mtebe Majigo
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Case Fatality ◽  
Blood Stream ◽  
Multi Drug Resistance ◽  
Resistant Bacteria ◽  
Clinical Microbiology Laboratory ◽  
Drug Resistant

AbstractBackgroundBlood-stream infections (BSI’s) are serious and life-threatening infections associated with high mortality and morbidity. In resource limited settings, there is paucity of data on predictors of outcome in patients with BSI. This study aimed at examining the predictors of mortality in patients with BSI as well as bacteria causing BSI.Methods and MaterialsThis was cross-sectional study conducted in Muhimbili National Hospital between April and May 2018. Blood culture results from all inpatients at clinical microbiology laboratory were recorded and clinical information were retrieved retrospectively from the files. Bacteria from positive blood culture were identified and antimicrobial susceptibility was performed.ResultsThe overall prevalence of BSI was 11.4% (46/402), with case fatality rate of 37%. There was significant high rate of BSI in patient who had died compared to those survived p= 0.008. Gram-negative bacteria (74%) were the common cause of BSI, with predominance of Enterobacteriaceae (22), followed by Pseudomonas aeruginosa (11). Majority (70.5%) of the bacteria isolated from patients with BSI were multi-drug resistant. Forty six percent of Pseudomonas aeruginosa were resistance to meropenem. Sixty eight percent 68.2% (15/22) of Enterobacteriaceae were ESBL producers. Carbapenemases production were detected in 27% (3/11) of Pseudomonas aeruginosa and in one Proteus mirabillis. Forty percent (40%) of Staphylococcus aureus were methicillin resistant Staphylococcus aureus (MRSA). Positive blood culture (cOR 7.4, 95%CI 1.24 – 43.83, p 0.03) and admission in ICU cOR 4 (95%CI 1.7 – 9.41, p 0.001) were independent factors for mortality in suspected BSI. Isolation of Multi-drug resistant bacteria was independent predictor for mortality in confirmed BSI (cOR 7.4, 95%CI 1.24 – 43.83, p 0.03).ConclusionThe prevalence of BSI was 11.4%, with majority of bacteria in BSI were MDR. Positive blood culture and MDR were predictors for mortality.

Short-Course Amphotericin B Therapy for Candidemia in Pediatric Patients

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 888-891
Author(s):  
Leigh G. Donowitz ◽  
J. Owen Hendley
Keyword(s):  
Blood Culture ◽  
Amphotericin B ◽  
Positive Blood Culture ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Series ◽  
Invasive Fungal Disease ◽  
Short Course ◽  
Days Of Therapy ◽  
Intravascular Catheters

Objective. To determine the efficacy of short-course (7 to 14 days of therapy after the last positive blood culture) amphotericin B therapy for candidemia in children. Design. Case series. Setting. Tertiary care university medical center in Virginia. Patients. Thirty patients younger than 17 years of age who had candidemia between 1983 and 1990. Measurements and results. The charts of 30 children with 31 episodes of candidemia were retrospectively reviewed for patient data, dates of positive and negative cultures for Candida from blood and other sites, dates of removal of the intravascular catheters, duration and dosage of amphotericin B administration, and outcome. Eight patients had persistent candidemia and died. Five patients were treated not in accordance with the short-course recommendations. Two had relapses; 1 was cured with catheter removal alone, and 2 were successfully treated with 26 and 30 days of amphotericin B therapy. Eighteen episodes (two episodes in 1 patient) of candidemia were cured using 7 to 14 days of amphotericin B therapy after the last positive blood culture. Conclusions. Once the bloodstream is sterilized, and there is no other evidence of invasive fungal disease, 7 to 14 additional days of amphotericin B at a dose of 0.5 mg/kg per day seems adequate for treatment of candidemia in children.

scholarly journals Rapid Identification of Pathogens in Positive Blood Culture of Patients with Sepsis: Review and Meta-Analysis of the Performance of the Sepsityper Kit

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Nils G. Morgenthaler ◽  
Markus Kostrzewa
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Meta Analysis ◽  
Extraction Methods ◽  
Blood Stream ◽  
Rapid Identification ◽  
Maldi Tof

Sepsis is one of the leading causes of deaths, and rapid identification (ID) of blood stream infection is mandatory to perform adequate antibiotic therapy. The advent of MALDI-TOF Mass Spectrometry for the rapid ID of pathogens was a major breakthrough in microbiology. Recently, this method was combined with extraction methods for pathogens directly from positive blood cultures. This review summarizes the results obtained so far with the commercial Sepsityper sample preparation kit, which is now approved forin vitrodiagnostic use. Summarizing data from 21 reports, the Sepsityper kit allowed a reliable ID on the species level of 80% of 3320 positive blood culture bottles. Gram negative bacteria resulted consistently in higher ID rates (90%) compared to Gram positive bacteria (76%) or yeast (66%). No relevant misidentifications on the genus level were reported at a log(score)cut-off of 1.6. The Sepsityper kit is a simple and reproducible method which extends the MALDI-TOF technology to positive blood culture specimens and shortens the time to result by several hours or even days. In combination with antibiotic stewardship programs, this rapid ID allows a much faster optimization of antibiotic therapy in patients with sepsis compared to conventional workflows.

scholarly journals Multiple Intravitreal Liposomal Amphotericin B for a Case of Candida glabrata Endophthalmitis

2021 ◽  
pp. 485-491
Author(s):  
Daiki Sakai ◽  
Hisanori Imai ◽  
Makoto Nakamura
Keyword(s):  
Blood Culture ◽  
Amphotericin B ◽  
Positive Blood Culture ◽  
Liposomal Amphotericin ◽  
Candida Glabrata ◽  
Liposomal Amphotericin B ◽  
Safety And Efficacy ◽  
Ophthalmologic Examination ◽  
Candida Endophthalmitis ◽  
Systemic Antifungal Therapy

We report a case of <i>Candida glabrata</i> endophthalmitis which was effectively treated by intravitreal liposomal amphotericin B (L-AMB) injection. A 72-year-old man was referred to our department for positive blood culture of <i>Candida glabrata</i>. First ophthalmologic examination revealed a chorioretinal lesion in left eye, and the patient was diagnosed as possible candida chorioretinitis. Despite systemic antifungal therapy, his chorioretinal lesion increased in both eyes and complicated by vitritis. Intravitreal administration of L-AMB was introduced for probable candida endophthalmitis. Finally, improvement of vitritis and regression of chorioretinal lesions were obtained by total of 9 times intravitreal injection. Our case suggests the safety and efficacy of intravitreal L-AMB injection for <i>Candida glabrata</i> endophthalmitis.

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