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March 2018: Medicine (Baltimore)
Muneyoshi Kimura, Hideki Araoka, Hisashi Yamamoto, Shigeki Nakamura, Minoru Nagi, Satoshi Yamagoe, Yoshitsugu Miyazaki, Sho Ogura, Takashi Mitsuki, Mitsuhiro Yuasa, Daisuke Kaji, Kosei Kageyama, Aya Nishida, Yuki Taya, Hiroshi Shimazu, Kazuya Ishiwata, Shinsuke Takagi, Go Yamamoto, Yuki Asano-Mori, Naoyuki Uchida, Atsushi Wake, Shuichi Taniguchi, Akiko Yoneyama
Limited data are available on micafungin breakthrough fungemia (MBF), fungemia that develops on administration of micafungin, in patients with hematological disorders. We reviewed medical and microbiological records of patients with hematological disorders who developed MBF between January 2008 and June 2015. A total of 39 patients with MBF were identified and Candida (30 strains) and non- Candida (9 strains) fungal species were recognized as causative strains. Among 35 stored strains, C. parapsilosis (14 strains), Trichosporon asahii (7 strains), C...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Xiaoming Yu, Xueding Cai, Xiaomei Xu, Lin Zhang, Xiaoying Huang, Liangxing Wang, Yanfan Chen
RATIONALE: This report describes a rare case in Wenzhou city of Zhejiang province that a non-HIV infected male recovering from fungemia caused by Penicillium marneffei (P. marneffei). Interestingly, it's very easy to misdiagnose with aspergillosis, a fungal disease prevalent in Wenzhou, during the whole procedure. PATIENT CONCERNS: An 80-year-old Chinese male subject with pre-existing chronic obstructive pulmonary disease (COPD) presented with symptoms of chest tightness and high fever for a month...
January 2018: Medicine (Baltimore)
Prajwal Boddu, Pei-Ling Chen, Priyadharsini Nagarajan, Victor G Prieto, Alex Won, Mark Chambers, Steven Kornblau
Oral fungal infections present with atypical and varied manifestations, and distinguishing them from other entities including leukemic infiltration can be diagnostically challenging. In this report, we describe a 62 year old female with acute myeloid leukemia who presented, towards the end of her second treatment cycle of decitabine in a prolonged neutropenic state, with a month of painful, necrotic-appearing marginal gingival lesions. She was duly initiated on empiric broad spectrum antifungal treatment but did not show a clinical response with the appearance of new skin lesions concerning for progressive fungemia...
January 2018: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Tajana Pavic, Davor Hrabar, Dominik Kralj, Ivan Lerotic, Doris Ogresta
Necrotizing pancreatitis remains a challenging and unpredictable condition accompanied by various complications. Endoscopic ultrasound-guided transmural drainage and necrosectomy have become the standard treatment for patients with walled-off necrosis (WON). Endoscopic therapy via lumen-apposing metal stents (LAMS) with large diameters has shown success in the management of pancreatic fluid collections, but there are few data on specific complications of that therapy. We report a case of infected WON and concomitant fungemia following LAMS placement and necrosectomy...
January 30, 2018: Clinical Journal of Gastroenterology
Saad J Taj-Aldeen
The resistance among various opportunistic Fusarium species to different antifungal agents has emerged as a cause of public health problems worldwide. Considering the significance of multi-drug resistant (MDR), this paper emphasizes the problems associated with MDR and the need to understand its clinical significance to combat microbial infections. The search platform PubMed/MEDLINE and a review of 32 cases revealed a common multidrug-resistant profile exists, and clinically relevant members of Fusarium are intrinsically resistant to most currently used antifungals...
April 10, 2017: Journal of Fungi (Basel, Switzerland)
Joel Rosenblatt, Ruth A Reitzel, Nylev Vargas-Cruz, Anne-Marie Chaftari, Ray Hachem, Issam I Raad
Fungal catheter-related bloodstream infections (CRBSIs)-primarily due to Candida species-account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved catheter lock solutions (heparin and saline) and three experimental antimicrobial catheter lock solutions-30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)-in an in vitro model of catheters colonized by fungi...
