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Infectious disease in neutropenic patients

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https://www.readbyqxmd.com/read/30297005/infectious-disease-emergencies-in-oncology-patients
#1
REVIEW
Lauren Cantwell, Jack Perkins
Oncology patients are a unique patient population in the emergency department (ED). Malignancy and associated surgical, chemotherapeutic, or radiation therapies put them at an increased risk for infection. The most ominous development is neutropenic fever, which happens often and may not present with signs or symptoms other than fever. A broad differential diagnosis is essential when considering infectious disease pathology in both neutropenic and non-neutropenic oncology patients in the ED.
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30113495/role-of-c-reactive-protein-and-procalcitonin-in-discriminating-between-infectious-fever-and-tumor-fever-in-non-neutropenic-lung-cancer-patients
#2
Zhifang Zhao, Xuze Li, Yunxia Zhao, Dongchang Wang, Yahua Li, Le Liu, Tao Sun, Gang Chen
This study assessed whether C-reactive protein (CRP) and procalcitonin (PCT) levels can discriminate between infectious fever and tumor fever (TF) in non-neutropenic patients with nonsmall cell lung cancer (NSCLC).This retrospective clinical study included 96 adults with NSCLC who were admitted to the Third Hospital of Hebei Medical University between July 2015 and July 2017. Febrile, non-neutropenic patients were enrolled. CRP and PCT levels, neutrophil count, and antimicrobial response were evaluated.This study included 26 patients with TF, 49 with localized bacterial infection (LBI), and 21 with bloodstream infection (BSI)...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29942661/empirical-antimicrobial-treatment-in-haemato-oncological-patients-with-neutropenic-sepsis
#3
REVIEW
Matthias Gerhard Vossen, Christopher Milacek, Florian Thalhammer
Neutropenic sepsis in haemato-/oncological patients is a medical emergency, as infections may show a fulminant clinical course. Early differentiation between sepsis and febrile neutropenic response often proves to be challenging. To assess the severity of the illness, different tools, which are discussed in this article, are available. Once the diagnosis has been established, the correct use of early empirical antibiotic and antifungal treatment is key in improving patient survival. Therefore, profound knowledge of local resistance patterns is mandatory and carefully designed antibiotic regimens have to be established in cooperation with local microbiologists or infectious diseases specialists...
2018: ESMO Open
https://www.readbyqxmd.com/read/29589346/-recommendations-for-diagnostics-and-therapy-of-children-with-cancer-presenting-with-fever-and-neutropenia-comparison-of-two-current-guidelines
#4
Thomas Lehrnbecher, Andreas Groll, Philipp Agyeman, Roland A Ammann, Andishe Attarbaschi, Uta Behrends, Christoph Berger, Axel Hamprecht, Markus Hufnagel, Hans-Jürgen Laws, Max Scheler, Christian Temme, Simon Vieth, Arne Simon
Immunocompromised children and adolescents receiving treatment for cancer have a considerably increased risk for infection. Neutropenia is the most important single risk factor for infectious complications, and fever in neutropenia is considered as an emergency. Whereas guidelines for the management of fever in neutropenic adults have been established for decades, specific pediatric guidelines have not been developed until recently. As children differ in many aspects from adults such as in the underlying malignancy or in the availability and dosing of antimicrobial compounds, guidelines for pediatric patients are important...
April 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29588065/atypical-presentation-of-escherichia-coli-monomicrobial-necrotizing-fasciitis-in-a-renal-transplant-patient-a-case-report
#5
S Afghani, V Ngo, T Khan, V Lewis
Skin and soft tissue infections (SSTIs) are one of most frequent infectious causes for referral to the emergency department and one of the most frequent infectious causes of hospital admissions. Escherichia coli, the most commonly occurring gram-negative pathogen involved in these infections, contributes to about 7% of all SSTIs cases where gram-positive organisms reign dominant. Patients are more susceptible to these gram-negative SSTIs if they are neutropenic, have hematologic malignancies, have undergone solid organ or hematopoietic transplantation, or have cirrhotic liver disease...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29501780/clinical-impact-of-pretransplant-multidrug-resistant-gram-negative-colonization-in-autologous-and-allogeneic-hematopoietic-stem-cell-transplantation
#6
Alessandra Forcina, Francesca Lorentino, Vincenzo Marasco, Chiara Oltolini, Magda Marcatti, Raffaella Greco, Maria Teresa Lupo-Stanghellini, Matteo Carrabba, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Fabio Ciceri
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Three-hundred forty-eight consecutive patients transplanted at our hospital from July 2012 to January 2016 were screened for a pretransplant MDR-GNB colonization and evaluated for clinical outcomes. A pretransplant MDR-GNB colonization was found in 16.9% of allo-HSCT and in 9.6% of auto-HSCT recipients. Both in auto- and in allo-HSCT, carriers of a MDR-GNB showed no significant differences in overall survival (OS), transplant-related mortality (TRM), or infection-related mortality (IRM) compared with noncarriers...
