Diagnosis and treatment of invasive fungal disease in the intensive care unit

2014 ◽  
Vol 5 (5) ◽  
pp. 287-296
Author(s):  
Mirosław Czuczwar ◽  
Alicja Bartkowska-Śniatkowska ◽  
Katarzyna Witulska ◽  
Dariusz Onichimowski ◽  
Jacek Cięszczyk ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Diagnosis And Treatment

scholarly journals A National Strategy to Diagnose Coronavirus Disease 2019–Associated Invasive Fungal Disease in the Intensive Care Unit

2020 ◽  
Author(s):  
P Lewis White ◽  
Rishi Dhillon ◽  
Alan Cordey ◽  
Harriet Hughes ◽  
Federica Faggian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Mortality Rate ◽  
Respiratory Distress ◽  
Antifungal Therapy ◽  
Invasive Fungal Disease ◽  
Chronic Respiratory Disease ◽  
Fungal Disease ◽  
Antifungal Prophylaxis ◽  
Severe Respiratory Distress

Abstract Background Fungal coinfection is a recognized complication of respiratory virus infections, increasing morbidity and mortality, but can be readily treated if diagnosed early. An increasing number of small studies describing aspergillosis in coronavirus disease 2019 (COVID-19) patients with severe respiratory distress are being reported, but comprehensive data are lacking. The aim of this study was to determine the incidence, risk factors, and impact of invasive fungal disease in adult COVID-19 patients with severe respiratory distress. Methods An evaluation of a national, multicenter, prospective cohort evaluation of an enhanced testing strategy to diagnose invasive fungal disease in COVID-19 intensive care patients. Results were used to generate a mechanism to define aspergillosis in future COVID-19 patients. Results One-hundred and thirty-five adults (median age: 57, M/F: 2.2/1) were screened. The incidence was 26.7% (14.1% aspergillosis, 12.6% yeast infections). The overall mortality rate was 38%; 53% and 31% in patients with and without fungal disease, respectively (P = .0387). The mortality rate was reduced by the use of antifungal therapy (mortality: 38.5% in patients receiving therapy vs 90% in patients not receiving therapy (P = .008). The use of corticosteroids (P = .007) and history of chronic respiratory disease (P = .05) increased the likelihood of aspergillosis. Conclusions Fungal disease occurs frequently in critically ill, mechanically ventilated COVID-19 patients. The survival benefit observed in patients receiving antifungal therapy implies that the proposed diagnostic and defining criteria are appropriate. Screening using a strategic diagnostic approach and antifungal prophylaxis of patients with risk factors will likely enhance the management of COVID-19 patients.

scholarly journals High-throughput lipidomics enables discovery of the mode of action of huaxian capsule impacting the metabolism of sepsis

RSC Advances ◽  
2017 ◽  
Vol 7 (71) ◽  
pp. 44990-44996 ◽  
Author(s):  
Qun Liang ◽  
Yongzhi Zhu ◽  
Han Liu ◽  
Bingbing Li ◽  
Ai-Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Severe Sepsis ◽  
Intensive Care ◽  
High Throughput ◽  
Mode Of Action ◽  
Rapid Diagnosis ◽  
Diagnosis And Treatment ◽  
Mortality And Morbidity

Severe sepsis (SS) is a major cause of mortality and morbidity in the intensive care unit and requires rapid diagnosis and treatment.

scholarly journals Diagnosis and Treatment of Neuroleptic Malignant Syndrome in the Intensive Care Unit: A Case Report

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Ana Maia ◽  
Gonçalo Cotovio ◽  
Bernardo Barahona-Corrêa ◽  
Albino J. Oliveira-Maia
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Severe Case ◽  
Altered Mental Status ◽  
Diagnosis And Treatment ◽  
Muscle Rigidity ◽  
Dopamine Receptor Antagonists ◽  
High Level

Neuroleptic malignant syndrome is a neurological emergency caused by dysregulation of dopaminergic neurotransmission. While it is typically characterized by muscle rigidity, fever and altered mental status, it may have a heterogeneous and non-specific presentation, leading to delays in diagnosis and treatment. Treatment involves cessation of dopamine-receptor antagonists and supportive measures, but in more severe cases, bromocriptine, dantrolene, benzodiazepines and/or electroconvulsive therapy should be considered. We present the case of a 66-year-old man with severe neuroleptic malignant syndrome, diagnosed due to need for continuous invasive ventilation in an Intensive Care Unit, after successful treatment for respiratory sepsis. The patient recovered after electroconvulsive therapy and administration of bromocriptine. This unusually severe case illustrates the need for a high level of suspicion for neuroleptic malignant syndrome in critically ill patients with malignant catatonic syndromes, allowing for an early diagnosis and potentially lifesavingtreatment.

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