scholarly journals Pyogenic Lung Abscess in an Infectious Disease Unit, a 20-year Retrospective Study

2020 ◽  
Author(s):  
Thomas Maitre ◽  
Vichita OK ◽  
Ruxandra CALIN ◽  
Ludovic LASSEL ◽  
Ana CANESTRI ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Medical Records ◽  
Lung Abscess ◽  
Bacterial Identification ◽  
Infectious Disease Unit ◽  
Younger Age ◽  
Poor Outcomes ◽  
Disease Unit

Abstract Rationale: Pyogenic lung abscesses are rare and poorly described infections. This study aimed to describe their prognostic factors.Methods: We retrospectively included all patients hospitalized between January 1st, 1998 and June 1st, 2018, with a IDC-10 diagnosis of pyogenic lung abscess, from the Diamm ® based medical records (Micro6, Nancy; France). Parasitic, mycological, or mycobacterial lung abscesses were excluded.Results: A total of 64 patients were included. Abscesses were associated with immunosuppression in 28 patients, including HIV infection and immunosuppressive therapy for 8 and 12 patients, respectively. Bacterial identification was obtained for 36 patients. Nine patients (14%) developed lung abscesses after haematogenous dissemination. They differed from bronchogenic abscesses by their younger age (p=0.03), the absence of smoking or emphysema (p=0.05), S. aureus (p=0.001) or Streptococcus spp (p=0.05) isolation, and the smaller size of their abscess (p=0.02). Overall, evolution was marked by radiological sequelae, relapse, and death. Radiological sequelae occurred more frequently during the course of bronchogenic abscesses (p=0.02), particularly when they spontaneously discharged (p=0.04). Relapses were more frequent in patients with emphysema (p=0.04) and when H. influenzae was isolated (p=0.04). In multivariate analysis, poor outcomes, including death, sequelae, and relapse occurred more frequently in patients who had bronchogenic abscess (p=0.02), and in those who received antibiotics during less than 6 weeks (p=0.05). Conclusion: Duration of antibiotic treatment of less than six weeks and bronchogenic presentation were globally associated with poor outcome of pyogenic lung abscesses. These data should be considered when proposing guidelines for the care of pyogenic lung abscesses.

scholarly journals Pyogenic lung abscess in an infectious disease unit: a 20-year retrospective study

2021 ◽  
Vol 15 ◽  
pp. 175346662110030
Author(s):  
Thomas Maitre ◽  
Vichita Ok ◽  
Ruxandra Calin ◽  
Ludovic Lassel ◽  
Ana Canestri ◽  
...  
Keyword(s):  
Medical Records ◽  
International Classification Of Diseases ◽  
Lung Abscess ◽  
Bacterial Identification ◽  
Infectious Disease Unit ◽  
Younger Age ◽  
Classification Of Diseases ◽  
Poor Outcomes ◽  
Disease Unit

Background: Pyogenic lung abscesses are rare and poorly described infections. This study aimed to describe their prognostic factors. Methods: We retrospectively included all patients hospitalized between 1 January 1998 and 1 June 2018, with an International Classification of Diseases, version 10 (IDC-10) diagnosis of pyogenic lung abscess, from the Diamm based medical records (Micro6, Nancy, France). Parasitic, fungal, or mycobacterial lung abscesses were excluded. Results: A total of 64 patients were included. Abscesses were associated with immunosuppression in 28 patients, including HIV infection and immunosuppressive therapy for eight and 12 patients, respectively. Bacterial identification was obtained for 36 patients. Nine patients (14%) developed lung abscesses after hematogenous dissemination. They differed from bronchogenic abscesses by their younger age ( p = 0.03), the absence of smoking or emphysema ( p = 0.05), Staphylococcus aureus ( p = 0.001) or Streptococcus spp. ( p = 0.05) isolation, and the smaller size of their abscess ( p = 0.02). Overall, evolution was marked by radiological sequelae (46.9%), relapse (12.5%), and death (4.8%). Radiological sequelae occurred more frequently during the course of bronchogenic abscesses ( p = 0.02), particularly when they spontaneously discharged ( p = 0.04). Relapses were more frequent in patients with emphysema ( p = 0.04) and when Haemophilus influenzae was isolated ( p = 0.04). In multivariate analysis, poor outcomes, including death, sequelae, and relapse occurred more frequently in patients who had bronchogenic abscess ( p = 0.02), and in those who received antibiotics during less than 6 weeks ( p = 0.05). Conclusion: A duration of antibiotic treatment of less than 6 weeks and bronchogenic presentation were globally associated with poor outcome of pyogenic lung abscesses. These data should be considered when proposing guidelines for the care of pyogenic lung abscesses. The reviews of this paper are available via the supplemental material section.

