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https://www.readbyqxmd.com/read/29141761/leptospirosis-cases-infected-with-uncommon-serogroups-puerto-rico-2013-2015
#1
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/29129539/leptospirosis-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#2
REVIEW
Juan Ignacio Silesky Jiménez, Jorge Luis Hidalgo Marroquin, Guy A Richards, Pravin Amin
Leptospirosis is a zoonosis caused by a gram negative aerobic spirochete of the genus Leptospira. It is acquired by contact with urine or reproductive fluids from infected animals, or by inoculation from contaminated water or soil. The disease has a global distribution, mainly in tropical and subtropical regions that have a humid, rainy climate and is also common in travelers returning from these regions. Clinical suspicion is critical for the diagnosis and it should be included in the differential diagnosis of any patient with a febrile hepatorenal syndrome in, or returning from endemic regions...
November 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29066581/reducing-time-to-antibiotics-in-children-with-intestinal-failure-central-venous-line-and-fever
#3
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/29061534/granulocyte-colony-stimulating-factor-use-after-autologous-peripheral-blood-stem-cell-transplantation-comparison-of-two-practices
#4
Amrita D Singh, Sapna Parmar, Khilna Patel, Shreya Shah, Tsiporah Shore, Usama Gergis, Sebastian Mayer, Adrienne Phillips, Jing-Mei Hsu, Ruben Niesvizky, Tomer M Mark, Roger Pearse, Adriana Rossi, Koen van Besien
Administration of granulocyte colony-stimulating factor (G-CSF) after autologous peripheral blood stem cell transplantation (PBSCT) is generally recommended to reduce the duration of severe neutropenia; however, there is limited and conflicting data regarding the optimal timing of G-CSFs post-transplant. A retrospective study was performed at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WC) from November 5, 2013 to August 9, 2016 of adult inpatient autologous PBSCT patients who received G-CSF empirically starting on day +5 (early) versus day +12 only if absolute neutrophil count (ANC) was <0...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29047427/pregnant-women-hospitalized-with-chikungunya-virus-infection-colombia-2015
#5
Maria Escobar, Albaro J Nieto, Sara Loaiza-Osorio, Juan S Barona, Fernando Rosso
In 2015 in Colombia, 60 pregnant women were hospitalized with chikungunya virus infections confirmed by reverse transcription PCR. Nine of these women required admission to the intensive care unit because of sepsis with hypoperfusion and organ dysfunction; these women met the criteria for severe acute maternal morbidity. No deaths occurred. Fifteen women delivered during acute infection; some received tocolytics to delay delivery until after the febrile episode and prevent possible vertical transmission. As recommended by a pediatric neonatologist, 12 neonates were hospitalized to rule out vertical transmission; no clinical findings suggestive of neonatal chikungunya virus infection were observed...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28975138/high-dose-cyclophosphamide-without-stem-cell-rescue-in-immune-mediated-necrotizing-myopathies
#6
Christopher A Mecoli, Arash H Lahouti, Robert A Brodsky, Andrew L Mammen, Lisa Christopher-Stine
OBJECTIVE: To describe the experience managing treatment-refractory immune-mediated necrotizing myopathies (IMNM) with high-dose cyclophosphamide (HiCy) therapy. METHODS: Five patients with severe refractory IMNM who were treated with HiCy without stem cell rescue were identified. Their medical records were reviewed to assess demographic, clinical, and histologic characteristics as well as response to therapy. RESULTS: Three patients with anti-signal recognition particle (SRP) and 2 patients with anti-HMG-CoA reductase autoantibodies were included...
September 2017: Neurology® Neuroimmunology & Neuroinflammation
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
#7
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/28923865/an-in-vitro-comparison-of-ceftolozane-tazobactam-compared-to-traditional-beta-lactams-as-an-alternative-to-combination-antimicrobial-therapy-for-pseudomonas-aeruginosa
#8
Kellie J Goodlet, David P Nicolau, Michael D Nailor
Background: Guidelines for sepsis, febrile neutropenia, and hospital-acquired pneumonia include empiric regimens incorporating two antibiotics from different classes with activity against Pseudomonas aeruginosa for select at-risk patients to increase the likelihood of susceptibility to at least one agent.Objectives: The activity and cross-resistance rates of ceftolozane/tazobactam were compared to β-lactam comparators cefepime, ceftazidime, piperacillin/tazobactam, and meropenem alone and cumulatively with ciprofloxacin or tobramycin against P...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#9
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28803441/thermoregulation-disorders-of-central-origin-how-to-diagnose-and-treat
#10
Marta Zawadzka, Marta Szmuda, Maria Mazurkiewicz-Bełdzińska
Fever is a common symptom in the Intensive Care Unit. At least half of febrile episodes are caused by infection. Excluding infectious etiology and other non-infectious causes of fever, especially in patients with central nervous system (CNS) disorders, attention should be paid to disturbances of thermoregulatory centre. In particular, subarachnoid haemorrhage, cerebral trauma, along with ischaemic or haemorrhagic stroke are strongly associated with the development of central fever. Proper, speedy diagnosis of the cause of fever makes it possible to implement preventive measures against the harmful effects of hyperthermia on the CNS and to avoid the consequences of inappropriate treatment...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28702342/pulmonary-manifestation-of-plasmodium-falciparum-malaria-case-reports-and-review-of-the-literature
#11
Fatehi Elzein, Nazik Mohammed, Najoud Ali, Abdelkarim Bahloul, Abeer Albadani, Nisreen Alsherbeeni
Pulmonary complications, including acute respiratory distress syndrome (ARDS), are well described in P. falciparum (PF) and to a lesser extent in other malaria species. In non-endemic areas, malaria diagnosis may be overlooked; if a thorough travel history is not obtained on all patients with acute febrile illness. Three patients with malaria associated respiratory distress were admitted to our intensive care unit. The diagnosis was delayed; however, all patients received artesunate and intensive therapy with a satisfactory outcome...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28674380/exceptionally-high-creatine-kinase-ck-levels-in-multicausal-and-complicated-rhabdomyolysis-a-case-report
#12
Pavan Luckoor, Mashal Salehi, Afua Kunadu
BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure...
