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https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#1
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28893806/low-dose-intrapleural-alteplase-without-deoxyribonuclease-in-complicated-parapneumonic-effusion-case-series-and-literature-reviews
#2
Carol Lai, Nurashikin Mohammad, Tidi Maharani Hassan, Mohamed Faisal Abdul Hamid
This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28889761/safety-issues-associated-with-using-medication-to-treat-overactive-bladder
#3
George Araklitis, Linda Cardozo
The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB. Areas covered: Patients with increased anticholinergic load are at risk of cognitive decline, dementia or even death. The elderly are particularly at risk due to polypharmacy. Botulinum toxin carries the risk of high urinary residuals, urinary tract infection and need to self catheterise. The use of vaginal oestrogens may improve OAB symptoms, but there is concern in those with a history of breast cancer...
September 10, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28882472/overwhelming-streptococcus-pyogenes-sepsis-in-an-elderly-patient-with-septic-arthritis
#4
Aarti Chadha, Wafaa Jamal, Abdul Raouf Abdul Aziz, Vincent O Rotimi
INTRODUCTION: The signs of Streptococcus pyogenes, group A streptococci (GAS) bacteremia are non-specific and patients can have wide presentations ranging from flu-like symptoms to life-threatening toxic-shock syndrome in just a few hours. CASE PRESENTATION: We report a case of fulminant S. pyogenes sepsis in an elderly woman with septic arthritis and remarkable past medical history/risk factors. She was febrile, hypotensive and had a swollen and tender right knee...
September 4, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28873266/prospective-cohort-study-of-risk-factors-for-extended-spectrum-%C3%A3-lactamase-producing-escherichia-coli-urinary-tract-infections-in-elderly-patients-admitted-to-hospital
#5
Arturo Artero, Ana Esparcia, Juan Alberola, Manuel Madrazo, José M Nogueira, José M Eiros
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are currently common in community-onset infections, limiting therapeutic options. In this work we aim to identify the prevalence of and risk factors for ESBL-producing E. coli in elderly patients with urinary tract infections (UTI) admitted to hospital. METHODS: Prospective cohort study on elderly patients with E. coli UTI admitted to a university hospital in Spain, from January 2013 to December 2015...
September 5, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28867756/successful-treatment-with-clarithromycin-and-or-tacrolimus-for-two-patients-with-polymyalgia-rheumatica
#6
Masashi Ohe, Haruki Shida, Tetsuya Horita, Kenji Oku
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease in the elderly. Glucocorticoids (GCs) remain the mainstay of treatment. GC therapy usually dramatically improves the clinical picture, but approximately one-third of patients experience disease recurrence when the dose is reduced. Moreover, long-term use of GCs causes adverse reactions. Macrolide antibiotics have anti-inflammatory action. Several recent studies have reported the successful treatment of rheumatoid arthritis (RA) and PMR treated using clarithromycin (CAM), a macrolide, because of its anti-inflammatory action...
2017: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/28852462/non-curative-surgery-for-aortoenteric-fistula
#7
Bent Are Hansen, Svein Amundsen, Håkon Reikvam, Øystein Wendelbo, Gustav Pedersen
Graft infection with secondary aortic fistula is a rare complication following implantation of aortic prostheses, frequently occurring after emergency procedures and reoperations. The condition is associated with considerable morbidity and mortality. Curative treatment consists of explantation of the infected graft followed by fistula revision and implantation of a new graft in combination with antimicrobial therapy. Non-curative treatment with aortic stentgraft and long-term substitution treatment with antibiotics may be an option in cases where graft explantation is deemed too risky...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28851278/toscana-virus-meningo-encephalitis-an-important-differential-diagnosis-for-elderly-travellers-returning-from-mediterranean-countries
#8
James Veater, Farhan Mehedi, Chee Kay Cheung, Laura Nabarro, Jane Osborne, Nicholas Wong, Martin Wiselka, Julian W Tang
BACKGROUND: Elderly patients have a long list of differentials for causes of acute confusion and altered consciousness levels, including infectious agents. In addition, elderly, retired patients often have more time to travel for tourism, particularly to exotic, warmer locations. Mediterranean countries such as Spain and Italy are popular holiday destinations for British and other tourists, especially during the winter months. However, these warm climates allow insect vectors to proliferate, increasing the risk of exposure to endemic vectorborne viral infections whilst on vacation...
