Posts filed under ‘F.O.D’

Chronic active Epstein–Barr virus infection associated with hemophagocytic syndrome and extra-nodal natural killer/T-cell lymphoma in an 18-year-old girl: A case report

MEDICINE May 2015 V.96 N.19 P.e6845

Xing, Yawei; Yang, Junwen; Lian, Guanghui; Chen, Shuijiao; Chen, Linlin; Li, Fujun

Rationale:

Chronic active Epstein–Barr virus infection (CAEBV) associated with hemophagocytic syndrome (HPS) and extra-nodal natural killer (NK)/T-cell lymphoma (ENKL) is a rare life-threatening disorder. This disease is easily misdiagnosed because of its varied presentations.

Patient concerns:

An 18-year-old girl was admitted to our hospital with a history of edema in the lower limbs and intermittent fever lasting for more than 1 month. At admission, she had severe liver injury of unknown etiology. Laboratory test results revealed pancytopenia, hyperferritinemia, hypertriglyceridemia, and hypofibrinogenemia. Results of serologic tests for EBV were positive. Results of a skin biopsy indicated EBV-positive NK/T-cell lymphoma, and bone marrow aspiration revealed focal hemophagocytosis and atypical lymphoid cells.

Diagnosis:

On the basis of these findings, we diagnosed the case as extra-nodal NK/T-cell lymphoma-associated HPS (natural killer/T-cell lymphoma-associated hemophagocytic syndrome), which is commonly induced by CAEBV.

Interventions:

Treatment consisted of general management of hepatitis, supplemented with albumin and empirical antibiotic therapy.

Outcomes:

The patient died from massive gastrointestinal hemorrhage a week after she was discharged from the hospital.

Lessons:

ENKL and HPS present with varied features and are generally fatal; therefore, clinicians should proceed with caution in suspected cases. HPS should be considered when the patient presents with fever, hepatosplenomegaly, pancytopenia, and liver failure. When HPS is suspected, clinicians should determine the underlying cause, such as severe infection, including infection with viruses such as EBV; genetic predisposition; or underlying malignancies, especially lymphoma because of its strong association with HPS.

FULL TEXT

http://journals.lww.com/md-journal/Fulltext/2017/05120/Chronic_active_Epstein_Barr_virus_infection.38.aspx

PDF (download haciendo CLIC en “Article as PDF”)

 

May 12, 2017 at 3:35 pm

Corticosteroids in treating CAP – has the time really come.

Clinical Microbiology and Infection May 2017 V.23 N.5

Blot, A. Salmon-Rousseau, P. Chavanet, L. Piroth*

Departement d’Infectiologie, Centre Hospitalier Universitaire, Dijon, France

Whether corticosteroids should be used in the treatment of severe community-acquired pneumonia (CAP) is still a matter of debate.

This question is all the more relevant as pneumonia remains a leading cause of death worldwide.

Severe CAP is associated with an increase in pulmonary and circulatory cytokines, which may be associated with treatment failure, especially in bacteraemic pneumococcal pneumonia.

Thus corticosteroids, which suppress inflammatory reactions and prevent the migration of inflammatory cells to tissues, may be of particular interest in the treatment of such severe pneumonias …

PDF

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(16)30388-3/pdf

May 9, 2017 at 8:25 am

A Case of Septic Arthritis of the Shoulder Due to Yersinia enterocolitica with Review of the Literature.

Open Forum Infect Dis. 2014 Aug 2;1(2):ofu054

BRIEF REPORT

Chan J1, Gandhi RT1.

Author information

1 Infectious Diseases Division , Massachusetts General Hospital , Boston, MA.

Abstract

Yersinia enterocolitica infection rarely can cause extra-intestinal infections. We present a case of septic arthritis of the shoulder due to this organism in an elderly man with liver and cardiac disease. We review previously published cases of Y. enterocolitica septic arthritis, and discuss risk factors and management.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281793/pdf/ofu054.pdf

May 7, 2017 at 2:53 pm

Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up

Clin Inf Dis May 15, 2017 V.64 N.10

EDITOR’S CHOICE

Walter-Alfredo Goycochea-Valdivia; Fernando Baquero-Artigao; Teresa del Rosal; Marie-Antoinette Frick; Pablo Rojo …

Human cytomegalovirus DNA detection in cerebrospinal fluid by polymerase chain reaction has been previously considered a risk factor for hearing loss or neurological sequelae in congenital infection. In the present study, it was not associated with neurological or audiological outcomes.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/64/10/10.1093_cid_cix105/2/cix105.pdf?Expires=1494188648&Signature=elPbA59yOsLDv42fJeuboBpe631YEKWqspSj4kf3mzPsMd~Zd0IeAsGb9A-ILbYIQh-c2pKhS9E-sgQqX9aOaWGXSPGco04ApD9tTq0Z-kYH2riAlIanC9BhT0d4XxhBghuaN9pXVUQuUCRBeBLyt4iYkrY-wwV0w3tUUQdWfyjPRGYtMeI9GXJMOStAHBQ1t270LKCZPIgXtR-gk-JcHhDmM-eE4~TKgHDBIMod8c1JBgPY~~fcX43D6HiH8S2Xsg08WiEJAhvQasvUNIQwzxl-DzwPVSPgmQEZ0580~KyMXN3lO0DgvcSVZYBD3nIGk6QKKrH3Ery5-iDBGl1NkA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

May 6, 2017 at 3:54 pm

Bartonella henselae Infective Endocarditis Detected by a Prolonged Blood Culture.

Intern Med. 2016;55(20):3065-3067. Epub 2016 Oct 15.

Mito T1, Hirota Y, Suzuki S, Noda K, Uehara T, Ohira Y, Ikusaka M.