July 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29322242/utility-of-fosfomycin-as-antibacterial-prophylaxis-in-patients-with-hematologic-malignancies
#7
Tanya Zapolskaya, Sarah Perreault, Dayna McManus, Jeffrey E Topal
PURPOSE: Prolonged and profound neutropenia is common among hematology and hematopoietic stem cell transplant (HSCT) patients as a result of chemotherapy. The National Comprehensive Cancer Network (NCCN) and Infectious Diseases Society of America (IDSA) currently recommend antibacterial prophylaxis in patients who are deemed at intermediate or high risk for infection. Specifically, fluoroquinolone prophylaxis should be considered for high-risk neutropenic patients. However, with prolonged and frequent exposure to fluoroquinolones, these high-risk patients may develop resistance to these agents...
June 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29290230/antimicrobial-treatment-of-urinary-tract-infections-in-children
#8
R Cohen, J Raymond, E Launay, Y Gillet, P Minodier, F Dubos, E Grimprel
Urinary tract infections are the most frequent documented bacterial infections in children. The antibiotic choices proposed in this manuscript are based on the guidelines published by the Pediatric Infectious Disease Group (GPIP) and the French-Language Infectious Disease Society (SPILF). Dipstick positive for leukocytes and/or nitrites must precede in most circumstances (excluding the newborns, neutropenic patients and those with sepsis), urine culture and antibiotic prescription. The proportion of extended-spectrum β-lactamase (ESBL) Escherichia coli strains has increased steadily in recent years, and the situations in which oral antibiotic switch is frequently not available are increasing...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29173155/imaging-of-bacteria-is-there-any-hope-for-the-future-based-on-past-experience
#9
Thomas Ebenhan, Elena Lazzeri, Olivier Gheysens
Infectious diseases remain a major health problem and cause of death worldwide. It is expected that the socio-economic impact will further intensify due to escalating resistance to antibiotics, an ageing population and an increase in the number of patients under immunosuppressive therapy and implanted medical devices. Even though radiolabeled probes and leukocytes are routinely used in clinical practice, it might still be difficult to distinguish sterile inflammation from inflammation caused by bacteria. Moreover, the majority of these probes are based on the attraction of leukocytes which may be hampered in neutropenic patients...
2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29119669/sinusitis-caused-by-exserohilum-rostratum-after-cord-blood-transplantation-for-myelodysplastic-syndrome-a-case-report-and-literature-review
#10
Sumiko Kohashi, Takaaki Toyama, Norisato Hashimoto, Masatoshi Sakurai, Jun Kato, Taku Kikuchi, Yuya Koda, Kayoko Sugita, Naoki Hasegawa, Kyoko Yarita, Katsuhiko Kamei, Shinichiro Okamoto, Takehiko Mori
Invasive fungal disease is a serious infectious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Exserohilum rostratum is a species causing phaeohyphomycosis, which rarely causes invasive disease in humans. We treated a case of sinusitis caused by E. rostratum after cord blood transplantation (CBT). A 60-year-old man with myelodysplastic syndrome, who had a medical history of an operation to correct deviation of the nasal septum, developed sinusitis caused by E. rostratum under prolonged profound neutropenia after a second CBT because of the graft rejection of the first transplantation...
November 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28936146/adherence-to-clinical-practice-guidelines-for-the-treatment-of-candidemia-at-a-veterans-affairs-medical-center
#11
Chester N Ashong, Andrew S Hunter, M David Mansouri, Richard M Cadle, Richard J Hamill, Daniel M Musher
OBJECTIVES: The primary objective of this study was to examine the appropriateness of candidemia management at a Veterans Affairs Medical Center as recommended by the 2009 Infectious Diseases Society of America (IDSA) guidelines for treatment of Candida infections. METHODS: A retrospective analysis of 94 adult patients with blood cultures positive for Candida spp. was performed. Patients were stratified by severity of disease into two groups: non-neutropenic, mild-moderate disease (Group 1, n = 54, 56%) and non-neutropenic, moderate-severe disease (Group 2, n = 40, 42%)...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28856437/diagnosis-and-empirical-treatment-of-fever-of-unknown-origin-fuo-in-adult-neutropenic-patients-guidelines-of-the-infectious-diseases-working-party-agiho-of-the-german-society-of-hematology-and-medical-oncology-dgho
#12
REVIEW
W J Heinz, D Buchheidt, M Christopeit, M von Lilienfeld-Toal, O A Cornely, H Einsele, M Karthaus, H Link, R Mahlberg, S Neumann, H Ostermann, O Penack, M Ruhnke, M Sandherr, X Schiel, J J Vehreschild, F Weissinger, G Maschmeyer
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade...