February 10, 2017: Journal of Fungi (Basel, Switzerland)
Kiyomi Morita, Akira Honda, Junji Koya, Kazuhiro Toyama, Ikeda Mahoko, Yoshiki Misawa, Shu Okugawa, Fumihiko Nakamura, Kyoji Moriya, Mineo Kurokawa
Bloodstream infection with non-Candida albicans Candida species is one of the serious complications among patients with hematological malignancies who receive long-term prophylactic antifungal agents. Here we describe three cases of Candida fermentati (C. fermentati) candidemia after allogeneic stem cell transplantation for hematological malignancies. Case 1 is fluconazole-breakthrough C. fermentati fungemia, which was well controlled with liposomal amphotericin B. Case 2 and 3 were caspofungin-breakthrough C...
January 19, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Balasubramanian Venkatesh, Simon Finfer, Jeremy Cohen, Dorrilyn Rajbhandari, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Maryam Correa, Parisa Glass, Meg Harward, Christopher Joyce, Qiang Li, Colin McArthur, Anders Perner, Andrew Rhodes, Kelly Thompson, Steve Webb, John Myburgh
Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group)...
January 19, 2018: New England Journal of Medicine
Murali Sandhya, Aparna V, Suresh Maneesha K, Biswas Raja, Jayakumar R, Sathianarayanan S
The current study assesses the potential of functionalised chitosan nanoparticles (CNPs) for proficient macrophage delivery of amphotericin B (AmpB) for the management of Candida glabrata fungemia. Chitosan was functionalised by the method of sulfation by using chlorosulfonic acid and the developed compound was confirmed by FTIR, 1H NMR and degree of sulfation and CHNS analysis. Amphotericin B encapsulated sulfated chitosan (AmpB-SCNPs), when characterized showed a hydrodynamic diameter of 310 ± 14 nm and zeta potential of 41...
January 12, 2018: International Journal of Biological Macromolecules
Danièle Maubon, Céline Dard, Cécile Garnaud, Muriel Cornet
Fungemia presents high morbi-mortality and thus rapid microbiological diagnosis may contribute to appropriate patient management. In the last decade, kits based on molecular technologies have become available and health care institutes are increasingly facing critical investment choices. Although all these tools aim to achieve rapid fungal detection and species identification, they display different inherent characteristics. Areas covered: Considering technologies allowing detection and identification of fungal species in a sepsis context, the market proposes either tests on positive blood culture or tests on patient's whole blood...
December 28, 2017: Expert Review of Molecular Diagnostics
Nicole T Shen, Jared A Leff, Yecheskel Schneider, Carl V Crawford, Anna Maw, Brian Bosworth, Matthew S Simon
Background: Systematic reviews with meta-analyses and meta-regression suggest that timely probiotic use can prevent Clostridium difficile infection (CDI) in hospitalized adults receiving antibiotics, but the cost effectiveness is unknown. We sought to evaluate the cost effectiveness of probiotic use for prevention of CDI versus no probiotic use in the United States. Methods: We programmed a decision analytic model using published literature and national databases with a 1-year time horizon...
2017: Open Forum Infectious Diseases
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
August 2017: Pediatric Hematology and Oncology
S Raj, D Sharma, P Mate, M R Capoor, K T Bhowmik
BACKGROUND: Patients of head and neck malignancies often develop oral mucositis and invite various pathogens to colonize over it. OBJECTIVES: The objective of this study is to identify the fungi isolated from patients undergoing radiotherapy (RT) for head and neck cancer, to determine the antifungal susceptibility of these isolates and to determine the time and week of fungal colonization. PATIENTS AND METHODS: Three specimens (throat, urine, and blood) were collected from each of the head and neck cancer patients, who were advised RT...
