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https://www.readbyqxmd.com/read/29158922/hypoxemic-respiratory-failure-from-acute-respiratory-distress-syndrome-secondary-to-leptospirosis
#1
Shannon M Fernando, Pierre Cardinal, Peter G Brindley
Acute respiratory distress syndrome (ARDS), characterized by hypoxemic respiratory failure, is associated with a mortality of 30-50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU) admission. The most common precipitant is community-acquired bacterial pneumonia, but other putative pathogens include viruses and fungi. On rare occasions, ARDS can be secondary to tropical disease...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29141761/leptospirosis-cases-infected-with-uncommon-serogroups-puerto-rico-2013-2015
#2
Hector Gorbea, Enid J Garcia-Rivera, Hilda Torres, Olga D Lorenzi, Aidsa Rivera, Renee L Galloway, Tyler M Sharp
Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients with laboratory-confirmed leptospirosis were identified. All patients had signs and symptoms of AFI, including fever, headache, and dehydration. Three patients had leukocytosis with thrombocytopenia and were admitted to the hospital...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29123884/a-case-of-cerebral-tuberculoma-mimicking-neurocysticercosis
#3
Hiroko Yuzawa, Yousuke Hirose, Tomonori Kimura, Sho Kimura, Hisanori Sugawara, Asako Yanagisawa, Sono Toi, Takashi Ohashi, Tomohito Sadahiro
Case: A 42-year-old Peruvian woman residing in Japan for 11 years with a family history of neurocysticercosis presented to our intensive care unit with fever and intense headache.Computed tomography indicated multiple micronodular lesions in the brain parenchyma, and cerebral tuberculoma and neurocysticercosis were considered in the differential diagnosis. Neurocysticercosis was initially suspected, and oral praziquantel was initiated. However, because of a high adenosine deaminase level in the cerebrospinal fluid and positive peripheral blood interferon gamma release test result, cerebral tuberculoma was subsequently considered...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29109879/legionnaires-disease-complicated-with-rhabdomyolysis-and-acute-kidney-injury-in-an-aids-patient
#4
Karan Seegobin, Satish Maharaj, Cherisse Baldeo, Julio Perez Downes, Pramod Reddy
Objective: To present a case of an uncommon triad of Legionella pneumonia, rhabdomyolysis, and renal failure, with review of the relevant literature. Case: A 51-year-old with a history of human immunodeficiency virus (HIV), chronic obstructive pulmonary disease (COPD), and hypertension presented with fever, cough, and shortness of breath over four days. Chest X-ray showed consolidation in left lower lung field; urine was positive for Legionella antigen and myoglobin; creatine kinase was 51092U/L; creatine was 6...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29096992/epidemiology-and-risk-factors-for-mortality-in-bloodstream-infection-by-cp-kp-esbl-e-candida-and-cdi-a-single-center-retrospective-study
#5
Silvia Corcione, Roberto Angilletta, Stefania Raviolo, Claudia Filippini, Lucina Fossati, Giovanni Di Perri, Rossana Cavallo, Francesco Giuseppe De Rosa
BACKGROUND: The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. METHODS: We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected...
October 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29066581/reducing-time-to-antibiotics-in-children-with-intestinal-failure-central-venous-line-and-fever
#6
Joel D Hudgins, Vera Goldberg, Gillian L Fell, Mark Puder, Matthew A Eisenberg
BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29062486/cardiac-tamponade-in-a-patient-with-autoimmune-polyglandular-syndrome-type-2
#7
Andromachi Vryonidou, Stavroula A Paschou, Fotini Dimitropoulou, Panagiotis Anagnostis, Vasiliki Tzavara, Apostolos Katsivas
We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Clinical and echocardiographic evaluation revealed cardiac tamponade, which was treated with pericardiocentesis. Pleural fluid samples were negative for malignancy, tuberculosis or bacterial infection...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29045690/clinical-characteristics-of-hospitalized-infants-with-laboratory-confirmed-pertussis-in-guatemala
#8
Varun K Phadke, John P McCracken, Jennifer L Kriss, Maria R Lopez, Kim A Lindblade, Joe P Bryan, Miguel E Garcia, Carlos E Funes, Saad B Omer
Background: Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala. Methods: As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained...
October 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#9
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#10
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29027499/non-infectious-fever-after-acute-spinal-cord-injury-in-the-intensive-care-unit
#11
Fatma Ülger, Mehtap Pehlivanlar Küçük, Çağatay Erman Öztürk, İskender Aksoy, Ahmet Oğuzhan Küçük, Naci Murat
Objective The aim of the present study is to evaluate the frequency, etiology, risk factors and clinical outcomes in acute traumatic SCI patients who develop fever and to evaluate the relationship between fever and mortality. Design Retrospective data were collected between January 2007 and August 2016 from patients diagnosed with persistent fever from SCI cases observed in the ICU. Participants Among 5370 intensive care patients, 435 SCI patients were evaluated for the presence of fever. A total of 52 patients meeting the criteria were evaluated...
