A Unique Case of Cutaneous Cunninghamella infection in an Immunocompromised Patient (Preprint)

2020 ◽  
Author(s):  
Mauricio Portillo ◽  
Shyam Allamaneni ◽  
Richard Goodman
Keyword(s):  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Lymphocytic Leukemia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Unique Case ◽  
Systemic Complications ◽  
Prompt Treatment ◽  
Mode Of Transmission ◽  
And Control

UNSTRUCTURED Cunninghamella species are an extremely rare cause of fungal infections. The usual mode of transmission is through inhalation however rare cases of cutaneous spread have been reported. The objective of this clinical case report is to highlight the uniqueness of which the patient acquired the infection, the progression, and control of it. A 57-year-old male with chronic lymphocytic leukemia was found to have an abscess next to his peripherally inserted central catheter (PICC) line. The abscess culture grew back Cunninghamella and was debrided and treated with a novel antifungal. The fungal infection was controlled and the total timeframe took 28 days. Rapid recognition and prompt treatment demonstrate the prevention of rapidly progressive angioinvasian and further systemic complications. This case also proves that a novel antifungal may be appropriate in controlling the spread of Cunninghamella species.

Trimethoprim-Sulfamethoxazole–Induced Stevens-Johnson Syndrome

2010 ◽  
Vol 100 (4) ◽  
pp. 299-303 ◽  
Author(s):  
Michael R. Langlois ◽  
Francis Derk ◽  
Ronald Belczyk ◽  
Thomas Zgonis
Keyword(s):  
Adverse Reaction ◽  
Case Report ◽  
Toxic Epidermal Necrolysis ◽  
Stevens Johnson Syndrome ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Unique Case ◽  
Diabetic Foot Infections ◽  
Johnson Syndrome ◽  
Antibiotic Drug

Stevens-Johnson syndrome and toxic epidermal necrolysis are rare; however, when they occur, they usually present with severe reactions in response to medications and other stimuli. These reactions are characterized by mucocutaneous lesions, which ultimately lead to epidermal death and sloughing. We present a unique case report of Stevens-Johnson syndrome and associated toxic epidermal necrolysis in a 61-year-old man after treatment for a peripherally inserted central catheter infection with trimethoprim-sulfamethoxazole. This case report reviews a rare adverse reaction to a commonly prescribed antibiotic drug used in podiatric medical practice for the management of diabetic foot infections. (J Am Podiatr Med Assoc 100(4): 299–303, 2010)

Chlorhexidine-coated peripherally inserted central catheters reduce fibroblastic sleeve formation in an in vivo ovine model

2018 ◽  
Vol 19 (6) ◽  
pp. 644-650 ◽  
Author(s):  
Charles J Sylvia ◽  
Molly A Wagel ◽  
Kamna Giare-Patel ◽  
Taylor A Spangler ◽  
Eugene M Breznock ◽  
...  
Keyword(s):  
Untreated Control ◽  
Blood Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Ovine Model ◽  
Peripherally Inserted Central Catheters ◽  
Complete Blood Counts ◽  
And Control ◽  
Central Catheters

Purpose: This study compared an antimicrobial and anti-thrombogenic peripherally inserted central catheter treated with a chlorhexidine-based technology, a peripherally inserted central catheter with bulk distributed fluoro-oligomers, and a poly 2-methoxyethyl acrylate–based peripherally inserted central catheter to an untreated peripherally inserted central catheter (control) in an ovine model at 14 and 30 days post-implant. Methods: One of four types of peripherally inserted central catheters was surgically implanted into the left jugular vein of each of 18 sheep for 14 or 30 days. Blood analysis consisted of complete blood counts, serum chemistries, and coagulation (fibrinogen, prothrombin time, and partial thromboplastin time) profiles. Sheep were sacrificed to examine the vein and thorax. Histological analysis was performed on serial catheter sections using standard microscopy on hematoxylin and eosin–stained tissues. Results: All catheters developed fibroblastic sleeves at both 14 and 30 days. The chlorhexidine-peripherally inserted central catheter showed a 64% lower mean fibroblastic sleeve weight and a 66% shorter mean fibroblastic sleeve length compared to the untreated control at 14 days. By 30 days, compared to untreated control, the chlorhexidine-peripherally inserted central catheter showed 81% lower mean fibroblastic sleeve weight with 75% shorter mean fibroblastic sleeve length, the fluoro-oligomer-peripherally inserted central catheter showed 54% lower mean sheath weight with 40% shorter mean fibroblastic sleeve length, and the poly 2-methoxyethyl acrylate-peripherally inserted central catheter had 41% lower mean fibroblastic sleeve weight with 57% lower fibroblastic sleeve length. Conclusion: Among the three anti-thrombogenic peripherally inserted central catheter technologies, the chlorhexidine-peripherally inserted central catheter had the smallest fibroblastic sleeves, followed by the fluoro-oligomer-peripherally inserted central catheter, poly 2-methoxyethyl acrylate-peripherally inserted central catheter, and control peripherally inserted central catheter.