July 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#13
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28425571/clinical-factors-affecting-costs-in-patients-receiving-systemic-antifungal-therapy-in-intensive-care-units-in-greece-results-from-the-estimator-study
#14
A Armaganidis, S Nanas, E Antoniadou, K Mandragos, K Liakou, A Koutsoukou, G Baltopoulos, G Nakos, A Kounougeri, K Ganas, A Prekates, M Kompoti, D Georgopoulos, I Pneumatikos, E Zakynthinos
Invasive fungal infections are common in intensive care units (ICUs) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult ICU patients with or without documented invasive fungal infection receiving systemic antifungal therapy (SAT) we have performed a prospective, multicentre, observational study enrolling patients receiving SAT in participating ICUs in Greece. During the study period, 155 patients received SAT at 14 participating ICUs: 37 (23...
April 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28405984/a-prospective-study-of-acute-kidney-injury-according-to-kdigo-definition-and-its-mortality-predictors
#15
Rakesh Bhadade, Rosemarie De'Souza, Minal J Harde, Kalpana S Mehta, Prabhat Bhargava
BACKGROUND: Acute kidney injury is no longer considered to be an innocent bystander merely reflecting co-existent pathologies but an independent risk factor for mortality in the ICU. AIMS AND OBJECTIVES: To study clinical profile and correlation of patients with acute kidney injury (AKI) according to KDIGO definition with respect to incidence, outcome and different causes of AKI in critical care unit. STUDY DESIGN AND SETTING: It is a prospective observational study; and was carried out in the ICU of a tertiary care, teaching, public hospital...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28399851/babesiosis-in-long-island-review-of-62-cases-focusing-on-treatment-with-azithromycin-and-atovaquone
#16
Ekaterina A Kletsova, Eric D Spitzer, Bettina C Fries, Luis A Marcos
BACKGROUND: Babesiosis is a potentially life-threatening, tick-borne infection endemic in New York. The purpose of this study was to review recent trends in babesiosis management and outcomes focusing on patients, who were treated with combination of azithromycin and atovaquone. METHODS: A retrospective chart review of patients seen at Stony Brook University Hospital between 2008 and 2014 with peripheral blood smears positive for Babesia was performed. Clinical and epidemiological information was recorded and analyzed...
April 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28396650/new-onset-refractory-status-epilepticus-with-claustrum-damage-definition-of-the-clinical-and-neuroimaging-features
#17
Stefano Meletti, Giada Giovannini, Giuseppe d'Orsi, Lisa Toran, Giulia Monti, Rahul Guha, Andreas Kiryttopoulos, Maria Grazia Pascarella, Tommaso Martino, Haris Alexopoulos, Martha Spilioti, Jana Slonkova
New-onset refractory status epilepticus (NORSE) is a rare but challenging condition occurring in a previously healthy patient, often with no identifiable cause. We describe the electro-clinical features and outcomes in a group of patients with NORSE who all demonstrated a typical magnetic resonance imaging (MRI) sign characterized by bilateral lesions of the claustrum. The group includes 31 patients (12 personal and 19 previously published cases; 17 females; mean age of 25 years). Fever preceded status epilepticus (SE) in 28 patients, by a mean of 6 days...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28390959/fever-after-peripheral-blood-stem-cell-infusion-in-haploidentical-transplantation-with-post-transplant-cyclophosphamide
#18
Marcos Arango, Juan F Combariza
OBJECTIVE/BACKGROUND: Noninfection-related fever can occur after peripheral blood stem cell infusion in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide. The objective of this study was to analyze the incidence of fever and characterize some clinical features of affected patients. METHODS: A retrospective case-series study with 40 patients who received haploidentical hematopoietic stem cell transplantation was carried out...
June 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28361596/a-case-of-fatal-agranulocytosis-that-developed-in-a-patient-with-%C3%AE-thalassemia-major-treated-with-deferiprone
#19
Maria Mainou, Aggeliki Kotsiafti, Philippos Klonizakis, Vasiliki Soulountsi, Chrysoula Apostolou, Kiriakos Psarras, Efthymia Vlachaki
A 29-year-old male with transfusion-dependent β-thalassemia major (β-TM), splenectomized and on chelation therapy with deferiprone (DFP or L1) due to heart and liver hemosiderosis, presented with high fever and agranulocytosis. Deferiprone was discontinued and a broad spectrum antibiotic therapy was started intravenously. The patient remained febrile and showed no recovery of neutrophil count even after the initiation of granulocyte colony-stimulation factor (G-CSF). After 12 days at the hospital, he developed respiratory failure and was transferred to the intensive care unit (ICU) where he developed multi-organ failure and died 3 days later...
November 2016: Hemoglobin
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#20
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
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