scholarly journals Late onset periprosthetic infection of the hip caused by the fish pathogen Lactococcus garvieae in a patient not associated with fish exposure

2020 ◽  
Vol 5 (3) ◽  
pp. 106-109
Author(s):  
Marianne Westberg ◽  
Hanne Brekke ◽  
Nils Olav Hermansen ◽  
Bernhard Flatøy
Keyword(s):  
Revision Surgery ◽  
Fish Consumption ◽  
Periprosthetic Infection ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Fish Pathogen ◽  
Lactococcus Garvieae ◽  
Fish Exposure ◽  
Hip Infection ◽  
Raw Fish

Abstract. Lactococcus garvieae is a fish pathogen, rarely causing opportunistic infections in humans. There are only a few cases reported in the literature, mainly endocarditis, suggesting an association with raw fish consumption. We report a case of a periprosthetic hip infection successfully treated with a two-stage revision surgery.

scholarly journals 1110. Very Late Onset Infections Amongst Long Term Survivors of Kidney Transplantation

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S585-S585
Author(s):  
Harry Cheung ◽  
Marwan M Azar ◽  
Geliang Gan ◽  
Yanhong Deng ◽  
Elizabeth A Cohen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Data ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Retrospective Chart Review ◽  
Kidney Transplant Recipients ◽  
Increased Risk ◽  
Simple Logistic ◽  
Long Term Survivors

Abstract Background Kidney transplant recipients (KTR) are at increased risk for infections immediately post-transplant due to intense immunosuppression. However, this risk decreases over time as immunosuppression is tapered. The incidence of infection in KTR many years after transplant is not well characterized. The aim of this study was to describe these “very-late onset infections” (VLIs) ≥ 10 years after KT. Methods We performed a retrospective chart review of patients age ≥ 18 years who underwent KT between 2003 and 2009 and who survived ≥ 10 years post-KT. VLIs included opportunistic infections (OIs) and non-OIs. Demographics, comorbidities, immunosuppression, and clinical data for VLIs ≥ 10 years from KT were collected. Simple logistic regression was performed to determine characteristics associated with risk for VLIs. Results Of 332 KTR that met the inclusion criteria, the majority were male (62.0%), white (59.6%), and the largest proportion was transplanted between the ages of 50-59 (28.3%); 220 (67.9%) were on mycophenolate-based regimens. The mean Charlson Comorbidity Index (CCI) was 4.7 (S.D. 2.0). Of 332, 103 (31.0%) KTR experienced ≥ 1 VLI amounting to 187 episodes. Compared to those without VLI, KTR with VLI were more likely to have diabetes (p=0.005), cardiovascular disease (p=0.004), low ALC (p < 0.001) and require dialysis (p=0.002). Of 103 KTR with VLI, 16 (15.5%) had OIs, while 87 KTR (84.5%) had non-OIs, most commonly urinary tract infection (n=85, 45.5%), pneumonia (n=35, 18.7%) and gastrointestinal infection (n=18, 9.6%). The most commonly isolated pathogens were E. coli (n=30, 16%), K. pneumoniae (n=16, 8.6%), MSSA (n=7, 3.7%), and P. aeruginosa (n=7, 3.7%). Higher CCI, diabetes, dialysis, cerebrovascular, cardiovascular disease and lower ALC were associated with increased risk for VLI (p < 0.05), while living donor KTR was protective (p=0.04). Additionally, every 1 year after transplant was associated with an increased risk of VLI (OR=1.31, p < 0.001). Table 1: Demographics, comorbidities, immunosuppression, and clinical data for all patients Conclusion VLIs were common in long-term survivors of KT and included both conventional and opportunistic pathogens. Every additional year from transplant incurred additional risk for VLI, particularly for those with multiple co-morbidities and lower ALC. Disclosures All Authors: No reported disclosures

scholarly journals Successful revision surgery for very late-onset stomal obstruction following Gomez gastroplasty: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yudai Hojo ◽  
Yasunori Kurahashi ◽  
Toshihiko Tomita ◽  
Tsutomu Kumamoto ◽  
Tatsuro Nakamura ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Preoperative Diagnosis ◽  
Late Onset ◽  
Staple Line ◽  
Weight Loss Surgery ◽  
Wedge Resection ◽  
Gastric Pouch ◽  
Sudden Onset ◽  
Gastric Body ◽  
Greater Curvature

