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Infectious Diseases in Clinical Practice: IDCP

Sheng Si, Michael J Durkin, Maureen M Mercier, Melanie L Yarbrough, Stephen Y Liang
Few antibiotic options exist for the management of infections due to vancomycin-resistant enterococci (VRE). We describe a case involving the safe and successful use of tedizolid, a new oxazolidinone, to treat VRE prosthetic joint infection.
March 2017: Infectious Diseases in Clinical Practice: IDCP
Natalie Mariam Salas, Nicole Klein
Mycobacterium goodii, a rapidly growing nontuberculous mycobacterium, is an emerging pathogen in nosocomial infections. Its inherent resistance patterns make it a challenging organism to treat, and delays in identification can lead to poor outcomes. We present a case of cardiac device pocket infection with M. goodii, complicated by both antibiotic resistance and drug reactions that highlight the challenges faced by clinicians trying to eradicate these infections. We also present a brief review of the English literature surrounding this disease, including a table of all reported cases of M...
March 2017: Infectious Diseases in Clinical Practice: IDCP
Jeffrey R Strich, Theresa D Jerussi, Adrian Wiestner, Steven M Holland
Pneumocystis jirovecii pneumonia is a known complication in patients with chronic lymphocytic leukemia who are treated with fludarabine-based chemotherapy; however, it is extremely uncommon in treatment naïve patients. Here we report a case of Pneumocystis jirovecii pneumonia in a patient with untreated chronic lymphocytic leukemia.
November 2016: Infectious Diseases in Clinical Practice: IDCP
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
Jeffrey D Jenks, Constance A Benson
We report the case of an otherwise healthy 28-year-old-man who presented with a first-time seizure. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a circumscribed left frontal lobe heterogeneous mass most consistent with a neoplasm. He underwent left supraorbital craniotomy with mass resection of the lesion, with histopathology of the brain tissue revealing heightened cellularity with perivascular neutrophilic predominance and neutrophils percolating through the brain parenchyma and surrounding cortical neurons, most consistent with a diagnosis of early cerebritis...
November 2016: Infectious Diseases in Clinical Practice: IDCP
Jillian E Raybould, Alison L Raybould, Megan K Morales, Misbah Zaheer, Michael S Lipkowitz, Joseph G Timpone, Princy N Kumar
Among culture-negative endocarditis in the United States, Bartonella species are the most common cause, with Bartonella henselae and Bartonella quintana comprising the majority of cases. Kidney manifestations, particularly glomerulonephritis, are common sequelae of infectious endocarditis, with nearly half of all Bartonella patients demonstrating renal involvement. Although a pauci-immune pattern is a frequent finding in infectious endocarditis-associated glomerulonephritis, it is rarely reported in Bartonella endocarditis...
September 2016: Infectious Diseases in Clinical Practice: IDCP
Kathleen M Tompkins, Melissa A Reimers, Becky L White, Michael E Herce
Tuberculosis (TB) remains an important cause of infectious morbidity in the United States (US), necessitating timely and accurate diagnosis. We report a case of concurrent pulmonary and extrapulmonary TB presenting as tuberculous otitis media in a hospitalized US patient admitted with cough, night sweats, and unilateral purulent otorrhea. Diagnosis was made by smear microscopy and rapidly confirmed by Xpert MTB/RIF-a novel, automated nucleic acid amplification test for the rapid detection of drug-susceptible and drug-resistant TB...
May 2016: Infectious Diseases in Clinical Practice: IDCP
Varun K Phadke, Jesse T Jacob
A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation...
May 2016: Infectious Diseases in Clinical Practice: IDCP
Trisha Patel, Mark E Lewis, Michelle L Niesley, Mashiul Chowdhury
Infections from Enterococcus faecalis and Enterococcus faecium are uncommon in the post-neurosurgical intervention setting., [1, 2, 3, 4] Intraventricular antibiotics are recommended when standard intravenous therapy fails. [5] Here we present a case of post-neurosurgical ventriculitis, meningitis, and cerebritis in an oncology patient caused by refractory Enterococcus faecalis successfully treated with intraventricular vancomycin.
May 2016: Infectious Diseases in Clinical Practice: IDCP
Dale N Gerding, Thomas M File, L Clifford McDonald
Early and accurate diagnosis is essential for optimal treatment of individuals with Clostridium difficile infection (CDI) and for implementation of effective infection control procedures. The decision about which diagnostic test to use is an important one that should be based on test sensitivity, specificity, and predictive value. The challenges of CDI go beyond rapid identification and management of symptomatic patients. Asymptomatic carriage has long been suspected in C. difficile transmission, but it may play a larger role than previously thought...
January 2016: Infectious Diseases in Clinical Practice: IDCP
Edward M Drozd, Timothy J Inocencio, Shamonda Braithwaite, Dayo Jagun, Hemal Shah, Nicole C Quon, Kelly C Broderick, Joseph L Kuti
BACKGROUND: The management of Clostridium difficile infection (CDI) among hospitalized patients is costly, and ongoing payment reform is compelling hospitals to reduce its burden. To assess the impact of CDI on mortality, hospital costs, healthcare use, and Medicare payments for beneficiaries who were discharged with CDI listed as a secondary International Classification of Diseases, Ninth Revision, Clinical Modification claim diagnosis. METHODS: Data were analyzed from the 2009 to 2010 5% random sample Medicare Standard Analytic Files of beneficiary claims...
