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https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#1
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28191374/klebsiella-pneumoniae-liver-abscess-a-case-report-and-review-of-literature
#2
Faisal Kamal, George Williams, Hina Akbar, Muhammad Ali Khan, Dipen Kadaria
Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Several groups of patients are particularly susceptible to infection, including patients with diabetes mellitus, those from Southeast Asia and those with the preexisting hepatobiliary disease. We present a case of K.pneumoniae PLA with bacteremia. A 39-year-old Vietnamese male with no previous medical history who presented with complaints of abdominal pain, nausea, vomiting, diarrhea and fever...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28165146/enterovirus-d68-detection-in-respiratory-specimens-association-with-severe-disease
#3
I Engelmann, M Fatoux, M Lazrek, E K Alidjinou, A Mirand, C Henquell, A Dewilde, D Hober
Molecular techniques increased the number of documented respiratory infections. In a substantial number of cases the causative agent remains undetected. Since August 2014, an increase in Enterovirus(EV)-D68 infections was reported. We aimed to investigate epidemiology and clinical relevance of EV-D68. From June to December 2014 and from September to December 2015, 803 and 847 respiratory specimens, respectively, were tested for respiratory viruses with a multiplex RT-PCR. This multiplex RT-PCR does not detect EV-D68...
February 6, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28164632/cushing-s-syndrome-presenting-with-hyponatremia
#4
Hayrullah Yazar, Necattin Firat, Ahmet Nalbant
We present a case of Cushing's syndrome that presented with hyponatremia. A 64-year-old obese woman presented to the hospital emergency service complaining of a high fever, hypertension, and generalized oedema. During the examination, the patient suddenly became confused and lost consciousness. She was admitted to the intensive care unit. In addition, blood was drawn to measure the cortisol and ACTH levels, and urine samples were sent for analysis. Adenoctomy was performed through unilateral surgical treatment...
July 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28159575/changing-target-temperature-from-33%C3%A2-c-to-36%C3%A2-c-in-the-icu-management-of-out-of-hospital-cardiac-arrest-a-before-and-after-study
#5
Janet E Bray, Dion Stub, Jason E Bloom, Louise Segan, Biswadev Mitra, Karen Smith, Judith Finn, Stephen Bernard
INTRODUCTION: In December 2013, our institution changed the target temperature management (TTM) for the first 24h in ventricular fibrillation out-of-hospital cardiac arrest (VF-OHCA) patients from 33°C to 36°C. This study aimed to examine the impact this change had on measured temperatures and patient outcomes. METHODS: We conducted a retrospective cohort study of consecutive VF-OHCA patients admitted to a tertiary referral hospital in Melbourne (Australia) between January 2013 and August 2015...
January 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#6
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
: 114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149146/antifungal-susceptibility-and-risk-factors-in-patients-with-candidemia
#7
Cigdem Mermutluoglu, Ozcan Deveci, Saim Dayan, Emel Aslan, Fatma Bozkurt, Recep Tekin
OBJECTIVE: This study aimed to investigate the antifungal susceptibility, typology, and risk factors of candidemia among adult and pediatric inpatients at a university hospital. MATERIALS AND METHODS: A case-control study was designed, and data collected between December 2013 and December 2014 were retrospectively evaluated. The case group consisted of patients with candidemia. The control group was selected from the inpatients that did not develop candidemia but were admitted in the same clinic and during the same period as the candidemia group...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28141683/fever-in-the-emergency-department-predicts-survival-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-the-icu
#8
Jonas Sundén-Cullberg, Rebecca Rylance, Jesper Svefors, Anna Norrby-Teglund, Jonas Björk, Malin Inghammar
OBJECTIVES: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN: Observational cohort study from the Swedish national quality register for sepsis. SETTING: Thirty ICU's in Sweden. PATIENTS: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included...
January 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28134768/unexpectedly-higher-morbidity-and-mortality-of-hospitalized-elderly-patients-associated-with-rhinovirus-compared-with-influenza-virus-respiratory-tract-infection
#9
Ivan F N Hung, Anna Jinxia Zhang, Kelvin K W To, Jasper F W Chan, Shawn H S Zhu, Ricky Zhang, Tuen-Ching Chan, Kwok-Hung Chan, Kwok-Yung Yuen
Rhinovirus is a common cause of upper and lower respiratory tract infections in adults, especially among the elderly and immunocompromised. Nevertheless, its clinical characteristics and mortality risks have not been well described. A retrospective analysis on a prospective cohort was conducted in a single teaching hospital center over a one-year period. We compared adult patients hospitalized for pneumonia caused by rhinovirus infection with those hospitalized for influenza infection during the same period...
January 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#10
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#11
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28118320/characteristics-of-children-with-microbiologically-confirmed-invasive-bacterial-infections-in-the-emergency-department
#12
Iker Gangoiti, Juan R Valle, Mercedes Sota, Lorea Martinez-Indart, Javier Benito, Santiago Mintegi
BACKGROUND: Determination of the characteristics of paediatric invasive bacterial infections (IBI) is essential for early identification of children requiring immediate antibiotic therapy. The main objective is to characterize the emergency presentation of the IBI among children aged younger than 14 years. PATIENTS AND METHODS: A prospective registry-based cohort study including all patients aged younger than 14 years diagnosed with confirmed IBI (culture or genomic detection using the polymerase chain reaction) was carried out in a paediatric emergency department between 2008 and 2015...
