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fever in icu

Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
Christian Geier, Jessica Davis, Marc Siegel
A previously healthy 66-year-old woman living in the Mid-Atlantic USA presented to the hospital with lethargy, ataxia and slurred speech. 2 weeks prior she had removed a tick from her right groin. She reported malaise, fevers, diarrhoea, cough and a rash. Physical examination revealed a maculopapular rash on her chest, and lung auscultation revealed bi-basilar rales. Laboratory tests were remarkable for hyponatraemia, leucopenia and thrombocytopenia. Chest X-ray demonstrated bilateral pleural effusions with pulmonary oedema...
October 6, 2016: BMJ Case Reports
Nicolas Lefèvre, Benjamin Noyon, Dominique Biarent, Francis Corazza, Jean Duchateau, Georges Casimir
PURPOSE AND METHODS: The severity and prognosis of various acute inflammatory conditions, such as sepsis, differ between males and females. The mechanisms underlying these sex differences probably involve both hormonal and genetic factors. In order to evaluate a possible genetic influence, we reviewed clinical signs and biological inflammatory markers of prepubertal children with severe sepsis admitted to the pediatric intensive care unit (PICU). FINDINGS: A total of 142 prepubertal children, 66 girls and 76 boys, suffering from severe sepsis and admitted to the PICU were included...
October 17, 2016: Shock
Mehmet Bosnak, Seher Erdogan, E Habibe Aktekin, Ali Bay
We report two children who were diagnosed as having primary hemophagocytic syndrome and who successfully underwent therapeutic plasma exchange (TPE). The first patient was a 6-month-old girl diagnosed with HLH who was admitted to the pediatric intensive care unit. The patient's clinical condition worsened on the 9th day of the HLH-2004 treatment protocol. Her ferritin level was found 50.000 ng/mL, and TPE was performed for 9 sessions, after which her clinical condition and laboratory findings improved. The patient is still on the HLH-2004 protocol and waits for a suitable stem cell transplantation donor...
September 28, 2016: Transfusion and Apheresis Science
Beejal R Ganti, Bernard L Marini, Jerod Nagel, Dale Bixby, Anthony J Perissinotti
PURPOSE: This study evaluated the impact of antibacterial prophylaxis with levofloxacin in relapsed/refractory acute myeloid leukemia (AML) patients. METHODS: This was a retrospective, single-center, cohort study. Adult patients with relapsed/refractory AML admitted for reinduction chemotherapy between November 1, 2006 and June 15, 2015 were screened for inclusion. A protocol initiating levofloxacin prophylaxis was implemented on December 1, 2013. Patients receiving hypomethylating agents (decitabine/azacitidine) were not administered antibacterial prophylaxis and thus not included in this analysis...
October 14, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Falguni Parikh
Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality...
February 2016: Journal of the Association of Physicians of India
S Kuzi, S E Blum, N Kahane, A Adler, O Hussein, G Segev, I Aroch
BACKGROUND: Members of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex cause severe outbreaks in humans, and are increasingly reported in animals. OBJECTIVE AND METHODS: A retrospective study, describing a severe outbreak in dogs and cats caused by a multidrug resistant member of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in a veterinary hospital, between July 2010 and November 2012. RESULTS: The study included 19 dogs and 4 cats...
October 5, 2016: Journal of Small Animal Practice
Khuen F Ng, Kah K Tan, Zhi H Sam, Grace Ss Ting, Wan Y Gan
AIM: The aim of this study is to describe epidemiology, clinical features, laboratory data and severity of respiratory syncytial virus (RSV) acute lower respiratory infection (ALRI) in Malaysian children and to determine risk factors associated with prolonged hospital stay, paediatric intensive care unit (PICU) admission and mortality. METHODS: Retrospective data on demographics, clinical presentation, outcomes and laboratory findings of 450 children admitted into Tuanku Jaafar Hospital in Seremban, Malaysia from 2008 to 2013 with documented diagnosis of RSV ALRI were collected and analysed...
