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https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#1
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27911143/factors-predicting-life-threatening-infections-with-respiratory-syncytial-virus-in-adult-patients
#2
Se Yoon Park, Taeeun Kim, Young Rock Jang, Min-Chul Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. METHODS: We conducted a retrospective cohort study from October 2013 to September 2015...
December 2, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27906087/legionella-pneumonia-in-the-niagara-region-ontario-canada-a-case-series
#3
Stephanie Cargnelli, Jeff Powis, Jennifer L Y Tsang
BACKGROUND: Legionella pneumophila, a major cause of Legionnaires' disease, accounts for 2-15 % of all community-acquired pneumonia requiring hospitalization and up to 30 % of community-acquired pneumonia requiring intensive care unit admission. Early initiation of appropriate antimicrobial therapy is a crucial step in the prevention of morbidity and mortality. However, recognition of Legionnaires' disease continues to be challenging because of its nonspecific clinical features. We sought to describe hospitalized community-acquired Legionnaires' disease to increase awareness of this important and potentially lethal disease...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27904453/outcome-of-severe-infections-in-afebrile-neutropenic-cancer-patients
#4
Ksenija Strojnik, Ksenija Mahkovic-Hergouth, Barbara Jezersek Novakovic, Bostjan Seruga
BACKGROUND: In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. PATIENTS AND METHODS: We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27888542/clinical-outcomes-of-extended-versus-intermittent-infusion-of-piperacillin-tazobactam-in-critically-ill-patients-a-prospective-clinical-trial
#5
Sheung-Yin Fan, Hoi-Ping Shum, Wing-Yee Cheng, Yat-Hei Chan, Sik-Yin McShirley Leung, Wing-Wa Yan
STUDY OBJECTIVE: To determine whether critically ill patients receiving extended-infusion (EI) piperacillin/tazobactam would have improved clinical outcomes compared with patients receiving intermittent infusions. DESIGN: Single-center, open-label, prospective study. SETTING: Twenty-two-bed intensive care unit (ICU) in a regional hospital in Hong Kong. PATIENTS: A total of 367 adults who had a diagnosis of either bacterial infection or neutropenic fever and had received treatment with piperacillin/tazobactam for at least 48 hours between December 1, 2013, and August 31, 2015...
November 26, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27882170/acute-encephalitis-with-refractory-repetitive-partial-seizures-a-case-report-and-literature-review
#6
Bin Zhang, Lin Wang
A male 46 year-old patient was admitted to the Emergency Intensive Care Unit of Qinghai Provincial People's Hospital (Xining, China) in December 2008 with complaints of a headache and fever that had lasted for three days. In addition, the patient had experienced two general convulsions accompanied with consciousness disorders for 7 h. Although the patient's clinical manifestations, laboratory tests and cerebrospinal fluid examinations were consistent with numerous features associated with acute encephalitis, the patient's clinical course was different to that of acute encephalitis, and the prognosis was poor...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27861258/septic-participation-in-cardiogenic-shock-exposure-to-bacterial-endotoxin
#7
Paula Ramirez, Esther Villarreal, Monica Gordon, María Dolores Gómez, Luis de Hevia, Karla Vacacela, Teresa Gisbert, Adrian Quinzá, Jesús Ruiz, Ricardo Alonso, Juan Bonastre, Jordi Vila
OBJECTIVE: In cardiogenic shock (CS), presence of fever, leukocytosis, relatively low systemic vascular resistances and high serum procalcitonin levels are quite frequent and recurrently involve the search for an infectious complication. We hypothesized that endotoxin exposure in CS could explain this sepsis-like syndrome. DESIGN AND SETTING: Prospective observational study of consecutive CS patients admitted to our intensive care unit (ICU). Patients were followed during the first three days after SC onset...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27856269/efficacy-and-safety-of-withholding-antimicrobial-treatment-in-children-with-cancer-fever-and-neutropenia-with-a-demonstrated-viral-respiratory-infection-a-randomized-clinical-trial
#8
María E Santolaya, Ana M Alvarez, Mirta Acuña, Carmen L Avilés, Carmen Salgado, Juan Tordecilla, Mónica Varas, Marcela Venegas, Milena Villarroel, Marcela Zubieta, Alberto Toso, Alexander Bataszew, Mauricio J Farfán, Verónica de la Maza, Alejandra Vergara, Romina Valenzuela, Juan P Torres
OBJECTIVES: To determine efficacy and safety of withholding antimicrobials in children with cancer, fever and neutropenia (FN) with a demonstrated respiratory viral infection. METHODS: Prospective, multicenter, randomized study in children presenting with FN at five hospitals in Santiago, Chile, evaluated at admission for diagnosis of bacterial and viral pathogens including PCR-microarray for 17 respiratory viruses. Children positive for a respiratory virus, negative for a bacterial pathogen and with a favorable evolution after 48 hours of antimicrobial therapy were randomized to either maintain or withhold antimicrobials...
November 14, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#9
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
November 17, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#10
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27848922/zika-virus-infection
#11
Laurence Pougnet, Chloé Thill, Richard Pougnet, Henri Auvinet, Christophe Giacardi, Isabelle Drouillard
A 21-year old woman from New-Caledonia had 40 ̊C fever with vomiting, arthralgia, myalgia, and measles-like rash. Etiological analyses showed primary infection with Zika virus. Because of severe clinical presentation, she was hospitalized in the intensive care unit of the Brest military Hospital. Zika virus is mainly transmitted by Aedes mosquitoes. If they settle in Metropolitan France, Zika virus might also spread there.
