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 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 Gastrointestinal Histoplasmosis Mimicking Crohn’s Disease

2021 ◽  
Author(s):  
Esfandiar Shojaei ◽  
Joanna C Walsh ◽  
Nikhil Sangle ◽  
Brian Yan ◽  
Michael S Silverman ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Antifungal Therapy ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Disseminated Histoplasmosis ◽  
Gastrointestinal Histoplasmosis ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Tissue Specimens

Abstract Disseminated histoplasmosis is a life-threatening disease usually seen in immunocompromised patients living in endemic areas. We present an apparently immunocompetent patient with gastrointestinal histoplasmosis who was initially diagnosed as biopsy-proven Crohn’s disease. Following discontinuation of anti-inflammatory drugs and institution of antifungal therapy, his GI illness completely improved. Specific fungal staining should be routinely included in histopathologic assessment of tissue specimens diagnosed as Crohn’s disease.

Toxoplasma Appendicitis: A Once-in-a-Lifetime Diagnosis!

2017 ◽  
Vol 26 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Anisha M. Fernandes ◽  
Maheshkumar M. Lakhe ◽  
Sanjay A. Pai
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Muscularis Propria ◽  
Immunocompromised Patients ◽  
Lymphoid Follicles ◽  
Negative Results ◽  
Immunosuppressed Patients ◽  
Life Threatening

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.

Cardiovascular complications of Streptococcus pneumoniae bacteraemia

2021 ◽  
Vol 14 (4) ◽  
pp. e240341
Author(s):  
Michelle M de Leau ◽  
Remko S Kuipers
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Cardiovascular Complications ◽  
Diagnosis And Treatment ◽  
Immunocompromised Patients ◽  
Correct Treatment ◽  
Life Threatening ◽  
Pneumococcal Bacteraemia

The incidence of Streptococcus pneumoniae bacteraemia has risen due to a worldwide increase in immunocompromised patients and antibiotic resistance. We describe three patients who experienced severe, including cardiovascular, complications of pneumococcal bacteraemia. Cardiovascular complications related to pneumococci may run a fulminant course. However, some of these life-threatening complications (eg, endocarditis and aortitis) may long remain unnoticed or be misdiagnosed and therefore delay correct treatment. We review the literature with regards to the incidence, diagnosis and treatment of these rare but possibly lethal and hence important cardiovascular complications.

Treatment of Non-HIV Cryptosporidial Diarrhea with Azithromycin

1995 ◽  
Vol 29 (10) ◽  
pp. 991-993 ◽  
Author(s):  
Robert E Bessette ◽  
Guy W Amsden
Keyword(s):  
High Dose ◽  
Immunocompromised Patients ◽  
Excessive Weight Loss ◽  
The Past ◽  
Excessive Weight ◽  
Case Summary ◽  
Effective Option ◽  
Stool Cultures ◽  
Immunocompetent Patients

Objective: To report a patient with non-HIV-related cryptosporidial diarrhea who was treated effectively with a regimen of high-dose azithromycin therapy. Case Summary: A 42-year-old immunocompetent man contracted cryptosporidiosis from an ailing calf that he had purchased. He finally was admitted to the hospital because of excessive weight loss and profuse diarrhea. The patient was started on a course of high-dose azithromycin therapy and symptoms resolved within 48 hours. Follow-up stool cultures were negative for the parasite. Discussion: Although usually associated with immunocompromised patients, cryptosporidiosis occurs in immunocompetent hosts in a significant portion of the reported cases each year. Although self-limiting in most cases in this population, the disease can be severe at times and require treatment. Paromomycin therapy has been used in the past with good results. Although macrolides have had erratic effects against this parasite in the past, azithromycin (an azalide) demonstrated good efficacy in this patient. Conclusions: Azithromycin has demonstrated that it may be an effective option for the treatment of cryptosporidiosis in immunocompetent patients. Studies involving its use in immunocompromised patients are currently underway.

scholarly journals Prostatic tuberculosis: case report

2008 ◽  
Vol 126 (4) ◽  
pp. 227-228 ◽  
Author(s):  
Daniel Sáenz-Abad ◽  
Santiago Letona-Carbajo ◽  
José Luis de Benito-Arévalo ◽  
Isabel Sanioaquín-Conde ◽  
Francisco José Ruiz-Ruiz
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Urine Culture ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Tuberculosis Case ◽  
Immunocompetent Patients