Detection of peripherally inserted central catheter (PICC) in chest X-ray images: A multi-task deep learning model

2020 ◽  
Vol 197 ◽  
pp. 105674
Author(s):  
Dingding Yu ◽  
Kaijie Zhang ◽  
Lingyan Huang ◽  
Bonan Zhao ◽  
Xiaoshan Zhang ◽  
...  
Keyword(s):  
Deep Learning ◽  
Learning Model ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
X Ray ◽  
Chest X Ray ◽  
Deep Learning Model

scholarly journals Catheter to vein ratio and risk of peripherally inserted central catheter (PICC)-associated thrombosis according to diagnostic group: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045895
Author(s):  
Rebecca Sharp ◽  
Peter Carr ◽  
Jessie Childs ◽  
Andrew Scullion ◽  
Mark Young ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Primary Outcome Measure ◽  
Diagnostic Group ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Characteristic Analysis

ObjectivesDetermine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group.DesignRetrospective cohort study.Setting4 tertiary hospitals in Australia and New Zealand.ParticipantsAdults who had undergone PICC insertion.Primary outcome measureSymptomatic thrombus of the limb in which the PICC was inserted.Results2438 PICC insertions were included with 39 cases of thrombosis (1.6%; 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30; 95% CI 1.202 to 4.383; p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions.ConclusionsAdherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.

scholarly journals Comparison of different techniques for the management of venous steno-occlusive lesions during placement of peripherally inserted central catheter

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woo Jin Yang ◽  
Danbee Kang ◽  
Ji Hoon Shin ◽  
Eun Ho Jang ◽  
Seung Yeon Noh ◽  
...  
Keyword(s):  
Clinical Success ◽  
Alternative Pathway ◽  
Transluminal Angioplasty ◽  
Second Line ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Success Rates ◽  
Initial Attempt ◽  
Technical Success Rate ◽  
Occlusive Lesion

AbstractThe purpose of this study is to investigate strategies for peripherally inserted central catheter (PICC) placement in patients with venous steno-occlusive lesion (VSOL). We performed a retrospective cohort study in adults with central or peripheral VSOL who underwent PICC placement procedures from January 2015 to December 2018. Four different strategies [selecting alternative pathway/over the wire (SAP/OTW), percutaneous transluminal angioplasty (PTA), re-puncture in ipsilateral arm (RIA), and catheter placement in the contralateral arm (CICA)] were analyzed and we compared the clinical outcomes by strategy and compared the strategy between central and peripheral VSOLs. During 4 years, 258 PICC procedures performed in patients with VSOLs, 100 PICC were included in the analysis. The overall technical success rate of initial attempt with SAP/OTW was 32.2%. As a second-line technique, PTA was most frequently used in both central (100%) and peripheral (68.2%) VSOL groups. The clinical success rates within 2 months of SAP/OTW, PTA, RIA, CICA were 55.2%, 43.2%, 14.3%, and 33.3%, respectively (P = 0.24). In conclusion, when the SAP/OTW failed, the PTA can be preferred as a second-line technique for both central and peripheral VSOLs. When guidewire passage fails, the operator could adopt the RIA or CICA technique as an alternative method.

Hindrances of peripherally inserted central catheter care of leukemia patients: a qualitative study

2021 ◽  
Author(s):  
Ya-ting Ai ◽  
Hui Hu ◽  
Chong-ming Yang ◽  
Xuan Zhou ◽  
Xiao-ying Yang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Care

scholarly journals Comparison of the Quality of Life of Patients with Breast or Colon Cancer with an Arm Vein Port (TIVAD) Versus a Peripherally Inserted Central Catheter (PICC)

2021 ◽  
Vol 28 (2) ◽  
pp. 1495-1506
Author(s):  
Brent Burbridge ◽  
Hyun Lim ◽  
Lynn Dwernychuk ◽  
Ha Le ◽  
Tehmina Asif ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Well Being ◽  
Venous Access ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Access Device ◽  
The Mean ◽  
Venous Access Device

Introduction: Venous access is a crucial element in chemotherapy delivery. It remains unclear whether cancer patients prefer a port to a peripherally inserted central catheter (PICC). Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the quality of life (QoL) of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30, and a locally developed quality of life survey (QLAVD), designed to assess satisfaction with venous access devices, were administered to breast or colorectal cancer patients over a one-year period following the device insertion. Mixed effects models were used to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited over a three-year period, (PICC group, n = 50; port group, n = 51). Survey response rates for months one and three were 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL. At three months, the mean pain scores were 3.5 ± 2.3 for the port and 1.3 ± 0.75 for PICC (<0.001). The mean score for a negative effect of the venous access device on psychosocial well-being was 6.0 ± 4.1 for PICC and 3.0 ± 2.7 for the port (p = 0.005). Complications related to PICCs occurred in 38% patients versus 41% with a port (p > 0.24). Conclusions: Although subjects with a port experienced more pain during the device insertion or access for chemotherapy, it had a smaller negative impact on psychosocial scores than the PICC. No significant differences in complications rates were observed between the two devices.

Pericardial Effusion as a Complication of PICC Line Insertion

2021 ◽  
pp. 097321792110076
Author(s):  
Abdah Hrfi ◽  
Mohammed H.A. Mohammed ◽  
Omar Tamimi
Keyword(s):  
Birth Weight ◽  
Pericardial Effusion ◽  
Metabolic Diseases ◽  
Neonatal Period ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Preterm Baby ◽  
Line Insertion ◽  
Uncommon Condition ◽  
Picc Line

Cardiac tamponade as a result of pericardial effusion (PE) is a serious uncommon condition in the neonatal period. PE in such cases could be associated with hydrops fetalis, neonatal sepsis, metabolic diseases, or as a complication of percutaneous indwelling central catheter. 1 We are reporting a preterm baby, with low birth weight who developed large PE as a complication of total parenteral nutrition via a peripherally inserted central catheter, managed successfully with pericardiocentesis.

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