October 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#12
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29020307/follow-up-blood-cultures-in-gram-negative-bacteremia-are-they-needed
#13
Christina N Canzoneri, Bobak J Akhavan, Zehra Tosur, Pedro E Alcedo Andrade, Gabriel M Aisenberg
Background: Bloodstream infections remain a major cause of morbidity and mortality. Gram-negative bacilli (GNB) bacteremia is typically transient and usually resolves rapidly after the initiation of appropriate antibiotic therapy and source control. The optimal duration of treatment and utility of follow-up blood cultures (FUBC) have not been studied in detail. Currently, the management of gram-negative bacteremia is determined by clinical judgment. To investigate the value of repeat blood cultures, we analyzed 500 episodes of bacteremia to determine frequency of FUBC and identify risk factors for persistent bacteremia...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28990896/acute-eosinophilic-pneumonia-secondary-to-heroin-inhalation
#14
Damla Eyüpoğlu, Ebru Ortaç Ersoy, Kazım Rollas, Arzu Topeli
Smoking heroin (chasing the dragon), is a method of inhaling heroin via heating the drug on a tin-foil above a flame. It also has been associated both with the indirect effects of heroin overdose and with direct pulmonary toxicity. We describe a case of acute eosinophilic pneumonia secondary to heroin inhalation in our medical intensive care unit. She presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed bilateral infiltrations. Examination of bronchoalveolar lavage fluid revealed significant eosinophilia...
June 2017: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28975065/vanishing-lung-syndrome-compound-effect-of-tobacco-and-marijuana-use-on-the-development-of-bullous-lung-disease-a-joint-effort
#15
Shimshon Wiesel, Faraz Siddiqui, Tahir Khan, Sami Hossri, Dany El-Sayegh
Marijuana use has been increasing across the United States due to its legalization as both a medicinal and recreational product. A small number of case reports have described a pathological entity called vanishing lung syndrome (VLS), which is a rare bullous lung disease usually caused by tobacco smoking. Recent case reports have implicated marijuana in the development of VLS. We present a case of a 47-year-old man, who presented to our hospital with shortness of breath, fevers and a productive cough. On physical exam, he was tachypneic with audible stridor and absent right sided breath sounds...
July 31, 2017: Curēus
https://www.readbyqxmd.com/read/28964650/community-acquired-legionnaires-disease-at-a-medical-center-in-northern-taiwan
#16
Wei-Fang Kao, Jann-Tay Wang, Wang-Huei Sheng, Yee-Chun Chen
BACKGROUND/PURPOSE: Legionella pneumophila had been recognized as an important pathogen for community-acquired pneumonia. We aimed to investigate clinical features and outcomes of patients with Legionnaires' disease at a tertiary medical center in northern Taiwan. METHODS: From June 2012 to February 2017, a retrospective review of adult community-acquired. Legionnaires' disease at a medical center was conducted. All Legionella infections were confirmed by positive urinary Legionella antigen assay, sera indirect immunofluorescence assay, or sputum culture for Legionella...
September 18, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28962814/nosocomial-infections-in-the-neurointensive-care-unit
#17
REVIEW
Katharina Maria Busl
Infectious complications in the neurointensive care unit (neuro-ICU) are common, including pneumonia, urinary tract infection, bloodstream infection, and intracranial infection. The neuro-ICU population poses a specific challenge in the diagnosis of infections, because of the high incidence of fever in acutely brain-injured patients. Furthermore, susceptibility to infections is likely enhanced by brain-injury (induced immune modulation). This article reviews the concept of brain injury-induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28954408/history-and-outcome-of-febrile-neutropenia-outside-the-oncology-setting-a-retrospective-study-of-76-cases-related-to-non-chemotherapy-drugs
#18
Emmanuel Andrès, Rachel Mourot-Cottet, Frédéric Maloisel, Olivier Keller, Thomas Vogel, François Séverac, Martine Tebacher, Jacques-Eric Gottenberg, Jean-Christophe Weber, Georges Kaltenbach, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht
BACKGROUND: Despite major advances in its prevention and treatment, febrile neutropenia remains a most concerning complication of cancer chemotherapy. Outside the oncology setting, however, only few data are currently available on febrile neutropenia related to non-chemotherapy drugs. We report here data on 76 patients with febrile neutropenia related to non-chemotherapy drugs, followed up in a referral center within a university hospital. PATIENTS AND METHODS: Data from 76 patients with idiosyncratic drug-induced febrile neutropenia were retrospectively reviewed...
September 26, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28934890/hyperglycemic-episodes-are-associated-with-postoperative-infections-after-cardiac-surgery
#19
K M Järvelä, N K Khan, E L Loisa, J A Sutinen, J O Laurikka, J A Khan
BACKGROUND AND AIMS: To describe the incidence of and risk factors for postoperative infections and the correlation between postoperative hyperglycemia despite tight blood glucose control with infectious and other complications after contemporary cardiac surgery. MATERIAL AND METHODS: The study comprised 1356 consecutive adult patients who underwent cardiac surgery between January 2013 and December 2014 and were followed up for 6 months. Patients surviving the first 2 days were included in the analysis...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28930238/a-thrombomodulin-gene-polymorphism-c1418t-is-associated-with-early-outcomes-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-a-conventional-cardiopulmonary-bypass-during-hospitalization
#20
Ching-Chou Pai, Yi-Wen Lin, Yi-Ting Tsai, Shih-Hurng Loh, Chih-Yuan Lin, Chin-Sheng Lin, Yi-Chang Lin, Hung-Yen Ke, Feng-Yen Lin, Chien-Sung Tsai
Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear...
April 23, 2017: Medicines (Basel, Switzerland)
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