October 5, 2016: Journal of Paediatrics and Child Health
Samia Hamouda, Karima Chraiet, Fatma Khalsi, Imen Bel Hadj, Ines Brini, Hanen Smaoui, Sihem Barsaoui, Azza Samoud, Saida Ben Becher, Najla Ben Jaballah, Amel Kechrid, Faten Tinsa, Khadija Boussetta
Background Community-acquired pleuropneumonia (CPP) is a common complication of pneumonia in children. It is serious given its high morbidity and significant mortality. Aim To study clinical and paraclinical features of CPP in children and to establish a common therapeutic strategy. Methods Our retrospective study included patients who were hospitalized for CPP between 2004 and 2012. All data were collected from patients' medical files. Statistical analysis was made by Epi-Info 6. Results One hundred and sixty four patients were registered...
April 2016: La Tunisie Médicale
Yingkang Jin, Li Huang, Huifeng Fan, Gen Lu, Yi Xu, Zhiyuan Wu
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening immune disorder that may be inherited or secondary to infection, malignancy or rheumatological disease. The aim of the present study was to highlight the clinical features of scrub typhus-associated HLH in children. A retrospective study was performed on 6 pediatric patients with scrub typhus-associated HLH. For each patient, medical records were reviewed and analyzed, and demographic, clinical and laboratory data and outcomes were collected. The duration of fever prior to admission ranged between 4 and 12 days...
October 2016: Experimental and Therapeutic Medicine
Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
Peter Seizer, Michaela Rockenstiehl, Suzanne Fateh-Moghadam, Susanne Haen, Ferruh Artunc, Martin R Müller, Azadeh Ebrahimi, Reimer Riessen, Meinrad Gawaz, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: A 55-year old man suffers from progressive, distinctive dyspnoea and physical weakness since 5 days. Due to ST-segment changes in the ECG and a positive troponin-test, the primary care physician initiates an hospitalization. INVESTIGATIONS: After admission, the laboratory tests confirm the elevated troponin-values, and show additionally elevated pro-brain-natriuric-peptide-values. The coronary angiography presents a highly reduced left ventricular function, an aortic insufficiency III° and a coronary heart disease...
September 2016: Deutsche Medizinische Wochenschrift
Janine Krüger, Matthias Kraft, Matthias Gründling, Sigrun Friesecke, Simone Gärtner, Lena J Vogt, Nicole Schüler, Antje Steveling, Markus M Lerch, Ali A Aghdassi
Continuous measurement of resting energy expenditure (REE) in critically ill patients remains challenging but is required to prevent malnutrition. SenseWear Pro 3 Armband (SWA) is a research grade accelerometer for assessment of REE with the advantage of easy handling. In a prospective study we compared SWA with indirect calorimetry (IC) and predictive equations in critically ill, ventilated patients. REE was measured by SWA, IC and calculated by predictive formulas. Potential confounding factors that influence REE were also recorded...
September 14, 2016: Journal of Clinical Monitoring and Computing
Carlos H Gómez-Quintero, Álvaro A Faccini-Martínez, Carlos A Botero-García, Marcela Lozano, Liliana Sánchez-Lerma, Jorge Miranda, Salim Mattar, Marylin Hidalgo
Spoted fever group (SFG) rickettsioses are actually considered as emerging and re-emerging zoonotic diseases, caused by pathogenic bacteria of the spotted fever group rickettsiae (SFGR). Recently, serologic studies in human and animals conducted in Colombian Orinoquia, showed a high seroprevalence against SFGR. In June 2015, a 50-year-old male was admitted to a hospital in Bogotá, Colombia, with two days of malaise and temperature of 39°C, associated to generalized rash 24h after the onset of fever. He referred a work visit and outdoor activities in rural area of the Department of Meta 15days prior the onset of symptoms...
