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Aktas M, Tunc H, Zaben B, Arı N, Midi I, Cinel L, Ergun T. An unusual diagnosis for sporotrichoid nodular lesions: Subcutaneous sarcoidosis. Indian J Dermatol Venereol Leprol 2023; 0:1-2. [PMID: 37609755 DOI: 10.25259/ijdvl_582_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 05/21/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Meryem Aktas
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Handenur Tunc
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Baha Zaben
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nursah Arı
- Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ipek Midi
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Leyla Cinel
- Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tulin Ergun
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey
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Cantón De Seoane J, Cabanillas Navarro I, Quevedo Soriano S, Lois Martínez N. Nodular lymphangitis due to nocardiosis. BMJ Case Rep 2022; 15:e252941. [PMID: 36581362 PMCID: PMC9806021 DOI: 10.1136/bcr-2022-252941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Nodular lymphangitis is an infectious disease characterised by the development of inflammatory skin nodules that follow the direction of lymphatic drainage. We present a woman in her 70s with nodular lymphangitis that developed after mild trauma with a cactus. Surgical intervention was performed on a finger abscess with isolation of Nocardia brasiliensis in the microbiological samples. Initial antibiotherapy was modified, treating with cotrimoxazole, firstly intravenous and finally oral, therapy during 3 months with a complete resolution of the infection.
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3
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Gaine S, Melia M, Marchitto M, Rozati S, Horne AJ. There Must Be Something in the Water: An Unusual Cutaneous Infection. Am J Med 2022; 135:966-968. [PMID: 35469735 DOI: 10.1016/j.amjmed.2022.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Sean Gaine
- The Longcope Firm, Department of Medicine
| | - Michael Melia
- Division of Infectious Diseases, Department of Medicine
| | - Mark Marchitto
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Sima Rozati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Md
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Rodríguez-Gómez FJ, Pérez Cáceres JA, Martínez-Marcos FJ, Merino Muñoz D. Hand and arm injuries of torpid evolution after a puncture wound in a male fond of hiking. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2021; 39:516-517. [PMID: 34563492 DOI: 10.1016/j.eimce.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/25/2021] [Indexed: 06/13/2023]
Affiliation(s)
| | | | | | - Dolores Merino Muñoz
- Unidad de Gestión de Enfermedades Infecciosas, Hospital Juan Ramón Jiménez, Huelva, Spain
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Rodríguez-Gómez FJ, Saavedra-Martín JM, Martínez-Marcos FJ, Merino-Muñoz D. Ulcerated lesion on the right hand with a torpid course and subsequent «sporotrichoid» dissemination, in a fish fancier woman. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2021; 39:355-356. [PMID: 34353514 DOI: 10.1016/j.eimce.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/23/2020] [Indexed: 06/13/2023]
Affiliation(s)
| | | | | | - Dolores Merino-Muñoz
- Unidad de Gestión de Enfermedades Infecciosas, Hospital Juan Ramón Jiménez, Huelva, Spain
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Rodríguez-Gómez FJ, Pérez Cáceres JA, Martínez-Marcos FJ, Merino Muñoz D. Hand and arm injuries of torpid evolution after a puncture wound in a male fond of hiking. Enferm Infecc Microbiol Clin 2021; 39:S0213-005X(21)00034-3. [PMID: 33750578 DOI: 10.1016/j.eimc.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Dolores Merino Muñoz
- Unidad de Gestión de Enfermedades Infecciosas, Hospital Juan Ramón Jiménez, Huelva, España
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7
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Rodríguez-Gómez FJ, Saavedra-Martín JM, Martínez-Marcos FJ, Merino-Muñoz D. Ulcerated lesion on the right hand with a torpid course and subsequent «sporotrichoid» dissemination, in a fish fancier woman. Enferm Infecc Microbiol Clin 2021. [PMID: 33441241 DOI: 10.1016/j.eimc.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | - Dolores Merino-Muñoz
- Unidad de Gestión de Enfermedades Infecciosas, Hospital Juan Ramón Jiménez, Huelva, España
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8
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Whitsell NW, Becker H. Tularemia Hand Infection From a Cat Bite—A Case Report. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2020; 2:320-322. [PMID: 35415518 PMCID: PMC8991864 DOI: 10.1016/j.jhsg.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/01/2020] [Indexed: 12/05/2022] Open
Abstract
Tularemia is an uncommon infection caused by the bacterium Francisella tularensis. The nonspecific presentation and infrequency with which it is encountered make it a diagnostic challenge. A rare and scarcely reported mode of tularemia inoculation is a cat bite to the hand. We report a cat bite hand infection with tularemia in a 66-year-old woman. She underwent treatment for presumed polymicrobial cellulitis. Over the next 5 days, the symptoms progressed to fever, malaise, and fluctuant lymphadenitis with nodules along draining lymphatics. Cultures grew F tularensis and antibiotics were switched to doxycycline, which resolved the infection. The patient remained symptom-free after the doxycycline was discontinued. The purpose of this case study is to alert treating providers to consider tularemia infection when a hand infection persists, particularly in the context of an animal bite.