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

scholarly journals 1484. Microbial Etiology of Community-acquired Pneumonia in Immunocompromised Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S743-S744
Author(s):  
Abhishek Deshpande ◽  
Pei-Chun Yu ◽  
Michael Rothberg
Keyword(s):  
Panel Member ◽  
Positive Culture ◽  
Empiric Therapy ◽  
Community Acquired Pneumonia ◽  
Immunocompromised Patients ◽  
Viral Pathogens ◽  
Chest X Ray ◽  
Microbial Etiology ◽  
Almost All ◽  
Immunocompetent Patients

Abstract Background Community-acquired pneumonia (CAP) is a leading cause of infection related mortality. Few studies have specifically evaluated the microbial etiology of CAP in immunocompromised patients. Using a large national inpatient database, we compared the microbial etiology of CAP in immunocompromised patients compared to immunocompetent patients. Methods We included adult patients admitted with pneumonia from 2010-2015 to 176 US hospitals participating in Premier. Patients were identified as having CAP if they had a chest X-ray and were on antimicrobials on the first day. Immunocompromised was defined by the receipt of immunosuppressive medications or ICD-9 codes for neutropenia/ hematological malignancy/ organ transplantation or comorbidities with AIDS. For microbial etiology, patients were included if they had a positive culture or test collected by hospital day 0 through 3. Patients with identical bacteria in blood and urine were excluded. Results A total of 168,159 patients had a diagnosis of CAP with a culture/test performed on first 3 days. A pathogen was detected in 18.8% of patients. Among pathogen positive patients, 4,851 patients were identified as immunocompromised and 26,752 as immunocompetent. Almost all patients (99%) had at least one culture, blood (96%) and respiratory (51%). Among patients who were immunocompromised, the most common bacterial pathogens (compared to immunocompetent patients) were, S. pneumoniae (17.7% vs 19.0%), MRSA (13.1% vs 14.4%), MSSA (12.0% vs 11.8%), P. aeruginosa (12.0% vs 9.9%), E. coli (7.4% vs 6.4%), K. pneumoniae (5.8% vs 4.9%), H. influenzae (5.5% vs 5.5%), M. pneumoniae (3.0% vs 3.0%) and L. pneumophila (0.93% vs 1.2%). Among viral pathogens, while the most common were influenza virus (12.9% vs 14.1%) followed by rhinovirus (1.5% vs 0.89%), immunocompromised patients has a higher prevalence of noninfluennza viruses (3.42% vs 2.43%). Conclusion In a large US inpatient sample, the causative organisms in immunocompromised patients did not differ much from those in immunocompetent patients. CAP pathogens in immunocompromised patients were more likely to involve gram-negative bacilli such as P.aeruginosa and E.coli, than gram-positive cocci. These findings may have implications when deciding on empiric therapy in these patients. Disclosures Abhishek Deshpande, MD, PhD, Ferring Pharmaceuticals (Advisor or Review Panel member)Merck (Consultant)

scholarly journals Using the Model of Resource and Time-Based Triage (MORTT) to Guide Scarce Resource Allocation in the Aftermath of a Nuclear Detonation

2011 ◽  
Vol 5 (S1) ◽  
pp. S98-S110 ◽  
Author(s):  
Rocco Casagrande ◽  
Nick Wills ◽  
Elizabeth Kramer ◽  
Louise Sumner ◽  
Mark Mussante ◽  
...  
Keyword(s):  
Medical Practitioners ◽  
Agent Based ◽  
Traumatic Injuries ◽  
Time To Death ◽  
Probability Of Survival ◽  
Death Probability ◽  
Impact On Survival ◽  
Life Threatening ◽  
Type Of Injury ◽  
The Impact

ABSTRACTConventional triage algorithms assume unlimited medical resource availability. After a nuclear detonation, medical resources are likely to be particularly limited, suggesting that conventional triage algorithms need to be rethought. To test various hypotheses related to the prioritization of victims in this setting, we developed the model of resource- and time-based triage (MORTT). This model uses information on time to death, probability of survival if treated and if untreated, and time to treat various types of traumatic injuries in an agent-based model in which the time of medical practitioners or materials can be limited. In this embodiment, MORTT focuses solely on triage for surgical procedures in the first 48 hours after a nuclear detonation. MORTT determines the impact on survival based on user-selected prioritization of victims by severity or type of injury. Using MORTT, we found that in poorly resourced settings, prioritizing victims with moderate life-threatening injuries over victims with severe life-threatening injuries saves more lives and reduces demand for intensive care, which is likely to outstrip local and national capacity. Furthermore, more lives would be saved if victims with combined injury (ie, trauma plus radiation >2 Gy) are prioritized after nonirradiated victims with similar trauma.(Disaster Med Public Health Preparedness. 2011;5:S98-S110)

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