Author information

1 Department of General Medicine, Chiba University Hospital, Japan.

Abstract

A 65-year-old Japanese man was admitted with a 4-month history of fatigue and exertional dyspnea. Transthoracic echocardiography revealed a vegetation on the aortic valve and severe aortic regurgitation. Accordingly, infective endocarditis and heart failure were diagnosed. Although a blood culture was negative on day 7 after admission, a prolonged blood culture with subculture was performed according to the patient’s history of contact with cats. Consequently, Bartonella henselae was isolated. Bartonella species are fastidious bacteria that cause blood culture-negative infective endocarditis. This case demonstrates that B. henselae may be detected by prolonged incubation of blood cultures.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109581/pdf/1349-7235-55-3065.pdf

April 20, 2017 at 4:02 pm

Synergistic Interaction Between Phage Therapy and Antibiotics Clears Pseudomonas aeruginosa Infection in Endocarditis and Reduces Virulence

Journal of Infectious Diseases March 1, 2017

Frank Oechslin,1 Philippe Piccardi,1 Stefano Mancini,1 Jérôme Gabard,3 Philippe Moreillon,1 José M. Entenza,1 Gregory Resch,1 and Yok-Ai Que2 1 Department of Fundamental Microbiology, University of Lausanne, and  2 Department of Intensive Care Medicine, Bern University Hospital, Switzerland; and  3 Pherecydes Pharma, Romainville, France

Background.

Increasing antibiotic resistance warrants therapeutic alternatives. Here we investigated the efficacy of bacteriophage-therapy (phage) alone or combined with antibiotics against experimental endocarditis (EE) due to Pseudomonas aeruginosa, an archetype of difficult-to-treat infection.

Methods.

In vitro fibrin clots and rats with aortic EE were treated with an antipseudomonas phage cocktail alone or combined with ciprofloxacin. Phage pharmacology, therapeutic efficacy, and resistance were determined.

Results.

In vitro, single-dose phage therapy killed 7 log colony-forming units (CFUs)/g of fibrin clots in 6 hours. Phage-resistant mutants regrew after 24 hours but were prevented by combination with ciprofloxacin (2.5 × minimum inhibitory concentration). In vivo, single-dose phage therapy killed 2.5 log CFUs/g of vegetations in 6 hours (P < .001 vs untreated controls) and was comparable with ciprofloxacin monotherapy. Moreover, phage/ciprofloxacin combinations were highly synergistic, killing >6 log CFUs/g of vegetations in 6 hours and successfully treating 64% (n = 7/11) of rats. Phage-resistant mutants emerged in vitro but not in vivo, most likely because resistant mutations affected bacterial surface determinants important for infectivity (eg, the pilT and galU genes involved in pilus motility and LPS formation).

Conclusions.

Single-dose phage therapy was active against P. aeruginosa EE and highly synergistic with ciprofloxacin. Phageresistant mutants had impaired infectivity. Phage-therapy alone or combined with antibiotics merits further clinical consideration.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jid/215/5/10.1093_infdis_jiw632/1/jiw632.pdf?Expires=1492519314&Signature=IX7VgknbY6WoG38D42jnp2D1bQJ42mOfQrwM6odCLBegLTrZ5Sr0Ae4~OQmtLaaLBIo4ZwREbkMQ3p4wTYaYKrvHv-oc3UwFqmXj2BVllcVyh0CkarlfbFie3u3A4l1V~OZRUEphJzLsToy2AEKtXKMr9sFbVDkwvaULGpMd75Okgsi9MprMryuVTBiRAaVkOI~-P0WFg~CTMXffzUK-DBaxKYk99VSObUKG6MPs99kAh02dM5tAK~HFGu080nIzj5c8vEibxAXHTN~L8O8rAAcWAcCXHTK1-seQVnDS3-6mcKKkAPf-Xle8TIghp4aSK5SXkIfpW4MyrfViOfhJ3A__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

April 14, 2017 at 10:02 am

ESCMID guideline: diagnosis and treatment of acute bacterial meningitis

Clinical Microbiology & Infection May 2016 V.22 Suppl 3 S37-62

van de Beek, C. Cabellos, O. Dzupova, S. Esposito, M. Klein, A.T. Kloek, S.L. Leib, B. Mourvillier, C. Ostergaard, P. Pagliano, H.W. Pfister, R.C. Read, O. Resat Sipahi, M.C. Brouwer for the ESCMID Study Group for Infections of the Brain (ESGIB)

Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. In the past decades the epidemiology and treatment strategies for community-acquired bacterial meningitis have significantly changed [[1], [2], [3]]. First, the introduction of conjugate vaccines in Europe resulted in the virtual disappearance of Haemophilus influenzae type b, while conjugate pneumococcal and meningococcal vaccines have substantially reduced the burden of bacterial meningitis [1]. As a result, community-acquired bacterial meningitis has become a disease that currently affects more adults than infants, with its specific complications and treatment options. A second important development is the increasing rate of reduced susceptibility to common antimicrobial agents among strains of Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus). Large differences in resistance rates in Europe exist, and empiric antibiotic treatment needs to be adjusted according to regional epidemiology. Finally, several adjunctive treatments have been tested in randomized controlled trials, often with conflicting results [3]. These developments leave the physician in need of a clear practical guideline, summarizing the available evidence for diagnostic methods, and antimicrobial and adjunctive treatment in bacterial meningitis. To this end the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) promotes guidelines development in the field of infectious diseases. This guideline project was initiated by the ESCMID Study Group for Infections of the Brain (ESGIB).

PDF

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(16)00020-3/pdf

April 13, 2017 at 5:05 pm

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