NOSOCOMIAL INFECTION WITH ECHOVIRUS TYPE II IN HANDICAPPED AND PREMATURE INFANTS

PEDIATRICS ◽  
1973 ◽  
Vol 51 (4) ◽  
pp. 603-607
Author(s):  
Henry G. Cramblett ◽  
Ralph E. Haynes ◽  
Parvin H. Azimi ◽  
Milo D. Hilty ◽  
Michael H. Wilder
Keyword(s):  
Infectious Disease ◽  
Premature Infants ◽  
Index Case ◽  
Hand Washing ◽  
Type Ii ◽  
Bacterial Sepsis ◽  
Infectious Disease Unit ◽  
Short Period ◽  
Echovirus Type ◽  
Disease Unit

This report describes an outbreak of nosocomial infections due to echovirus type 11 among premature and/or handicapped infants in an intensive care unit. Four patients became ill within a short period of time and echovirus 11 was recovered from several of their specimens. The illnesses were clinically suggestive of bacterial sepsis and/or bacterial meningitis. Each of the four infants who became ill was in an isolette for a period of from 20 to 54 days before onset of illness. Three of the four patients became ill within 24 hours of one another which suggested a common exposure at nearly the same time. No index case could be identified, but it appears that this outbreak of enteroviral infections was due to inadequate hand washing by personnel. The outbreak was halted by removing the infants to an infectious disease unit and by closing the involved unit to new admissions for seven days.

Prognostic Factors Influencing Survival in Solitary Plasmacytoma: A SEER Database Analysis.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1670-1670
Author(s):  
Paul Mehan ◽  
Giridharan Ramsingh ◽  
Jingqin Luo ◽  
Daniel Morgansztern ◽  
Ravi Vij
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Solitary Plasmacytoma ◽  
Seer Database ◽  
Disease Specific Survival ◽  
Factors Influencing ◽  
Younger Age ◽  
Disease Specific

Abstract Solitary plasmacytoma (PCM) is a focal, neoplastic, plasma cell disorder without evidence of systemic disease. While PCM is a clinically distinct entity, survival can be limited by progression to multiple myeloma. Prior studies have attempted to identify factors influencing survival in PCM but have been limited by small patient cohorts. This study identified 1472 patients with PCM using the SEER database between 1988 and 2004. The median age of the patients was 64 years (range 12–97), 65.4% male, 34.6% female, 83% Caucasians, 10.7% African Americans and 6.3% other races. 63.8% had medullary PCM and 36.2% extramedullary PCM. 84% of medullary PCM occurred in axial skeleton and the rest in appendicular skeleton. Extramedullary PCM most frequently occurred in the head and neck region (51.4%) followed by skin/subcutaneous tissue (16.2%), GI tract 6% and other sites (26.4%). 55.2% were treated with radiation therapy alone, 29.5% with radiation therapy and surgery and 15.3% with surgery alone. 558 died during this period and the mean overall survival was 6.83 years (range, 0–16.9). The cause of death was multiple myeloma in 49.6%, other cancers 20.9% and cardiovascular diseases 12.9%. In all patients, survival probability at one year was 87.6% (95% CI, 85–89%), at five years was 58.9% (95% CI, 56–62%), and at 10 years was 40.0% (95% CI, 36–44%). The five year overall survival in the ≤40yo cohort was 83.5% as compared to 76.7% and 44.8% in the 40–60yo and >60yo groups, respectively (p<0.0001). The five year disease specific survival probability in the ≤40yo cohort was 94.5% as compared to 86.0% and 66.2% in the 40–60yo group and >60yo group, respectively (p<0.0001) (figure 1)). Overall survival in the extramedullary PCM was 65.9% at five years as compared to 54.6% in the medullary PCM (p<0.0001) and the disease specific survival in the extramedullary PCM was 86.2% compared to 70.1% in the medullary PCM (p<0.0001) (figure 1). Multivariate analysis of disease specific survival revealed that younger age, male gender, extramedullary type, and race other than African American or Caucasian were favorable prognostic factors (Table 1). Younger age, extramedullary site, treatment with XRT + surgery, and race other than African Americans were associated with improved overall survival by multivariate analysis (Table 1). To our knowledge, this is the largest published review of survival in PCM. This study identifies several prognostic risk factors influencing survival in PCM. These risk factors can be used to identify patients at high risk for progression to multiple myeloma. Those at highest risk could be considered for future trials comparing adjuvant systemic therapy compared to local therapy alone. Table 1. Multivariate Analysis of Prognostic Factors Disease Specific Survival Overall Survival Variable Category HR 95% CI P HR 95%CI P Abbreviations: HR, Hazard Ratio; Q, Confidence Inverval Sex Female --- -- --- -- --- --- Male 0.74 0.58~ 0.94 0.01 0.95 0.80~1.13 0.57 Age <40yo --- --- --- --- --- --- 40–60yo 2.68 115~ 6.2 0.02 1.74 1.04~2.91 0.03 >60yo 6.94 3.06~ 15.73 <0.01 5.55 3.40~9.06 <0.01 Race Black --- --- --- --- --- --- White 0.74 0.52~ 1.06 0.1 0.72 0.56~0.92 0.01 Others 0.31 0.13~ 0.75 <0.01 0.48 0.29~0.79 <0.01 Primary Site Extramedullary --- --- --- --- --- --- Medullary 2.35 1.74~.3.18 <0.01 1.37 1.13~1.65 <0.01 Treatment Surgery Only --- --- --- --- --- --- XRT Only 0.90 0.62~ 1.31 0.59 0.82 0.64~1.04 0.10 XRT + Surgery 0.84 0.55~1.26 0.39 0.68 0.52~0.89 <0.01 Period 1988–1993 --- --- --- --- --- --- 1994–1999 0.96 0.72~1.30 0.8 0.96 0.78~1.19 0.74 2000–2004 0.94 0.68~1.30 0.7 0.94 0.75~1.18 0.6 Figure 1: Figure 1:.