September 7, 2016: Journal of Infection and Public Health
G Lachmann, P La Rosée, T Schenk, F M Brunkhorst, C Spies
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) has well been studied as a genetic disorder in children (primary HLH). Mutations in the regulatory complex of the cellular immune synapse lead to a loss of function of cytotoxic T‑cells and natural killer cells with excessive inflammation based on a cytokine storm. During the last decade, an increasing number of adult HLH patients without a family history of HLH (secondary or acquired HLH) have been reported. Various triggers - infections, malignancies or autoimmune diseases - result in an acquired loss of function of these cells and a sepsis-like disease...
October 2016: Der Anaesthesist
Raafia Memon, WuQiang Fan, Richard Snyder, Mahesh Krishnamurthy
INTRODUCTION: While extremely uncommon, diabetic ketoacidosis (DKA) and thyroid storm (TS) are endocrine emergencies that can coexist. We describe a case with a confounding clinical presentation that identifies these two emergencies within the setting of sepsis and influenza. CASE: A 69-year-old diabetic female was found by the paramedic staff to be disoriented. She demonstrated tachycardia and had a foul-smelling abdominal wound. Laboratory evaluation revealed DKA, leukocytosis, influenza B, and urinary tract infection...
2016: Journal of Community Hospital Internal Medicine Perspectives
Rakesh Bhadade, Rosemarie de'Souza, Minal Harde, Dileep Asgaonkar, Nilesh Tuplondhe
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a clinical syndrome of severe dyspnoea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure in the absence of cardiac failure. We did the study to asses various aetiologies of ARDS, to determine the correlation between the diagnostic criteria, mortality predictors, need of mechanical ventilation and the outcome of patients. This was an observational, prospective study in medical intensive care unit (MICU) of a tertiary care hospital, over a period of 15 months...
November 2015: Journal of the Association of Physicians of India
Jonathan Elmer, David Yamane, Peter C Hou, Susan R Wilcox, Ednan K Bajwa, Dean R Hess, Carlos A Camargo, Steven M Greenberg, Jonathan Rosand, Daniel J Pallin, Joshua N Goldstein, Sukhjit S Takhar
BACKGROUND: Fever is common among intensive care unit (ICU) patients. Clinicians may use microbiological cultures to differentiate infectious and aseptic fever. However, their utility depends on the prevalence of infection; and false-positive results might adversely affect patient care. We sought to quantify the cost and utility of microbiological cultures in a cohort of ICU patients with spontaneous intracerebral hemorrhage (ICH). METHODS: We performed a secondary analysis of a cohort with spontaneous ICH requiring mechanical ventilation...
September 7, 2016: Neurocritical Care
Ching-Chia Kuo, Yu-Shin Lee, Ming-Ru Lin, Shao-Hsuan Hsia, Chih-Jung Chen, Cheng-Hsun Chiu, Mao-Sheng Hwang, Yhu-Chering Huang
BACKGROUND/PURPOSE: Kawasaki disease (KD) is a febrile systemic vasculitis, and some patients may develop serious complications requiring intensive care. We aim to ascertain the clinical presentations and outcomes of these patients. METHODS: From October 2004 to October 2014, children with KD who had stayed in the pediatric intensive care unit (ICU) for acute stage treatment were defined as case patients; for each case, three age/sex-matched patients with KD but without ICU stay, if identified, were selected as control patients...
July 29, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Noa Biran, Scott D Rowley, David H Vesole, Shijia Zhang, Michele L Donato, Joshua Richter, Alan P Skarbnik, Andrew Pecora, David S Siegel
Escalating doses of bortezomib with high-dose melphalan was evaluated as as a conditioning regimen for autologous stem cell transplantation (ASCT) in patients with relapsed or refractory multiple myeloma (MM). MM patients with less than a partial remission (PR) (or 50% reduction) compared to their pretransplantation paraprotein parameters after a prior ASCT with melphalan conditioning, or who were in relapse after a prior autologous transplantation, were eligible for study. Bortezomib was dose escalated in steps of 1, 1...
August 31, 2016: Biology of Blood and Marrow Transplantation
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