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Affiliation(s)
| | - Hillary Becker
- Sanford Orthopedics and Sports Medicine, Sioux Falls, SD
- Corresponding author: Hillary Becker, MD, Sanford Orthopedics and Sports Medicine, 1210 W 18th Street, Suite G01, Sioux Falls, SD 57104.
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Makadia S, Patel I, Soosaipillai I, Tarasiuk-Rusek A. First Case of Nocardia pseudobrasiliensis Causing Primary Cutaneous Nocardiosis in an Immunocompetent Patient. J Investig Med High Impact Case Rep 2020; 8:2324709620938228. [PMID: 32602372 PMCID: PMC7328479 DOI: 10.1177/2324709620938228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nocardia brasiliensis is the most common cause of cutaneous nocardiosis.
Nocardia pseudobrasiliensis is an emerging species responsible for
invasive and disseminated disease in immunocompromised patients. We describe a case of a
67-year-old immunocompetent patient without significant past medical history diagnosed
with primary cutaneous nocardiosis with N pseudobrasiliensis as the
causative organism. In our opinion, we report the first case of primary cutaneous
nocardiosis in an immunocompetent patient with N pseudobrasiliensis being
the causative agent.
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Affiliation(s)
| | - Ishan Patel
- Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Ivan Soosaipillai
- Ocala Regional Medical Center, University of Central Florida, Ocala, FL, USA
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Duani H, Palmerston MF, Rosa Júnior JF, Ribeiro VT, Alcântara Neves PL. Meningeal and multiorgan disseminated sporotrichosis: A case report and autopsy study. Med Mycol Case Rep 2019; 26:47-52. [PMID: 31737471 PMCID: PMC6849419 DOI: 10.1016/j.mmcr.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/21/2019] [Accepted: 10/27/2019] [Indexed: 11/10/2022] Open
Abstract
This case report presents a 36-year old man with a disseminated sporotrichosis who presented with seizures and crusted lesions all over the body. Imaging studies revealed acute ischemic brain event with haemorrhagic transformation in right frontal lobe. Skin biopsy showed Sporothrix schenckii. He was treated with standard amphotericin B. Despite therapy, he developed consciousness loss, multiorgan-failure and eventually expired. Necropsy findings showed renal, hepatic, splenic, prostate, testicles and meningeal/cerebral involvement.