November 2015: Infectious Diseases in Clinical Practice: IDCP
Jeffrey D Jenks, Michael Preziosi
Near-drowning, a relatively common event, is often complicated by subsequent pneumonia. While endogenous and exogenous bacteria are typical pathogens, rarely fungi are as well. We report a complicated case of invasive pulmonary aspergillosis in a 30-year-old man after a near-drowning event. We also review the medical literature for similar cases. All cases of invasive pulmonary aspergillosis after near-drowning reported in the literature involve Aspergillus fumigatus. The majority of cases involved submersion in stagnant water after a motor vehicle accident (MVA)...
September 1, 2015: Infectious Diseases in Clinical Practice: IDCP
Yun Xia, Anthony Cutrona, Timothy J Barreiro
Tetanus is a rare disease in the United States. Fewer than 40 cases are reported annually because of the high incidence of vaccination. Recognition of the clinical presentations is important because laboratory recovery of pathogen is only 30%, and toxin detection is rare because of consumption at motor neurons. We report a case of tetanus in an elderly man who had a reaction to tetanus vaccination as a child and was nonvaccinated through adult life.
July 2015: Infectious Diseases in Clinical Practice: IDCP
Ronald Angoff, Jillian Wood, Maria C Chernock, Diane Tipping
BACKGROUND: The aim of this study was to determine whether the use of visual freeze indicators on vaccines would assist health care providers in identifying vaccines that may have been exposed to potentially damaging temperatures. METHODS: Twenty-seven sites in Connecticut involved in the Vaccine for Children Program participated. In addition to standard procedures, visual freeze indicators (FREEZEmarker(®) L; Temptime Corporation, Morris Plains, NJ) were affixed to each box of vaccine that required refrigeration but must not be frozen...
July 2015: Infectious Diseases in Clinical Practice: IDCP
Rahul Pathak, Anish Patel, Hilary Enuh, Oluwaseyi Adekunle, Vasanthy Shrisgantharajah, Keith Diaz
HYPOTHESIS: Our objective was to evaluate whether the use of midline venous catheters in place of central line venous catheters, when appropriate, decreased the overall incidence of central line-associated bacteremia in a ventilator unit. METHODS: The time interval between February 2012 and February 2013 was divided into 2 periods. Group A was the first half of the year, before the introduction of midline catheters, and group B was the second half of the year, 6 months after their introduction...
May 2015: Infectious Diseases in Clinical Practice: IDCP
Jose A Vazquez, Christy R Maggiore, Phillip Cole, Alexander Smith, Alena Jandourek, H David Friedland
BACKGROUND: The Clinical Assessment Program and Teflaro® Utilization Registry is designed to collect information on the clinical use of ceftaroline fosamil in the Unites States. This report presents data on the treatment of patients with Staphylococcus aureus bacteremia (SAB) secondary to acute bacterial skin and skin structure infections (ABSSSIs) or community-acquired bacterial pneumonia (CABP). METHODS: Patients diagnosed with ABSSSI or CABP were identified through sequential review of randomly ordered charts generated from pharmacy listings from August 2011 to February 2013...
January 2015: Infectious Diseases in Clinical Practice: IDCP
Edward H Eiland, Adam J Sawyer, Nicholas L Massie
BACKGROUND: Fidaxomicin has been scrutinized because of its high acquisition cost. Real-world experience is needed to determine whether fidaxomicin has value in patients with Clostridium difficile-associated diarrhea (CDAD) and certain risk factors. METHODS: In this single-center, retrospective cohort study, patients 18 years or older with diarrheal symptoms and positive polymerase chain reaction assay for C. difficile toxin B gene or pseudomembranes were administered fidaxomicin between August 2011 and March 2013...
January 2015: Infectious Diseases in Clinical Practice: IDCP
Scott B Robinson, Frank R Ernst, Craig Lipkin, Xingyue Huang
BACKGROUND: Community-acquired bacterial pneumonia (CABP) is a leading cause of morbidity and mortality especially in hospitalized patients. In place of clinical end points traditionally used to evaluate antimicrobial efficacy for its treatment, Food and Drug Administration guidelines now require all registration trials to assess clinical response at day 4. The primary objective of this study was to assess health outcomes (length of stay [LOS] and hospital charges) between responders and nonresponders at this time point...
November 2014: Infectious Diseases in Clinical Practice: IDCP
Benjamin S Thomas, Koh Okamoto, Matthew J Bankowski, Todd B Seto
Pseudomonas putida is an uncommon cause of skin and soft tissue infections. It is often associated with trauma or immunocompromised state. We present the first lethal case of bacteremia due to skin and soft tissue infections, which had malnutrition, immobility, and peripheral vascular disease as risk factors.
May 2013: Infectious Diseases in Clinical Practice: IDCP
Mehdi Mirsaeidi, Fatima Syed, Elaine S Jaffe
INTRODUCTION: EBV has been a leading candidate as a trigger for several autoimmune diseases. We describe an antineutrophil cytoplasmic autoantibody (ANCA) -associated systemic vasculitis as the initial presenting illness of AIDS. CASE REPORT AND RESULTS: The patient was diagnosed ANCA -associated systemic vasculitis in the setting of HIV infection because of a high level of ANCA level, crescent glomerulonephritis in pathology, and clinical signs and symptoms compatible with systemic vasculitis...
January 2013: Infectious Diseases in Clinical Practice: IDCP
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