January 2017: Indian Journal of Cancer
Joanna L Conant, Ian Rabinowitz, Qian-Yun Zhang
A 41-year-old woman was admitted for Candida fungemia. On hospital day 4, a routine complete blood count and peripheral smear showed circulating plasma cells. Initial work up showed an M-component on serum protein electrophoresis with 6% lambda-predominate plasma cells by flow cytometry. The patient was treated with intravenous antifungal therapy. Her six month follow up laboratory evaluation revealed resolution of the M-component and only rare polyclonal plasma cells in peripheral blood by flow cytometry. This case illustrates that transient monoclongal gammopathy can be induced by fungal infection...
November 24, 2017: Human Pathology
Travis M Jones, Richard H Drew, Dustin T Wilson, Christina Sarubbi, Deverick J Anderson
PURPOSE: The impact of automatic infectious diseases (ID) consultation for inpatients with fungemia at a large academic medical center was studied. METHODS: In this single-center, retrospective study, the time to appropriate antifungal therapy before and after implementing a policy requiring automatic ID consultation for the management of fungemia for all patients with an inpatient positive blood culture for fungus was examined. The rates of ID consultation; the likelihood of receiving appropriate antifungal therapy; central venous catheter (CVC) removal rates; performance of ophthalmologic examinations; infection-related length of stay (LOS); rates of all-cause inhospital mortality, death, or transfer to an intensive care unit within 7 days of first culture; and inpatient cost of antifungals were also evaluated...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
Abd Elazeez Shabaan, Lobna Mahmoud Elbaz, Wafaa M El-Emshaty, Basma Shouman
OBJECTIVES: To study the microbiological pattern of late onset neonatal sepsis cultures and to assess the diagnostic performance of serum (1,3)-β-d-glucan level for early diagnosis of invasive fungemia in high-risk infants admitted to a neonatal intensive care unit. METHODS: A prospective multicenter clinical trial conducted on infants at high risk for invasive fungal infections, with suspected late onset sepsis, admitted to a neonatal intensive care unit at Mansoura University Children's Hospital and Mansoura General Hospital between March 2014 and February 2016...
November 13, 2017: Jornal de Pediatria
Rashmi Mishra, Paul Kelly, Omesh Toolsie, Puvvalingam Ayyadurai, Muhammad Adrish
INTRODUCTION: We present an interesting case of Candida lusitaniae infection in a patient diagnosed with renal clear cell carcinoma.An 82-year-old male presented with worsening back pain for 1 week. Physical examination including neurologic examination was normal. A computed tomography scan of the abdomen revealed a mass in the right upper pole of the kidney suggestive of a renal neoplasm. Pathology from a percutaneous biopsy of the kidney revealed clear cell carcinoma. During his hospitalization the patient developed fungemia due to C lusitaniae...
November 2017: Medicine (Baltimore)
I Kara, F Yıldırım, Ö Özgen, S Erganiş, M Aydoğdu, M Dizbay, G Gürsel, A Kalkanci
Saccharomyces cerevisiae is a common colonizer of the human gastrointestinal system as a benign organism. Enteral supplementation of this yeast as a probiotic product is effective in the treatment of antibiotic associated diarrhae. In rare occasions it can cause invasive infections. We present two fungemia cases in an intensive care unit following probiotic treatment containing S. boulardii. We are warning the safety of probiotic treatment in critically ill patients.
November 10, 2017: Journal de Mycologie Médicale
Shinya Yamamoto, Mahoko Ikeda, Fumie Fujimoto, Koh Okamoto, Yoshitaka Wakabayashi, Tomoaki Sato, Keita Tatsuno, Toshikatsu Kaburaki, Shuntaro Yoshida, Shu Okugawa, Kazuhiko Koike, Kyoji Moriya
Candida lusitaniae is an uncommon cause of candidiasis in humans. Ocular manifestations of C. lusitaniae infection have not been reported. C. lusitaniae is either intrinsically resistant to amphotericin B or can acquire such resistance. We describe a case of bilateral endophthalmitis due to C. lusitaniae bloodstream infection in a liver transplant patient with rectal cancer. The patient suffered fungemia and endophthalmitis and was treated with liposomal amphotericin B. The isolate was identified as C. lusitaniae by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, the system based on biochemical tests, and sequencing of the internal transcribed spacer region...
October 25, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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