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Affiliation(s)
- Helena Duani
- Tropical Medicine and Infectious Diseases Section, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marina Fernandes Palmerston
- Tropical Medicine and Infectious Diseases Section, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jésus Faria Rosa Júnior
- Department of Pathologic Anatomy and Legal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vitor Teatini Ribeiro
- Tropical Medicine and Infectious Diseases Section, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pedro Lobo Alcântara Neves
- Department of Pathologic Anatomy and Legal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Hemmersbach-Miller M, Catania J, Saullo JL. Updates on Nocardia Skin and Soft Tissue Infections in Solid Organ Transplantation. Curr Infect Dis Rep 2019; 21:27. [PMID: 31227922 DOI: 10.1007/s11908-019-0684-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Due to their immunocompromised status, solid organ transplant (SOT) recipients are at risk for Nocardia infections. These infections often necessitate early invasive diagnostics alongside prolonged, often combination antimicrobial therapy. This review summarizes the importance of this pathogen in skin and soft tissue infections (SSTIs) in SOT recipients inclusive of recently reported cases in the literature and an update on the epidemiology, diagnostics, and management. RECENT FINDINGS Six studies with 13 isolated SSTIs due to Nocardia have been published in the last 5 years in SOT recipients. The most common underlying type of transplant was kidney and time from transplantation to infection varied from 6 months to 16 years. Misdiagnosis was frequent. Available identified species included N. brasiliensis (2), N. farcinica (2), N. flavorosea (1), N. abscessus (1), N. anaemiae (1), N. asteroides (1), N. nova (1), and N. vinacea (1). Treatment choice and duration varied widely, and trimethoprim-sulfamethoxazole was utilized most often with no documented infection relapse. Nocardia SSTIs can occur both in isolation and as a component of a disseminated infection. Overall, isolated Nocardia SSTIs are uncommon in SOT recipients and are often initially misdiagnosed. They present multiple challenges to the clinician including evaluation for potential co-pathogens and/or non-infectious processes and ruling out the presence of disseminated infection. While trimethoprim-sulfamethoxazole remains the agent of choice for management of most isolated SSTIs, therapy must be tailored to the individual patient based on species-specific susceptibility patterns and formal susceptibility testing, site(s) of infection, and patient tolerability.
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Affiliation(s)
- Marion Hemmersbach-Miller
- Infectious Diseases Division, Duke University Medical Center, Durham, NC, USA.
- Duke Clinical Research Institute, Durham, NC, USA.
| | - Jelena Catania
- Infectious Disease Section, Orlando Veterans Affairs Medical Center, Orlando, FL, USA
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Jennifer L Saullo
- Infectious Diseases Division, Duke University Medical Center, Durham, NC, USA
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Faccini-Martínez ÁA, Zanotti RL, Moraes MS, Falqueto A. Nodular Lymphangitis Syndrome. Am J Trop Med Hyg 2019; 97:1282-1284. [PMID: 29140231 PMCID: PMC5817783 DOI: 10.4269/ajtmh.17-0397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Álvaro A Faccini-Martínez
- Health Science Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.,Postgraduate Program in Infectious Diseases, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Raphael L Zanotti
- Health Science Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.,Postgraduate Program in Infectious Diseases, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Maithê S Moraes
- School of Medicine, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Aloísio Falqueto
- Health Science Center, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.,Postgraduate Program in Infectious Diseases, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
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Cutaneous Complications in Recipients of Lung Transplants: A Pictorial Review. Chest 2018; 155:178-193. [PMID: 30201407 DOI: 10.1016/j.chest.2018.08.1060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/16/2018] [Indexed: 12/26/2022] Open
Abstract
Lung transplant is now an established modality for a broad spectrum of end-stage pulmonary diseases. According to the International Society for Heart and Lung Transplantation Registry, more than 50,000 lung transplants have been performed worldwide, with nearly 11,000 recipients of lung transplants alive in the United States. With the increasing use of lung transplant, pulmonologists must be cognizant of the common as well as the unique posttransplant dermatologic complications. Immunosuppression, infections, and a variety of medications and environmental exposures can contribute to these complications. This review aims to provide representative pictures and describe the pathogenesis, epidemiologic characteristics, and clinical manifestations of dermatologic complications encountered among recipients of lung transplants.