Abstract Background Gomez gastroplasty, which was developed in the 1970s as one of the gastric restrictive surgeries for severe obesity, partitions the stomach using a stapler from the lesser towards the greater curvature at the upper gastric body, leaving a small channel. This procedure is no longer performed due to poor outcomes, but surgeons can encounter late-onset complications even decades after the surgery. Here, we report a case of very late-onset stomal obstruction following Gomez gastroplasty which was successfully treated by revision surgery. Case presentation A 58-year-old man was referred to our institution with sudden-onset nausea and vomiting. He underwent weight loss surgery in the USA in 1979, but the details of the surgery were unclear. Esophagogastroduodenoscopy demonstrated a stoma at the greater curvature of the upper gastric body, and fluoroscopy showed retention of contrast medium in the fundus and poor outflow through the stoma. Abdominal computed tomography revealed a staple line partitioning the stomach. Considering these preoperative investigation findings and the period during which the surgery was performed, the patient was diagnosed with very late-onset stomal obstruction following Gomez gastroplasty. Supporting the preoperative diagnosis, the surgical findings revealed a staple line extending from the lesser towards the greater curvature of the upper gastric body and a channel reinforced by a running seromuscular suture on the greater curvature. Moreover, gastric torsion caused by the enlarged proximal gastric pouch was found. Re-gastroplasty involving wedge resection of the original channel was performed followed by construction of a new channel. Postoperative course was uneventful, and the patient no longer had symptoms of stomal obstruction after revision surgery. Conclusions Re-gastroplasty was safe and feasible for very late-onset stomal obstruction following Gomez gastroplasty. Accurate preoperative diagnosis based on the patient’s interview and the investigation findings was important for surgical planning. A careful follow-up is required to prevent excessive weight regain after revision surgery.

Effects of Enterococcus faecalis UGRA10 and the enterocin AS-48 against the fish pathogen Lactococcus garvieae. Studies in vitro and in vivo

2019 ◽  
Vol 77 ◽  
pp. 69-77 ◽  
Author(s):  
Alberto Baños ◽  
Juan José Ariza ◽  
Cristina Nuñez ◽  
Lidia Gil-Martínez ◽  
J. David García-López ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Fish Pathogen ◽  
Lactococcus Garvieae

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

Late Onset Hepatitis and Prolonged Deterioration in Hepatic Function Associated with Nevirapine Therapy

2000 ◽  
Vol 11 (5) ◽  
pp. 336-337 ◽  
Author(s):  
S Clarke ◽  
P Harrington ◽  
C Condon ◽  
D Kelleher ◽  
O P Smith ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Hepatic Dysfunction ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Hepatic Function ◽  
Transcriptase Inhibitor ◽  
Hepatitis C Infection ◽  
Significant Incidence ◽  
Reverse Transcriptase Inhibitor

The aetiology of hepatic dysfunction in patients with HIV infection is multifactorial. Re-activation of hepatitis C infection, drug toxicity, and opportunistic infections are all potential causes. Nevirapine (NVP) is a non-nucleoside reverse transcriptase inhibitor used as part of combination antiretroviral therapy for the treatment of HIV infection. It is associated with a significant incidence of hepatotoxicity, usually occurring in the initial month of therapy. We report the case of a 49-year-old man who developed NVP-induced prolonged hepatotoxicity 5 months after commencing antiretroviral therapy.

scholarly journals Late Onset Combined Immunodeficiency Presenting with RecurrentPneumocystis jiroveciPneumonia