November 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#13
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28672417/-infections-as-a-cause-of-unexplained-fever
#14
REVIEW
Bernd Salzberger, Gabriele Birkenfeld, Michael Iberer, Florian Hitzenbichler
Fever of unexplained (or unknown) origin (FUO) remains a relevant clinical problem even with modern diagnostic methods. In addition to the classical definition, new categories of FUO describe different clinical situations: nosocomial FUO, FUO in neutropenic/immundeficient patients and FUO in patients with HIV-infection. The new categories are defined by much shorter duration of fever, i. e. mostly three days. Each category of FUO shows a different spectrum of infectious diseases. Often, subacute bacterial endocarditis is very difficult to verify...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28579084/j%C3%A3-vea-consensus-guidelines-for-the-treatment-of-candida-peritonitis-and-other-intra-abdominal-fungal-infections-in-non-neutropenic-critically-ill-adult-patients
#15
Javier Pemán, Gerardo Aguilar, Juan Carlos Valía, Miguel Salavert, David Navarro, Rafael Zaragoza
BACKGROUND: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. AIMS: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection...
July 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28056830/development-of-aspergillosis-in-a-cohort-of-non-neutropenic-non-transplant-patients-colonised-by-aspergillus-spp
#16
MULTICENTER STUDY
José Barberán, Francisco-Javier García-Pérez, Victoria Villena, Alberto Fernández-Villar, Eduardo Malmierca, Cristina Salas, María-José Giménez, Juan-José Granizo, Lorenzo Aguilar
BACKGROUND: A previous study explored factors discriminating colonization and true infection among non-transplant, non-neutropenic patients with repeated Aspergillus spp. isolation from lower respiratory samples. The present study explored the evolution of patients with Aspergillus colonization in that study to determine the percentage of cases progressing to aspergillosis and time to development. METHODS: Clinical records were retrospectively reviewed (for each patient from his end date in the past study) and data from all respiratory processes suffered by patients up to April 2015 were recorded...
January 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27769740/epico-3-0-management-of-non-neutropenic-patients-in-medical-wards
#17
Ricardo Ferrer, Rafael Zaragoza, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Francisco Álvarez-Lerma, Guillermo Quindós, Miguel Salavert, Rafael Huarte
BACKGROUND: Although the management of invasive fungal infection (IFI) has improved, a number of controversies persist regarding the approach to invasive fungal infection in non-neutropenic medical ward patients. AIMS: To identify the essential clinical knowledge to elaborate a set of recommendations with a high level of consensus necessary for the management of IFI in non-neutropenic medical ward patients. METHODS: A prospective, Spanish questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists (intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases) in IFI and belonging to six scientific national societies...
October 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27690629/optimizing-antifungal-strategies-to-improve-patient-survival
#18
Paul Verweij, Sue Lyon
Report from the 26th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2016), 9-12 April Amsterdam, The Netherlands Invasive fungal infections are a major threat to the lives of the increasing number of immunocompromized patients, but neutropenic hemato-oncology patients are at especially high risk. Since effective antifungal treatment and prophylaxis are critical to improve survival in these patients, the emergence of antifungal drug resistance has become an increasing cause of concern...
October 3, 2016: Future Microbiology
https://www.readbyqxmd.com/read/27688611/bloodstream-infections-in-febrile-neutropenic-patients-at-a-tertiary-cancer-institute-in-south-india-a-timeline-of-clinical-and-microbial-trends-through-the-years
#19
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/27638133/management-of-neutropenic-patients-in-the-intensive-care-unit-newborns-excluded-recommendations-from-an-expert-panel-from-the-french-intensive-care-society-srlf-with-the-french-group-for-pediatric-intensive-care-emergencies-gfrup-the-french-society-of-anesthesia
#20
REVIEW
David Schnell, Elie Azoulay, Dominique Benoit, Benjamin Clouzeau, Pierre Demaret, Stéphane Ducassou, Pierre Frange, Matthieu Lafaurie, Matthieu Legrand, Anne-Pascale Meert, Djamel Mokart, Jérôme Naudin, Frédéric Pene, Antoine Rabbat, Emmanuel Raffoux, Patricia Ribaud, Jean-Christophe Richard, François Vincent, Jean-Ralph Zahar, Michael Darmon
Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society...
December 2016: Annals of Intensive Care
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