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Ayoade F, Mada P, Joel Chandranesan AS, Alam M. Sporotrichoid Skin Infection Caused by Nocardia brasiliensis in a Kidney Transplant Patient. Diseases 2018; 6:diseases6030068. [PMID: 30046022 PMCID: PMC6163291 DOI: 10.3390/diseases6030068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 12/16/2022] Open
Abstract
Prompt and accurate diagnosis of Nocardia skin infections is important in immunocompromised hosts, especially transplant patients. The sporotrichoid form, which is otherwise known as the lymphocutaneous form of Nocardia skin involvement, can mimic other conditions, including those caused by fungi, mycobacteria, spirochetes, parasites and other bacteria. Delayed or inaccurate diagnosis and treatment of Nocardia skin infections in transplant patients could lead to dissemination of disease and other poor outcomes. Nocardia brasiliensis is a rare cause of lymphocutaneous nocardiosis in solid organ transplant patients with only two other cases reported to our knowledge. This case describes a middle-aged man, who presented 16 years post kidney transplant. He developed a sporotrichoid lesion on his upper extremity one week after gardening. Ultrasound showed a 35-cm abscess tract on his forearm, which was subsequently drained. Nocardia brasiliensis was isolated from pus culture and he was treated successfully with amoxicillin/clavulanate for 6 months. A review of the relevant literature is included.
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Affiliation(s)
- Folusakin Ayoade
- Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | - Pradeep Mada
- Texas Health Presbyterian Hospital, Dallas, TX 75231, USA.
| | | | - Mohammed Alam
- Health Science Center, Louisiana State University, Shreveport, LA 71103, USA.
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Nodular Lymphangitis (Sporotrichoid Lymphocutaneous Infections). Clues to Differential Diagnosis. J Fungi (Basel) 2018; 4:jof4020056. [PMID: 29747448 PMCID: PMC6023502 DOI: 10.3390/jof4020056] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 02/07/2023] Open
Abstract
Nodular lymphangitis, also known as sporotrichoid lymphocutaneous infections, is characterized by suppurative inflammatory nodules along the lymphatic vessels. This manifestation is classic of sporotrichosis, however, other infections such as nocardiosis, atypical mycobacteriosis, leishmaniasis, among others, can also express this clinical pattern. Sporotrichosis, which often occurs in gardeners, remains the most recognized cause of nodular lymphangitis. The histopathological studies, as well as the culture are diagnostic standards of lesions that do not respond to empirical treatment. In this article, we will review the main causes of nodular lymphangitis or lymphocutaneous sporotrichoid infections.
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Duretz C, Buchlin P, Huguenin A, Durlach A, Hentzien M, Mestrallet S, Lebrun D. Pseudo pyoderma gangrenosum à Scedosporium apiospermum. Med Mal Infect 2018; 48:212-214. [DOI: 10.1016/j.medmal.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/02/2017] [Accepted: 09/12/2017] [Indexed: 11/28/2022]
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17
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Mossad SB. A Pancreas Transplant Recipient With Cutaneous Lesions After Handling A Rose Bush. Clin Infect Dis 2017. [DOI: 10.1093/cid/cix070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nocardia mikamiia Novel Species Causing Disseminated Nocardiosis: A Literature Review of Disseminated Nocardiosis. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:869153. [PMID: 27437492 PMCID: PMC4897366 DOI: 10.1155/2014/869153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 07/10/2014] [Indexed: 11/18/2022]
Abstract
Nocardiais an uncommon Gram-positive organism. It typically appears as delicate filamentous Gram-positive branching rods. In the United States it was estimated to be approximately 500 to 1000 new cases per year. The organism causes disease in immunocompromised individuals with pulmonary infection representing the most common site of infection.Nocardia mikamiihas been a recently isolated pathogen and not many cases of disseminated infection with this organism has been reported in the literature; we present a case of disseminated nocardiosis (mikamii sp.) in an immunocompromised patient. We also present a literature review on nocardiosis.