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ilias Papakonstantinou ◽  
Ioannis G. Baraboutis ◽  
Lazaros Karnesis
Keyword(s):  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Combined Immunodeficiency ◽  
Pneumocystis Jiroveci ◽  
Cd4 Lymphocyte ◽  
Idiopathic Cd4 Lymphocytopenia ◽  
Hospital Acquired ◽  
Immunoglobulin Levels ◽  
Common Variable

Late onset combined immunodeficiency (LOCID) is a recently described variant of common variable immunodeficiency (CVID), involving adult patients presenting with opportunistic infections and/or low CD4+ lymphocyte counts. A 36-year-old male with unremarkable past medical history presented with fever, respiratory failure, and lymphocytopenia. He was found to havePneumocystis jirovecipneumonia (PJP), subsequently complicated by recurrent hospital-acquiredPseudomonas aeruginosapneumonia and immune reconstitution phenomena, attributed to restoration of immunoglobulin levels. Clinicians should be aware of LOCID, which could be confused with HIV infection/AIDS or idiopathic CD4 lymphocytopenia. In the English bibliography there is only one case report, where PJP was the initial presentation of CVID (that case would probably be classified as LOCID). Phenomena of immune reconstitution are described in various settings, including primary immunodeficiency, manifesting as temporary clinical and radiologic deterioration and leading to misperceptions of therapeutic failure and/or presence of alternative/additional diagnoses.

scholarly journals Algorithm approach for revision surgery following late-onset bleb complications after trabeculectomy: long-term follow-up

2017 ◽  
Vol 80 (1) ◽  
Author(s):  
Claudio I. Perez ◽  
María J. Oportus ◽  
Felipe Mellado ◽  
Felipe Valenzuela ◽  
Cristián Cartes ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Late Onset ◽  
Long Term Follow Up

scholarly journals What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031645
Author(s):  
Fran E Carroll ◽  
Rachael Gooberman-Hill ◽  
Simon Strange ◽  
Ashley W Blom ◽  
Andrew J Moore
Keyword(s):  
Treatment Option ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Revision Surgery ◽  
Choice Experiment ◽  
Joint Infection ◽  
Major Complication ◽  
Everyday Activities ◽  
Hip Infection ◽  
The Uk

ObjectivesUnderstanding patients’ preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects between 0.4% and 3% of patients. There is more than one treatment option for this major complication, and our study aimed to assess the value that patients place on aspects of revision surgery for periprosthetic hip infection.DesignWe identified four attributes of revision surgery for periprosthetic hip infection. Using a discrete choice experiment (DCE), we measured the value placed on each attribute by 57 people who had undergone either one-stage or two-stage revision surgery for infection.SettingThe DCE was conducted with participants from nine National Health Service hospitals in the UK.ParticipantsAdults who had undergone revision surgery for periprosthetic hip infection (N=57).ResultsOverall, the strongest preference was for a surgical option that resulted in no restrictions on engaging in valued activities after a new hip is fitted (β=0.7). Less valued but still important attributes included a shorter time taken from the start of treatment to return to normal activities (6 months; β=0.3), few or no side effects from antibiotics (β=0.2), and having only one operation (β=0.2).ConclusionsThe results highlight that people who have had revision surgery for periprosthetic hip infection most value aspects of care that affect their ability to engage in normal everyday activities. These were the most important characteristics in decisions about revision surgery.

Potential aquaculture probiont Lactococcus lactis TW34 produces nisin Z and inhibits the fish pathogen Lactococcus garvieae

2014 ◽  
Vol 197 (3) ◽  
pp. 449-458 ◽  
Author(s):  
Cynthia Sequeiros ◽  
Marisa E. Garcés ◽  
Marisol Vallejo ◽  
Emilio R. Marguet ◽  
Nelda L. Olivera
Keyword(s):  
Lactococcus Lactis ◽  
Fish Pathogen ◽  
Lactococcus Garvieae ◽  
Nisin Z
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