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Culture-negative sepsis

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https://www.readbyqxmd.com/read/27908336/appropriate-antibiotic-therapy
#1
REVIEW
Michael G Allison, Emily L Heil, Bryan D Hayes
Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that determine the optimal breadth of antimicrobial therapy. Cultures should be drawn before antibiotic therapy if it does not significantly delay administration. Combination antibiotic therapy against gram-negative infections is not routinely required, and combination therapy involving vancomycin and piperacillin/tazobactam is associated with an increase in acute kidney injury...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27899386/thyroid-abscess-in-case-of-pre-b-acute-lymphoblastic-leukaemia-a-rare-presentation
#2
Siddhesh Arun Kalantri, Saikat Datta, Dhritiman Maitra, Maitreyee Bhattacharyya
Thyroid abscess is a very rare clinical condition. It usually occurs in immunocompromised individuals or those with underlying malignancy. We report a case of multiple thyroid abscesses in the patient with Pre B acute lymphoblastic leukaemia which developed secondary to hematogenous spread from pyomyositis of right calf muscle. The patient developed sepsis-associated disseminated intravascular coagulation, which got resolved after thyroidectomy. He became afebrile after surgical intervention. Unfortunately, all the cultures were negative...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27891369/the-diagnostic-value-of-urinalysis-in-hemodialysis-patients-with-fever-sepsis-or-suspected-urinary-tract-infection
#3
Katerina G Oikonomou, Adib Alhaddad
INTRODUCTION: The diagnostic validity of urinalysis in asymptomatic Hemodialysis (HD) patients is low and there is limited data on the diagnostic value of urinalysis in HD patients with fever, sepsis, or suspected Urinary Tract Infection (UTI). AIM: The aim of this study was to assess the sensitivity, specificity, positive and negative predictive value of pyuria, bacteriuria, Leukocyte Esterase (LE) and nitrite positivity in symptomatic, febrile or/and septic HD patients...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890455/the-detection-of-microbial-dna-but-not-cultured-bacteria-is-associated-with-increased-mortality-in-patients-with-suspected-sepsis-a-prospective-multi-centre-european-observational-study
#4
Michael J O'Dwyer, Malgorzata H Starczewska, Jacques Schrenzel, Kai Zacharowski, David Ecker, Rangarajan Sampath, David Brealey, Mervyn Singer, Nicolas Libert, Mark Wilks, Jean-Louis Vincent
OBJECTIVES: Blood culture results inadequately stratify the mortality risk in critically ill patients with sepsis. We sought to establish the prognostic significance of the presence of microbial DNA in the bloodstream of patients hospitalised with suspected sepsis. METHODS: We analysed the data collected during the Rapid Diagnosis of Infections in the Critically Ill (RADICAL) study which compared a novel culture-independent polymerase chain reaction/electrospray ionization-mass spectrometry (PCR/ESI-MS) assay with standard microbiological testing...
November 23, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27889413/molecular-diagnosis-of-bloodstream-infections-in-onco-haematology-patients-with-pcr-esi-ms-technology
#5
Elena Jordana-Lluch, Belén Rivaya, Clara Marcó, Montserrat Giménez, Ma Dolores Quesada, Agustín Escobedo, Montserrat Batlle, Elisa Martró, Vicente Ausina
OBJECTIVES: Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. METHODS: A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information...
November 23, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#6
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
https://www.readbyqxmd.com/read/27850331/692-practice-patterns-for-antibiotic-de-escalation-in-mrsa-culture-negative-sepsis
#7
Farid Sadaka, Matthew Korobey, Alexis Dumm, Greggory Wegener, Rachna Kumar, Alex Bryant, Jackyln O'Brien
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#8
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/27848063/concordance-of-renal-stone-culture-pmuc-rpuc-rsc-and-post-pcnl-sepsis-a-non-randomized-prospective-observation-cohort-study
#9
Annerleim Walton-Diaz, José Ignacio Vinay, Jaime Barahona, Pieter Daels, Mariano González, Juan Pablo Hidalgo, Cristian Palma, Pablo Díaz, Alfredo Domenech, Rodrigo Valenzuela, Fernando Marchant
INTRODUCTION: Between 5 and 10% of patients undergoing percutaneous nephrolithotomy (PCNL) develop postoperative sepsis 1, 2. Strategies to prevent infectious complications are based on information provided by preoperative midstream urine cultures (PMUC). The aim of this study is to evaluate the concordance of the microbiologic findings of PMUC, cultures of the renal stone (RSC) and urine obtained directly from the renal pelvis (RPUC) in patients undergoing PCNL. MATERIALS AND METHODS: This is a multicenter prospective study...