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Boyce Z, Collins N. Scedosporium apiospermum:An unreported cause of fungal sporotrichoid-like lymphocutaneous infection in Australia and review of the literature. Australas J Dermatol 2013; 56:e39-42. [DOI: 10.1111/ajd.12119] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Zachary Boyce
- Dermatology Department; Cairns Base Hospital; Cairns Queensland Australia
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Abstract
Subcutaneous mycoses are common in tropical and subtropical regions of the world. These infections have multiple features in common, including similar epidemiology, mode of transmission, indolent chronic presentation with low potential for dissemination in immunocompetent hosts, and pyogranulomatous lesions on histopathology. Herein, we provide up-to-date epidemiologic, clinical, diagnostic, and therapeutic data for three important subcutaneous mycoses: chromoblastomycosis, mycetoma, and sporotrichosis.
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Affiliation(s)
- Ricardo M La Hoz
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, Tinsley Harrison Tower 229, Birmingham, AL, 35294-0006, USA
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González-López MA, González-Vela MC, Salas-Venero CA, Conde R, Val-Bernal JF. Cutaneous infection caused by Nocardiopsis dassonvillei presenting with sporotrichoid spread. J Am Acad Dermatol 2011; 65:e90-e91. [DOI: 10.1016/j.jaad.2011.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 04/27/2011] [Accepted: 05/01/2011] [Indexed: 10/17/2022]
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Outhred AC, Watts MR, Chen SCA, Sorrell TC. Nocardia Infections of the Face and Neck. Curr Infect Dis Rep 2011; 13:132-40. [DOI: 10.1007/s11908-011-0165-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
This article presents a case of a chronic, nonhealing thumb wound in a patient with diabetes mellitus. A 67-year-old right-hand-dominant man presented with progressive erythema and swelling of the right thumb several months after sustaining a paper cut along the eponychium. The patient had already completed an extensive laboratory evaluation, including bacterial and fungal cultures, as well as a punch biopsy that was inconclusive. In addition, the patient underwent several rounds of empiric antibiotic therapy without resolution of his symptoms. Despite these measures, the patient's thumb wound persisted and new lesions began to appear proximally along the forearm. Excisional biopsy of the lesions was ultimately required to obtain additional tissue for a pathologic analysis. Culture of the specimen on Saboraud dextrose agar revealed a definitive diagnosis of infection with Sporothrix schenkii. A subsequent course of oral antifungal therapy with itraconazole was well tolerated and resulted in disease regression. Early diagnosis of sporotrichosis is essential to prevent complications including septic arthritis, systemic infection, and death. This case illustrates the importance of maintaining a high index of suspicion for atypical infectious agents in patients with poor immune function.
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Affiliation(s)
- Andrew H Milby
- School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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An Elderly Man With Sporotrichoid Infection. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e31819fe544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Palmero ML, Pope E, Brophy J. Sporotrichoid aspergillosis in an immunocompromised child: a case report and review of the literature. Pediatr Dermatol 2009; 26:592-6. [PMID: 19840318 DOI: 10.1111/j.1525-1470.2009.00991.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Primary cutaneous aspergillosis is an uncommon, opportunistic infection. Atypical presentations have recently emerged with the expanding range of primary and acquired diseases that cause immunosuppression. Primary cutaneous aspergillosis may invade the deep lymphatic structures and present in a sporotrichoid pattern. In pediatric patients with an otherwise normal previous medical history, primary cutaneous aspergillosis should raise the suspicion of an immunodeficiency and prompt referral to immunology and infectious disease specialists should be made. Early diagnosis and management of primary cutaneous aspergillosis prevents invasive aspergillosis, minimizing morbidity and mortality in the immunocompromised patients.