August 29, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28840057/evaluation-of-the-mann-assessment-of-swallowing-ability-in-elderly-patients-with-pneumonia
#9
Yasuo Chojin, Tatsuji Kato, Mariko Rikihisa, Masami Omori, Shingo Noguchi, Kentaro Akata, Takaaki Ogoshi, Kazuhiro Yatera, Hiroshi Mukae
Elderly pneumonia patients have various underlying diseases and social backgrounds, and it is difficult to predict their mortality using the current severity assessment tools. However, aspiration is a risk factor for mortality in pneumonia patients. In the evaluation of aspiration, endoscopic and video fluoroscopic methods are reliable but cannot be performed in all pneumonia patients. We evaluated the significance of the Mann Assessment of Swallowing Ability (MASA) in these patients. This study was prospectively performed between December 2014 and June 2015, and all adult hospitalized patients with pneumonia were consecutively enrolled...
July 2017: Aging and Disease
https://www.readbyqxmd.com/read/28828113/parastomal-gallbladder-hernia-in-a-septic-patient
#10
Joseph Frankl, Maria Michailidou, Felipe Maegawa
Parastomal gallbladder herniation is a rare complication of enterostomies with only 6 previously reported cases. Most cases have occurred in elderly women. Patients typically presented with acute abdominal pain and the majority was managed operatively. Here, we report the clinical course of an 88-year-old female who presented with signs of sepsis and minimal abdominal symptoms. She was subsequently found to have a parastomal gallbladder herniation and Klebsiella pneumoniae bacteremia. Given the patient's multiple comorbidities, she was managed nonoperatively with manual reduction of the parastomal hernia and antibiotics...
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28820897/persistent-infection-due-to-a-small-colony-variant-of-burkholderia-pseudomallei-leads-to-pd-1-upregulation-on-circulating-immune-cells-and-mononuclear-infiltration-in-viscera-of-experimental-balb-c-mice
#11
Jia-Xiang See, Samudi Chandramathi, Mahmood Ameen Abdulla, Jamuna Vadivelu, Esaki M Shankar
BACKGROUND: Melioidosis is a neglected tropical disease endemic across South East Asia and Northern Australia. The etiological agent, Burkholderia pseudomallei (B.pseudomallei), is a Gram-negative, rod-shaped, motile bacterium residing in the soil and muddy water across endemic regions of the tropical world. The bacterium is known to cause persistent infections by remaining latent within host cells for prolonged duration. Reactivation of the recrudescent disease often occurs in elders whose immunity wanes...
August 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28802826/human-leptospirosis-cases-in-palermo-italy-the-role-of-rodents-and-climate
#12
Maria Vitale, Stefano Agnello, Michele Chetta, Benedetta Amato, Giustina Vitale, Calogero Di Bella, Domenico Vicari, Vincenzo Di Marco Lo Presti
Many regions of the world are increasingly exposed to leptospirosis due to poverty, global warming and high urban density. Here, we report a molecular survey for pathogenic Leptospira spp. in rodents and two symptomatic human cases of leptospirosis in the city of Palermo, Italy. Four rodent species were captured in six areas of the city, and a molecular analysis for pathogenic Leptospira spp. on DNA from the kidney samples showed a different prevalence of leptospirosis in all the species of rodents. In addition, two human cases that occurred in May and October of 2009 in the city were also reported...
August 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28795380/peritoneal-dialysis-associated-catheter-infection-caused-by-mycobacterium-abscessus-in-an-elderly-patient-who-was-successfully-treated-with-catheter-removal
#13
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Keisuke Kamiya, Chiharu Ito, Satoru Kominato, Ken Mizuguchi, Toshiyuki Miura, Katsushi Koyama
An 89-year-old Japanese man on peritoneal dialysis (PD) was suspected of having a PD-associated catheter infection. He visited the hospital because of the discharge of pus from the exit site of his catheter. Gram staining of the pus showed Gram-positive bacilli, but these were acid-fast bacilli. The rapidly growing nontuberculous mycobacteria, Mycobacterium abscessus, was isolated. PD catheter removal and debridement were immediately performed. The patient received combination antibiotic therapy. His clinical course was good, but he required hemodialysis due to the discontinuation of PD...
August 9, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28791071/periorbital-and-mediastinal-emphysema-after-upper-gastrointestinal-endoscopy-case-report-of-a-rare-complication
#14
Thankappan Lekha, Leelakrishnan Venkatakrishnan, Karuppannasamy Divya, Perumal Lavanya
PURPOSE: To report a rare case of periorbital emphysema concurrent with cervicofacial and mediastinal emphysema in an elderly woman who underwent upper gastrointestinal endoscopy for chronic liver disease. CASE REPORT: An elderly woman with decompensated chronic liver disease presented with features of periorbital, facial, and mediastinal emphysema, characterized with crepitant swelling over the right periorbital area, face, neck, and mediastinum after undergoing upper gastrointestinal endoscopy...