November 15, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27837325/reduced-length-of-hospital-stay-through-a-point-of-care-placed-automated-blood-culture-instrument
#10
M J Bruins, M J Egbers, T M Israel, S H A Diepeveen, M J H M Wolfhagen
Early appropriate antimicrobial treatment of patients with sepsis has a large impact on clinical outcome. To enable prompt and efficient processing of blood cultures, the inoculated vials should be placed into an automated continuously monitoring blood culture system immediately after sampling. We placed an extra BACTEC FX instrument at the emergency department of our hospital and validated the twice-daily re-entering of ongoing vials from this instrument into the BACTEC FX at the laboratory. We subsequently assessed the benefits of shortening the transport time between sampling and monitored incubation of blood culture vials by comparing the turnaround times of positive blood cultures from emergency department patients with a historical control group...
November 11, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27832977/development-and-validation-of-a-parsimonious-and-pragmatic-charm-score-to-predict-mortality-in-patients-with-suspected-sepsis
#11
Kuan-Fu Chen, Su-Hsun Liu, Chih-Huang Li, Chin-Chieh Wu, Chung-Hsien Chaou, I-Shiang Tzeng, Yu-Hsiang Hsieh, Gerald N Blaney, Zhen-Ying Liu, Shih-Tsung Han, Yi-Lin Chan
BACKGROUND: We aimed to derive and validate a parsimonious and pragmatic clinical prediction rule using the concepts of Predisposition, Infection, Response, and Organ Dysfunction to predict in-hospital mortality; and to compare it with other prediction rules, as well as with conventional biomarkers for evaluating the mortality risk of patients with suspected sepsis in the emergency department (ED). METHODS: We conducted a pragmatic cohort study with consecutive ED patients aged 18 or older with documented diagnostic codes of infection and two sets of blood culture ordered by physicians between 2010 and 2012 in a tertiary teaching hospital...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27828901/fusarium-solani-subretinal-abscess-in-a-patient-with-acute-myeloid-leukemia
#12
Ariel Schlaen, Mariana Ingolotti, Pablo Lorenzon, Jorge Mancini, Cristobal Couto, Maria Casanova, Gustavo Kusminsky, Matias Tisi Baña, Gloria Pineda, Alejandra Rima, Mario Saravia
PURPOSE: To report on a case of Fusarium solani subretinal abscess in a patient with acute myeloid leukemia treated with an allogenic bone marrow transplant. METHODS: A 47-year-old male with a history of acute myeloid leukemia with intermediate cytogenetic risk was admitted in our hospital. The disease relapsed after two cycles of chemotherapy. He was then treated with an allogenic bone marrow transplant, with busulfan, cyclophosphamide, and thymoglobulin. One week after the procedure, a sepsis of unknown origin in neutropenia occurred...
November 8, 2016: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/27828898/pediatric-ventilator-associated-infections-the-ventilator-associated-infection-study
#13
Douglas F Willson, Michelle Hoot, Robinder Khemani, Christopher Carrol, Aileen Kirby, Adam Schwarz, Rainer Gedeit, Sholeen T Nett, Simon Erickson, Heidi Flori, Spencer Hays, Mark Hall
OBJECTIVE: Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes. DESIGN: Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia...