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Affiliation(s)
- Maria Lourdes Palmero
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
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DiNubile MJ. Nodular lymphangitis: A distinctive clinical entity with finite etiologies. Curr Infect Dis Rep 2008; 10:404-10. [DOI: 10.1007/s11908-008-0065-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Bernal E, Ahmad N, López P, Gutiérrez F. [Lymphocutaneous syndrome due to Nocardia brasiliensis in an immunocompetent patient]. Enferm Infecc Microbiol Clin 2008; 26:58-60. [PMID: 18208769 DOI: 10.1157/13114398] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kauffman CA, Bustamante B, Chapman SW, Pappas PG. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis 2007; 45:1255-65. [PMID: 17968818 DOI: 10.1086/522765] [Citation(s) in RCA: 269] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Accepted: 08/21/2007] [Indexed: 10/17/2023] Open
Abstract
Guidelines for the management of patients with sporotrichosis were prepared by an Expert Panel of the Infectious Diseases Society of America and replace the guidelines published in 2000. The guidelines are intended for use by internists, pediatricians, family practitioners, and dermatologists. They include evidence-based recommendations for the management of patients with lymphocutaneous, cutaneous, pulmonary, osteoarticular, meningeal, and disseminated sporotrichosis. Recommendations are also provided for the treatment of sporotrichosis in pregnant women and in children.
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Affiliation(s)
- Carol A Kauffman
- Infectious Diseases Section, Veterans Affairs Medical Center, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
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Abstract
A 40-year-old man visited Haiti in the winter. His visit was uneventful, and he went swimming in the ocean. A week after his return he developed a small "pimple" on his right fifth finger. This condition progressed for several weeks, with new lesions developing over the extensor surface of his forearm and in the antecubital fossa. He had tender axillary adenopathy. The patient started a new job when he returned from Haiti, working 4 days per week in a greenhouse. He denied any fever, chills, or night sweats. He was in good health without any underlying chronic health problems. Physical examination revealed a small eschar over the distal phalanx of the patient's right fifth finger (Figure 1). There were 2 erythematous nodules over the extensor surface of his right forearm (Figure 2) as well as over the antecubital fossa (Figure 3). A punch biopsy was performed and results showed suppurative granulomatous dermatitis. Sporothrix schenckii was grown from the specimen.
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Affiliation(s)
- Jodie Engle
- Wright State University School of Medicine, 4100 West Third Street, Dayton, OH 45428, USA
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Abstract
This report describes a 23 year-old male florist gardener diagnosed with subcutaneous sporotrichosis caused by the dimorphic pathogenic soil fungus Sporothrix schenckii. The patient had several small skin lesions over the left upper arm with ascendant chains of enlarged lymph nodes.Sporothrix schenckii was detected from clinical samples by direct microscopy and culture and its ability to switch from mould to yeast form at 37 degrees C. The patient was successfully treated with long-term potassium iodide and advised to wear gloves and long sleeves when handling any kind of plant material.
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Affiliation(s)
- Abdolhassan Kazemi
- National Public Health Management Center (NPMC) and Immunology and Parasitology Department, Biotechnology Research Center (BRC), Tabriz University of Medical Sciences Tabriz, Iran.
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Dessy LA, Mazzocchi M, Fioramonti P, Scuderi N. Conservative management of local Mycobacterium chelonae infection after combined liposuction and lipofilling. Aesthetic Plast Surg 2006; 30:717-22. [PMID: 17093877 DOI: 10.1007/s00266-006-0031-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A case of Mycobacterium chelonae infection in the buttock after combined liposuction and lipoinjection is presented. The real possibility of contamination from operating room equipment was the potential etiologic factor of this infection. The clinical presentation of the disease was typical. The difficulty confirming the diagnosis was solved by specific culturing techniques. Successful treatment with limited debridement and irrigation combined with prolonged specific antibiotic therapy effected a long-term cure.
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Affiliation(s)
- Luca A Dessy
- Department of Plastic Surgery, University "La Sapienza" of Rome, Rome, Italy.
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Abstract
The evaluation of patients with subcutaneous nodules remains a diagnostic challenge. The presence of nodules can be a clue to an underlying systemic disease; however, the varied presentations of nodules and numerous disease associations make the assessment of patients with nodules far from simple. With further investigation into the appearance, location, and symptoms associated with nodules, the clinical significance of these lesions can become clearer and aid in logical diagnostic evaluation. We have reviewed the causes of nodules with emphasis on those associated with rheumatic disease and provide guidelines for nodule evaluation to better characterize disease association and lead to directed diagnostic assessment.