December 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27823918/the-association-between-intrauterine-balloon-tamponade-duration-and-postpartum-hemorrhage-outcomes
#12
Brett D Einerson, Moeun Son, Patrick Schneider, Ian Fields, Emily S Miller
BACKGROUND: Intrauterine balloon tamponade is an effective treatment for postpartum hemorrhage when first-line treatments fail. The optimal duration of intrauterine balloon tamponade for management of postpartum hemorrhage is unclear. OBJECTIVE: The objective of the study was to determine whether intrauterine balloon tamponade removal >12 hours of duration is associated with postpartum hemorrhage-related clinical outcomes. STUDY DESIGN: This was a retrospective cohort study of women with postpartum hemorrhage from 2007 through 2014 who underwent intrauterine balloon tamponade...
November 4, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27822946/the-association-of-fever-with-total-mechanical-ventilation-time-in-critically-ill-patients
#13
Dong Won Park, Moritoki Egi, Masaji Nishimura, Youjin Chang, Gee Young Suh, Chae Man Lim, Jae Yeol Kim, Keiichi Tada, Koichi Matsuo, Shinhiro Takeda, Ryosuke Tsuruta, Takeshi Yokoyama, Seon Ok Kim, Younsuck Koh
This research aims to investigate the impact of fever on total mechanical ventilation time (TVT) in critically ill patients. Subgroup analysis was conducted using a previous prospective, multicenter observational study. We included mechanically ventilated patients for more than 24 hours from 10 Korean and 15 Japanese intensive care units (ICU), and recorded maximal body temperature under the support of mechanical ventilation (MAX(MV)). To assess the independent association of MAX(MV) with TVT, we used propensity-matched analysis in a total of 769 survived patients with medical or surgical admission, separately...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27821396/morphine-induced-hearing-loss
#14
Leire Leache, Irene Aquerreta, Libe Moraza, Ana Ortega
PURPOSE: A case of severe bilateral sensorineural hearing loss associated with oral morphine is reported. SUMMARY: A 52-year-old Spanish man was admitted to the intensive care unit with a Glasgow Coma Scale score of 3, a fever, and sudden hearing loss with tinnitus in both ears. His medical history included type 2 diabetes mellitus, depression, sleep disorder, and hypertension. The patient also had pyelonephritis in 2011 and pulmonary embolism in 2014, requiring the placement of an inferior vena cava filter and chronic anticoagulation...
November 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27821124/severe-leptospirosis-and-pancreatitis-a-case-series-from-a-leptospirosis-outbreak-in-anuradhapura-district-sri-lanka
#15
N J Herath, C J Kamburapola, S B Agampodi
BACKGROUND: Acute pancreatitis is identified as an atypical and rare presentation of leptospirosis. In this report, we discuss a case series of severe leptospirosis with pancreatitis as a main complication during an unusual outbreak of leptospirosis in Anuradhapura district, Sri Lanka. CASE PRESENTATION: We retrospectively reviewed clinical presentation, investigations, treatment and outcome of six confirmed cases of severe leptospirosis admitted to intensive care unit (ICU) of Teaching Hospital, Anuradhapura, within a three months period from November 2014 to January 2015...
November 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27818685/primary-sjogren-s-syndrome-presenting-as-acute-interstitial-pneumonitis-hamman-rich-syndrome
#16
Abidullah Khan, Mohammad Humayun, Iqbal Haider, Maimoona Ayub, Zakir Shah, Fahad Ajmal
A previously well, 45-year-old Pakistani lady was admitted to the medical unit on-call of Khyber Teaching Hospital (KTH) Peshawar with a 5-day history of fever, productive cough with copious mucoid sputum, dyspnea, and pleuritic chest pain. She also complained of dry eyes, mouth, and vagina. Her chest X-ray showed diffuse alveolar shadowing and arterial gas analysis confirmed type 1 respiratory failure. Over the next few days, she deteriorated rapidly making an urgent transfer to the medical intensive care unit (MICU) necessary, where she was mechanically ventilated...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27814324/outcome-of-pediatric-gastroenterology-outpatients-with-fever-and-central-line
#17
Thomas Alexander, Julie Blatt, Asheley Cockrell Skinner, Ravi Jhaveri, Meghan Jobson, Katherine Freeman
OBJECTIVE: Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. METHODS: Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012...
November 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27809807/nosocomial-infection-of-cchf-among-health-care-workers-in-rajasthan-india
#18
Pragya D Yadav, Deepak Y Patil, Anita M Shete, Prasad Kokate, Pulkit Goyal, Santosh Jadhav, Sanjeev Sinha, Divya Zawar, Surendra K Sharma, Arti Kapil, D K Sharma, Kamlesh J Upadhyay, Devendra T Mourya
BACKGROUND: Ever since Crimean-Congo hemorrhagic fever [CCHF] discovered in India, several outbreaks of this disease have been recorded in Gujarat State, India. During the year 2011 to 2015 several districts of Gujarat and Rajasthan state (Sirohi) found to be affected with CCHF including the positivity among ticks and livestock. During these years many infected individuals succumbed to this disease; which subsequently led to nosocomial infections. Herein, we report CCHF cases recorded from Rajasthan state during January 2015...
November 3, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#19
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27803496/left-atrial-to-esophageal-fistula-a-case-report-and-literature-review
#20
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
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