November 8, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27827282/primary-wound-closure-of-diabetic-foot-ulcers-by-debridement-and-stitching
#14
M E Ahmed, M S Mohammed, S I Mahadi
OBJECTIVE: The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs. METHOD: This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27823893/sepsis-clinical-criteria-in-emergency-department-patients-admitted-to-an-intensive-care-unit-an-external-validation-study-of-quick-sequential-organ-failure-assessment
#15
Michael D April, Jose Aguirre, Lloyd I Tannenbaum, Tyler Moore, Alexander Pingree, Robert E Thaxton, Daniel J Sessions, James H Lantry
BACKGROUND: Quick Sequential Organ Failure Assessment (qSOFA) is a prognostic score for patients with sepsis. OBJECTIVE: Our aim was to compare the area under the receiver operating curve (AUROC), sensitivity, specificity, and likelihood ratios of qSOFA vs. systemic inflammation response syndrome (SIRS) in predicting in-hospital mortality among emergency department (ED) patients with suspected infection admitted to intensive care units (ICUs). METHODS: We conducted a retrospective cohort chart review study of ED patients admitted to an ICU with suspected infection from August 1, 2012 to February 28, 2015...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818808/persistent-bacteremia-from-pseudomonas-aeruginosa-with-in-vitro-resistance-to-the-novel-antibiotics-ceftolozane-tazobactam-and-ceftazidime-avibactam
#16
Louie Mar Gangcuangco, Patricia Clark, Cynthia Stewart, Goran Miljkovic, Zane K Saul
Ceftazidime-avibactam and ceftolozane-tazobactam are new antimicrobials with activity against multidrug-resistant Pseudomonas aeruginosa. We present the first case of persistent P. aeruginosa bacteremia with in vitro resistance to these novel antimicrobials. A 68-year-old man with newly diagnosed follicular lymphoma was admitted to the medical intensive care unit for sepsis and right lower extremity cellulitis. The patient was placed empirically on vancomycin and piperacillin-tazobactam. Blood cultures from Day 1 of hospitalization grew P...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27803084/severe-soft-tissue-infection-masquerading-as-necrotising-fasciitis-in-a-31-year-old-woman-with-a-background-of-right-thigh-arteriovenous-malformation
#17
Pennylouise Hever, Naveen Cavale, Paul Harnett
A 31-year-old woman with a history of a right thigh arteriovenous malformation presented with an acute history of right thigh pain and swelling. This rapidly progressed to gross sepsis. She was intubated, requiring inotropic support and renal replacement therapy. She was considered disproportionately unwell, with the impression one of necrotising fasciitis (NF). She was taken to theatre for emergency exploration and debridement. There was no evidence of NF to note in theatre. Tissue samples cultured group C Streptococcus, with histopathological examination confirming group C Streptococcal soft tissue infection...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27793578/diagnostic-value-of-sepsis-biomarkers-in-hematopoietic-stem-cell-transplant-recipients-in-a-condition-of-high-prevalence-of-gram-negative-pathogens
#18
Igor Stoma, Igor Karpov, Anatoly Uss, Oleg Rummo, Natalia Milanovich, Igor Iskrov
OBJECTIVE/BACKGROUND: A decision about the need for antimicrobial therapy in a patient with febrile neutropenia after hematopoietic stem cell transplantation (HSCT) is often complicated because of the low frequency of culture isolation and reduced clinical manifestation of infection. Usefulness and choice of sepsis biomarkers to distinguish bloodstream infection (BSI) from other causes of febrile episode is still argued in HSCT recipients in modern epidemiological situations characterized by the emergence of highly resistant gram-negative microorganisms...
October 20, 2016: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/27781969/-a-blood-culture-containing-coagulase-negative-staphylococci-not-always-due-to-contamination
#19
E C F Wagenaar, P van Wijngaarden, C M Verduin, D Beelen, R W van Etten
Staphylococcus lugdunensis (SL) is a species belonging to the group of coagulase-negative staphylococci (CNS). It can cause severe infections such as endocarditis. Three cases of endocarditis caused by SL are presented. The first case describes a 71-year-old man with a fever and endogenous endophthalmitis. The second case describes delirium in an 87-year-old woman, thought to be due to pneumonia. The third case describes a 76-year-old man with an infection of unknown origin. In all cases, the first blood cultures drawn were positive for CNS and considered to be contaminated...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27777118/the-occurrence-of-infective-endocarditis-with-staphylococcus-lugdunensis-bacteremia-a-retrospective-cohort-study-and-systematic-review
#20
Lemuel R Non, Carlos A Q Santos
BACKGROUND: Staphylococcus lugdunensis is a coagulase-negative staphylococcus with similar virulence characteristics as S. aureus. Whether S. lugdunensis causes infective endocarditis (IE) in a similar proportion of cases as S. aureus (reported to be 12.6% in a definitive multicenter prospective study) is unclear. METHODS: We conducted a retrospective cohort study of adult patients with at least one blood culture positive for S. lugdunensis at our institution from January 2006 to December 2014...
October 21, 2016: Journal of Infection
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