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Abstract
The endemic mycoses are diverse group of fungi that share several characteristics. They are able to cause disease in healthy hosts, they each occupy a specific ecologic niche in the environment, and they exhibit temperature dimorphism, existing as molds in the environment at temperature of 25 degrees C to 30 degrees C, and as yeasts, or spherules in the case of coccidioidomycosis, at body temperatures. This article discusses histoplasmosis and blastomycosis. Sporotrichosis, which differs in that it is usually a localized lymphocutaneous infection, is included because it shares the characteristics of endemic mycoses.
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Affiliation(s)
- Carol A Kauffman
- University of Michigan Medical School, Ann Arbor, MI 48109, USA.
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Bartralot R, García-Patos V, Sitjas D, Rodríguez-Cano L, Mollet J, Martín-Casabona N, Coll P, Castells A, Pujol RM. Clinical patterns of cutaneous nontuberculous mycobacterial infections. Br J Dermatol 2005; 152:727-34. [PMID: 15840105 DOI: 10.1111/j.1365-2133.2005.06519.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous nontuberculous mycobacterial infections result from external inoculation, spread of a deeper infection, or haematogenous spread of a disseminated infection. There are two species-specific infections (fish-tank or swimming-pool granuloma, due to Mycobacterium marinum, and Buruli ulcer, caused by M. ulcerans). Most infections, however, produce a nonspecific clinical picture. OBJECTIVES To define clinical patterns of cutaneous disease in nontuberculous mycobacterial infections. METHODS Fifty-one patients with cutaneous nontuberculous mycobacterial infections were reviewed. Clinical and histopathological features of normal hosts and immunosuppressed patients were compared. Two subgroups of immunosuppressed patients were distinguished: patients with cutaneous infection and patients with a disseminated infection and cutaneous involvement. RESULTS In immunosuppressed patients the number of lesions was significantly higher. Abscesses and ulceration were also more frequently observed. Different species were found in normal hosts and immunosuppressed patients. Several clinical patterns of cutaneous infection were defined: lymphocutaneous or sporotrichoid lesions; nonlymphocutaneous lesions at the site of trauma; folliculitis and furunculosis involving the lower extremities; disseminated lesions on the extremities in immunosuppressed patients. Two patterns were observed in patients with a disseminated infection: localized cutaneous lesions and disseminated cutaneous and mucosal lesions. CONCLUSIONS Cutaneous manifestations of nontuberculous mycobacterial infections may be classified according to criteria such as cutaneous lesions and immune status.
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Affiliation(s)
- R Bartralot
- Microbiology, Hospital Vall d'Hebron and Facultat de Medicina, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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Maraki S, Chochlidakis S, Nioti E, Tselentis Y. Primary lymphocutaneous nocardiosis in an immunocompetent patient. Ann Clin Microbiol Antimicrob 2004; 3:24. [PMID: 15544704 PMCID: PMC534796 DOI: 10.1186/1476-0711-3-24] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2004] [Accepted: 11/15/2004] [Indexed: 12/11/2022] Open
Abstract
Background Nocardia brasiliensis is a rare human pathogen usually associated with localized cutaneous infections. Case Presentation We report a case of primary lymphocutaneous Nocardia brasiliensis infection developed after a bone fracture of the left hand of an otherwise healthy 32-year-old man. Treatment with trimethoprim-sulfamethoxazole given for a total of three months combined with surgical debridement resulted in complete resolution of the infection. Conclusion Nocardiosis should be part of the differential diagnosis in patients with sporotrichoid infection, particularly those with a history of outdoor injury. Culture of the affected tissue and antimicrobial susceptibility testing of the isolate should be performed for diagnosis and treatment.