scholarly journals A prospective pharmacovigilance study in the infectious diseases unit of a tertiary care hospital

2019 ◽  
Vol 13 (07) ◽  
pp. 649-655 ◽  
Author(s):  
Berna Karaismailoglu ◽  
Nese Saltoglu ◽  
Ilker Inanc Balkan ◽  
Bilgul Mete ◽  
Fehmi Tabak ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Risk Factors ◽  
Teaching Hospital ◽  
Significant Risk ◽  
Care Hospital ◽  
Infectious Disease Unit ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Tissue Reactions ◽  
Disease Unit

Introduction: The frequency, causality, severity, preventability and risk factors of ADRs (adverse drug reactions) in infectious disease units are not well defined in the literature. Thus, the aim of this study was to determine the characteristics of the ADRs encountered in an infectious disease unit of a tertiary teaching hospital. Methodology: The patients who were admitted to the infectious disease unit of a tertiary teaching hospital longer than 24 hours between January and December of 2016 were followed prospectively. Patients were observed and questioned for any sign of ADRs. The proportion of ADRs and patient characteristics were investigated. Causality was evaluated by the Naranjo algorithm, severity was determined using the Hartwig classification, and preventability was assessed using the Schumock and Thornton scale. Results: 210 patients were admitted to the unit during the study period, of whom 44 patients (20.9%) experienced 51 ADRs. 5.9% of ADRs were found to be serious according to the Hartwig severity classification. In addition, 88.1% of ADRs were not preventable. The most frequently detected ADR was skin and subcutaneous tissue reactions (33.3%), and systemic antimicrobials were the most common type of drugs that caused an ADR. Prolonged hospitalization (p < 0.001) and usage of an increased number of drugs (p < 0.001) were found to be significant risk factors for ADR development. Conclusions: Prolonged hospital stay and polypharmacy are significant risk factors that increase the incidence of ADRs in infectious disease units. The likelihood of unavoidable ADRs should arouse the attention of clinicians when prescribing antimicrobials.

scholarly journals The Complexity, Relative Value, and Financial Worth of Curbside Consultations in an Academic Infectious Disease Unit

2011 ◽  
Vol 52 (4) ◽  
pp. 557-557 ◽  
Author(s):  
C. Grace ◽  
W. K. Alston ◽  
M. Ramundo ◽  
L. Polish ◽  
B. Kirkpatrick ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Disease Unit ◽  
Relative Value ◽  
Disease Unit

scholarly journals The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit Outside the Emergency Department

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S187-S188
Author(s):  
Jun Sik Kang ◽  
Hee Yoon ◽  
Byung Woo Jhun ◽  
Seong Mi Lim ◽  
Eun Sil Ko ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Emergency Department ◽  
Patient Evaluation ◽  
Infectious Disease Unit ◽  
Disease Unit

scholarly journals The Profile of Health Problems in African Immigrants Attending an Infectious Disease Unit in Melbourne, Australia

2009 ◽  
Vol 80 (5) ◽  
pp. 805-811 ◽  
Author(s):  
Katherine B. Gibney ◽  
Caroline Marshall ◽  
Joseph Torresi ◽  
Beverley-Ann Biggs ◽  
Karin Leder ◽  
...  
Keyword(s):  
Infectious Disease ◽  
African Immigrants ◽  
Health Problems ◽  
Infectious Disease Unit ◽  
Disease Unit

scholarly journals Severe Herpes Zoster Infection in the United Kingdom: Experience in a Regional Infectious Disease Unit

1989 ◽  
Vol 82 (3) ◽  
pp. 145-146 ◽  
Author(s):  
P Bannister ◽  
B Crosse
Keyword(s):  
Infectious Disease ◽  
Herpes Zoster ◽  
Elderly Patients ◽  
Complication Rate ◽  
Herpes Zoster Infection ◽  
Infectious Disease Unit ◽  
Duration Of Hospital Stay ◽  
The United Kingdom ◽  
Acyclovir Therapy ◽  
Disease Unit

Seventy-three cases of severe herpes zoster infection admitted to a regional infectious disease unit over a 3-year period were reviewed. Complications were common. Elderly patients were in the majority (55%), were hospitalized for longer and accounted for 78% of all complications. Acyclovir therapy was used in 44 cases with a reduction in both the duration of hospital stay and complication rate.

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