January 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28114337/association-between-body-temperature-patterns-and-neurological-outcomes-after-extracorporeal-cardiopulmonary-resuscitation
#13
Jeong-Am Ryu, Taek Kyu Park, Chi Ryang Chung, Yang Hyun Cho, Kiick Sung, Gee Young Suh, Tae Rim Lee, Min Seob Sim, Jeong Hoon Yang
We evaluated the association of body temperature patterns with neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). Between December 2013 and December 2015, we enrolled 48 patients with cardiac arrest who survived for at least 24 hours after ECPR. Based on their body temperature patterns and the intention to control fever, we divided the patients into those in whom fever was actively controlled (N = 25), those with normothermia (N = 17), and those with unintended hypothermia (N = 6)...
2017: PloS One
https://www.readbyqxmd.com/read/28103590/risk-factors-for-intrapartum-fever-in-term-gestations-and-associated-maternal-and-neonatal-sequelae
#14
Angela P H Burgess, Justin E Katz, Michael Moretti, Nisha Lakhi
AIM: To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes. METHODS: Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant. RESULTS: Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria...
January 20, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#15
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28097438/attitudes-towards-fever-amongst-uk-paediatric-intensive-care-staff
#16
Thomas Brick, Rachel S Agbeko, Patrick Davies, Peter J Davis, Akash Deep, Peter-Marc Fortune, David P Inwald, Amy Jones, Richard Levin, Kevin P Morris, John Pappachan, Samiran Ray, Shane M Tibby, Lyvonne N Tume, Mark J Peters
: The role played by fever in the outcome of critical illness in children is unclear. This survey of medical and nursing staff in 35 paediatric intensive care units and transport teams in the United Kingdom and Ireland established attitudes towards the management of children with fever. Four hundred sixty-two medical and nursing staff responded to a web-based survey request. Respondents answered eight questions regarding thresholds for temperature control in usual clinical practice, indications for paracetamol use, and readiness to participate in a clinical trial of permissive temperature control...
January 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28096867/nasal-nosocomial-myiasis-infection-caused-by-chrysomya-bezziana-diptera-calliphoridae-following-the-septicemia-a-case-report
#17
Seyed Farzin Mircheraghi, Seyed Farzam Mircheraghi, Hamed Ramezani Awal Riabi, Arezoo Parsapour
A 74 yr old woman from Gonabad, southern part of Khorasan Razavi Province of Iran was admitted to a Hospital of Gonabad, because of respiratory distress, exertional dyspnea and fever. Close contact with domestic animals, history of chronic obstructive pulmonary disease (COPD), and completely resolved pulmonary tuberculosis (TB) in remote past, were notable parts of her past medical history. Due to clinical, paraclinical and radiographic findings and because of recent hospitalization, she was admitted to internal medicine ward with the diagnosis of health care associated pneumonia (HCAP)...
April 2016: Iranian Journal of Parasitology
https://www.readbyqxmd.com/read/28093651/infections-in-intensive-care-unit-adult-patients-harboring-multidrug-resistant-pseudomonas-aeruginosa-implications-for-prevention-and-therapy
#18
B Borgatta, L Lagunes, A T Imbiscuso, M N Larrosa, M Lujàn, J Rello
The purpose of this paper was to report the burden and characteristics of infection by multidrug-resistant Pseudomonas aeruginosa (MDR-PA) in clinical samples from intensive care unit (ICU) adults, and to identify predictors. This was a retrospective observational study at four medical-surgical ICUs. The case cohort comprised adults with documented isolation of an MDR-PA strain from a clinical specimen during ICU stay. Multivariate analysis was performed to identify predictors for MDR-PA infection. During the study period, 5667 patients were admitted to the ICU and P...
January 16, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28092284/persistent-fever-in-medical-intensive-care-unit-evans-syndrome-versus-actinomycotic-osteomyelitis
#19
Amandeep Aujla, Palash Samanta, Gerardo Cabanillas, Hossam Amin
No abstract text is available yet for this article.
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28091389/trali-syndrome-during-the-treatment-of-a-plasmodium-falciparum-malaria-case
#20
Hülya Çaşkurlu, Rahman Nurmuhammedov, Zarni Htway
Malaria, which is one of the three most important infectious diseases globally, is endemic in many areas of the world. Plasmodium falciparum is not endemic to Turkey but can be seen after travel to epidemic countries. Transfusion-related acute lung injury (TRALI) syndrome is a rare disease, which may develop following the transfusion of all types of blood products, including plasma. Here we describe a case of TRALI syndrome in a 29-year-old male, who presented with fever after 15 days of returning from a business trip to Burkina Faso...
December 2016: Türkiye Parazitolojii Dergisi
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