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Affiliation(s)
- Sofia Maraki
- Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Crete, 712 01 Heraklion, Crete, Greece
| | - Stavros Chochlidakis
- Department of Orthopedics, University Hospital of Crete, 712 01 Heraklion, Crete, Greece
| | - Eleni Nioti
- Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Crete, 712 01 Heraklion, Crete, Greece
| | - Yannis Tselentis
- Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Crete, 712 01 Heraklion, Crete, Greece
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Bernstein JM. The farmer and the tractor. Skinmed 2003; 2:101-3. [PMID: 14673307 DOI: 10.1111/j.1540-9740.2003.02228.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jack M Bernstein
- The Department of Internal Medicine, Veterans Affairs Medical Center, Wright State University School of Medicine, Dayton, OH 45435, USA.
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Safdar A. Clinical microbiological case: infection imitating lymphocutaneous sporotrichosis during pregnancy in a healthy woman from the south-eastern USA. Clin Microbiol Infect 2003. [DOI: 10.1046/j.1469-0691.2003.00586.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vega J, Miranda A, Cuadrado C, Samaniego E, Bordel MT. Actualización de la tularemia en España. ACTAS DERMO-SIFILIOGRAFICAS 2003. [DOI: 10.1016/s0001-7310(03)76678-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
The zoonotic infections caused by Francisella tularensis and Coxiella burnetii, tularemia and Q fever, respectively, are two less commonly encountered clinical illnesses that are becoming increasingly recognized as epidemiologically important human diseases. The prevalence of tularemia and Q fever can be positively impacted by increased awareness of the clinical entities that arise from infection by these arthropod-borne organisms. Improved recognition of these clinical syndromes will lead to greater diagnostic accuracy in recognizing these diseases in patients. Ultimately, more stringent measures to prevent infection may be required, through raising public awareness, since current therapeutic regimens for these two diseases are limited, and knowledge of the pathogenesis of these two organisms are still in developing stages.
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Affiliation(s)
- Elisa Choi
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. echo:@caregroup.harvard.edu
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Palomo C, Santos-Juanes J, Galacheb C, Romero F, Telenti M, Sánchez Del Río JA. [Lymphocutaneous syndrome due to Mycobacterium marinum in a young aquarium enthusiast]. Enferm Infecc Microbiol Clin 2001; 19:506-7. [PMID: 11844463 DOI: 10.1016/s0213-005x(01)72716-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Canet JJ, Pagerols X, Sánchez C, Vives P, Garau J. Lymphocutaneous syndrome due to Scedosporium apiospermum. Clin Microbiol Infect 2001; 7:648-50. [PMID: 11737093 DOI: 10.1046/j.1198-743x.2001.00333.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Acute lymphangitis mimicking mechanical neck pain. J Manipulative Physiol Ther 2001. [DOI: 10.1016/s0161-4754(01)19132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bishara J, Cohen Y, Gabay B, Pavlov R, Samra Z, Pitlik S. Sporotrichoid Lymphangitis Due to Group AStreptococcus. Clin Infect Dis 2001; 32:e154-7. [PMID: 11360227 DOI: 10.1086/320753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2000] [Revised: 10/13/2000] [Indexed: 11/03/2022] Open
Abstract
We describe what is, to our knowledge, the first case of sporotrichoid lymphangitis caused solely by group A Streptococcus in an otherwise healthy patient. Infection with pyogenic pathogens, such as streptococci and staphylococci, as well as with the most common causes of sporotrichoid lymphangitis (i.e., Sporothrix schenkii, Nocardia brasiliensis, Mycobacterium marinum, and Leishmania species) should be considered in differential diagnosis for some patients.
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Affiliation(s)
- J Bishara
- Department of Internal Medicine C, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 29-2000. A 69-year-old renal transplant recipient with low-grade fever and multiple pulmonary nodules. N Engl J Med 2000; 343:870-7. [PMID: 10995868 DOI: 10.1056/nejm200009213431208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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