July 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28780720/evaluation-of-lactic-acid-bacteria-isolated-from-fermented-plant-products-for-antagonistic-activity-against-urinary-tract-pathogen-staphylococcus-saprophyticus
#15
Cheng-Chih Tsai, Tzu-Min Lai, Pei-Pei Lin, You-Miin Hsieh
Urinary tract infections (UTIs) are the most common infectious diseases in infants and the elderly; they are also the most common among nosocomial infections. The treatment of UTIs usually involves a short-term course of antibiotics. The purpose of this study was to identify the strains of lactic acid bacteria (LAB) that can inhibit the urinary tract pathogen Staphylococcus saprophyticus, as alternatives to antibiotics. In this study, we collected 370 LAB strains from fermented plant products and reference strains from the Bioresources Collection and Research Center (BCRC)...
August 5, 2017: Probiotics and Antimicrobial Proteins
https://www.readbyqxmd.com/read/28768257/autoimmunity-in-the-elderly-insights-from-basic-science-and-clinics-a-mini-review
#16
Abdulla Watad, Nicola Luigi Bragazzi, Mohammad Adawi, Howard Amital, Elias Toubi, Bat-Sheva Porat, Yehuda Shoenfeld
Advancements in the field of biomedicine, including the control of infectious diseases through antibiotics and vaccination practices and the prevention of chronic disorders, have led to reduced mortality, increased life expectancy and, as such, growth of the older population. Ageing is accompanied by profound morphological and physiological alterations. In particular, the immune system undergoes a complex series of remodeling/restructuring events, involving almost all compartments - both the innate and the adaptive system...
July 29, 2017: Gerontology
https://www.readbyqxmd.com/read/28762620/a-case-of-chediak-higashi-syndrome-presented-with-accelerated-phase-could-be-treated-effectively-by-unrelated-cord-blood-transplantation
#17
Yan Zhang, Zhiyong Gao, Xinjian Yu
CHS is a rare immunodeficiency syndrome with defects in the functions of cytotoxic cells and neutrophils. Approximately 85% of patients with CHS undergo an AP within the first decade, which is similar to FHLH. Chemotherapy could induce transient remission, but only allogeneic HCT could correct the underlying genetic defect and prevent relapse. We reported a case of CHS diagnosed at 19 months, who had an elder brother who had previously succumbed to the same disease. The little girl presented with severe AP manifestations including recurrent high fever, enlarged superficial lymph nodes, and extraordinary hepatosplenomegaly occupying the whole abdominal and pelvic cavity...
August 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28756939/bacteriology-of-peritonsillar-abscess-the-changing-trend-and-predisposing-factors
#18
Yi-Wen Tsai, Yu-Hsi Liu, Hsing-Hao Su
INTRODUCTION: Peritonsillar abscess (PTA) is the most common deep neck infection. The infectious microorganism may be different according to clinical factors. OBJECTIVE: To identify the major causative pathogen of peritonsillar abscess and investigate the relationship between the causative pathogen, host clinical factors, and hospitalization duration. METHODS: This retrospective study included 415 hospitalized patients diagnosed with peritonsillar abscess who were admitted to a tertiary medical center from June 1990 to June 2013...
July 17, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28754533/benefits-and-harms-of-treatment-of-asymptomatic-bacteriuria-a-systematic-review-and-meta-analysis-by-the-european-association-of-urology-urological-infection-guidelines-panel
#19
Bela Köves, Tommaso Cai, Rajan Veeratterapillay, Robert Pickard, Thomas Seisen, Thomas B Lam, Cathy Yuhong Yuan, Franck Bruyere, Florian Wagenlehner, Riccardo Bartoletti, Suzanne E Geerlings, Adrian Pilatz, Benjamin Pradere, Fabian Hofmann, Gernot Bonkat, Björn Wullt
People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and eligible trials were assessed for risk-of-bias and Grading of Recommendations, Assessment, Development and Education quality. Where possible, a meta-analysis of extracted data was performed or a narrative synthesis of the evidence was presented...
July 25, 2017: European Urology
https://www.readbyqxmd.com/read/28748440/pharmaceuticals-released-from-senior-residences-occurrence-and-risk-evaluation
#20
Silvia Lacorte, Silvia Luis, Cristian Gómez-Canela, Teresa Sala-Comorera, Audrey Courtier, Benoit Roig, Ana Maria Oliveira-Brett, Claire Joannis-Cassan, Juan Ignacio Aragonés, Lucia Poggio, Thierry Noguer, Luisa Lima, Carlos Barata, Carole Calas-Blanchard
One of the main pursuits, yet most difficult, in monitoring studies is to identify the sources of environmental pollution. In this study, we have identified health-care facilities from south European countries as an important source of pharmaceuticals in the environment. We have estimated that compounds consumed in by the elderly and released from effluents of senior residences can reach river waters at a concentration higher than 0.01 μg/L, which is the European Medicines Agency (EMA) threshold for risk evaluation of pharmaceuticals in surface waters...
July 27, 2017: Environmental Science and Pollution Research International
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