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Maiwall R, Piano S, Singh V, Caraceni P, Alessandria C, Fernandez J, Soares EC, Kim DJ, Kim SE, Marino M, Vorobioff J, Ribeiro Barea RDC, Merli M, Elkrief L, Vargas V, Krag A, Singh SP, Lesmana LA, Toledo C, Marciano S, Verhelst X, Wong F, Intagliata N, Rabinowich L, Colombato L, Kim SG, Gerbes A, Durand F, Roblero JP, Bhamidimarri KR, Maevskaya M, Fassio E, Kim HS, Hwang JS, Gines P, Bruns T, Gadano A, Angeli P, Sarin SK. Determinants of clinical response to empirical antibiotic treatment in patients with cirrhosis and bacterial and fungal infections-Results from the ICA "Global Study" (EABCIR-Global Study). Hepatology 2024; 79:1019-1032. [PMID: 38047909 DOI: 10.1097/hep.0000000000000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/30/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The administration of an appropriate empirical antibiotic treatment is essential in cirrhosis and severe bacterial infections. We aimed to investigate the predictors of clinical response of empirical antibiotic treatment in a prospective cohort of patients with cirrhosis and bacterial and fungal infections included in the International Club of Ascites "Global Study." METHODS Patients hospitalized with cirrhosis and bacterial/fungal infection were prospectively enrolled at 46 centers. Clinical response to antibiotic treatment was defined according to changes in markers of infection/inflammation, vital signs, improvement of organ failure, and results of cultures. RESULTS From October 2015 to September 2016, 1302 patients were included at 46 centers. A clinical response was achieved in only 61% of cases. Independent predictors of lack of clinical response to empirical treatment were C-reactive protein (OR = 1.16; 95% CI = 1.02-1.31), blood leukocyte count (OR = 1.39;95% CI = 1.09-1.77), serum albumin (OR = 0.70; 95% CI = 0.55-0.88), nosocomial infections (OR = 1.96; 95% CI = 1.20-2.38), pneumonia (OR = 1.75; 95% CI = 1.22-2.53), and ineffective treatment according to antibiotic susceptibility test (OR = 5.32; 95% CI = 3.47-8.57). Patients with a lack of clinical response to first-line antibiotic treatment had a significantly lower resolution rate of infections (55% vs. 96%; p < 0.001), a higher incidence of second infections (29% vs. 15%; p < 0.001), shock (35% vs. 7%; p < 0.001) and new organ failures (52% vs. 19 %; p < 0.001) than responders. Clinical response to empirical treatment was an independent predictor of 28-day survival ( subdistribution = 0.20; 95% CI = 0.14-0.27). CONCLUSIONS Four out of 10 patients with cirrhosis do not respond to the first-line antibiotic therapy, leading to lower resolution of infections and higher mortality. Broader-spectrum antibiotics and strategies targeting systemic inflammation may improve prognosis in patients with a high degree of inflammation, low serum albumin levels, and severe liver impairment.
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Affiliation(s)
- Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Virendra Singh
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Paolo Caraceni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Alessandria
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Javier Fernandez
- Liver ICU, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August-Pi-Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHED), Barcelona, Spain
- European Foundation of Chronic Liver Failure (EF-Clif), Barcelona, Spain
| | - Elza Cotrim Soares
- Gastroenterology Division, Medicine Department, Faculty of Medical Sciences, University of Campinas (UNICAMP). Campinas, São Paulo, Brazil
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Sung Eun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang city, Republic of Korea
| | - Monica Marino
- Liver Unit, Hospital Dr. Carlos B. Udaondo, Buenos Aires, Argentina
| | | | | | - Manuela Merli
- Gastroenterology and Hepatology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Laure Elkrief
- Service de Transplantation, Service d'Hépato-gastroentérologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Victor Vargas
- Liver Unit, Department of Internal Medicine, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, CIBERehd, Barcelona. Spain
| | - Aleksander Krag
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
| | | | | | - Claudio Toledo
- Gastroenterology Unit, Hospital Valdivia, Universidad Austral de Chile, Valdivia, Chile
| | - Sebastian Marciano
- Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Xavier Verhelst
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Florence Wong
- Division of Gastroenterology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Nicolas Intagliata
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, Virginia, USA
| | - Liane Rabinowich
- Liver Unit, Department of Gastroenterology, Tel-Aviv Medical Center and Tel-Aviv University, Tel-Aviv, Israel
| | - Luis Colombato
- Gastroenterology Department, Buenos Aires British Hospital, Argentine Catholic University (UCA), Buenos Aires, Argentina
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Alexander Gerbes
- Department of Medicine II, Liver Centre Munich, University Hospital, LMU Munich, Germany
| | - Francois Durand
- Hepatology & Liver Intensive Care, Hospital Beaujon, Clichy, University Paris Diderot, Paris, France
| | - Juan Pablo Roblero
- Departamento de Medicina, Universidad de Chile Campus Centro, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | | | | | - Eduardo Fassio
- Liver Unit, Hospital Nacional Prof. Alejandro Posadas, El Palomar, Buenos Aires, Argentina
| | - Hyoung Su Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jae Seok Hwang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Pere Gines
- Liver ICU, Liver Unit, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August-Pi-Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHED), Barcelona, Spain
| | - Tony Bruns
- Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Adrian Gadano
- Liver Unit and Department of Research, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Paolo Angeli
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Chen F, Shao Y, Huang Q, Chen Y, Yang B, Jiang L. Visual function loss in fungal sphenoid sinusitis: clinical characteristics and outcomes. Sci Rep 2024; 14:8649. [PMID: 38622183 PMCID: PMC11018747 DOI: 10.1038/s41598-024-59107-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
Potentially fatal fungal sphenoid sinusitis (FSS) causes visual damage. However, few studies have reported on its visual impairment and prognosis. Five hundred and eleven FSS patients with ocular complications treated at Beijing Tongren Hospital were recruited and clinical features and visual outcomes were determined. Thirty-two of the 511 patients (6%) had visual impairment, with 13 and 19 patients having invasive and noninvasive FSS, respectively. Eighteen patients (56.25%) had diabetes and 2 patient (6.25%) had long-term systemic use of antibiotics (n = 1) and corticosteroids (n = 1). All patients had visual impairment, which was more severe in invasive FSS than in noninvasive FSS. Bony wall defects and sclerosis were observed in 19 patients (59.38%), and 11 patients (34.38%) had microcalcification in their sphenoid sinusitis on computed tomography (CT). After a 5-year follow-up, three patients (9.38%) died. Patients with noninvasive FSS had a higher improvement rate in visual acuity than their counterparts. In the multivariate analysis, sphenoid sinus wall sclerosis on CT was associated with better visual prognosis. FSS can cause vision loss with persistent headaches, particularly in those with diabetes. CT showed the sphenoid sinus wall sclerosis, indicating a better visual prognosis in FSS with visual impairment.
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Affiliation(s)
- Fei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomin Lane, Dongcheng District, Beijing, 100010, China
- Department of Ophthalmology, Tengzhou Central People's Hospital, No.181 Xingtan Road, Tengzhou City, 277500, Shandong Province, China
| | - Yonghui Shao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomin Lane, Dongcheng District, Beijing, 100010, China
| | - Qian Huang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100010, China
| | - Yue Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomin Lane, Dongcheng District, Beijing, 100010, China
| | - Bentao Yang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100010, China
| | - Libin Jiang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomin Lane, Dongcheng District, Beijing, 100010, China.
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Jin Q, Lin S, Chen X, Xu Y, Tian X, He L, Jiang W, Chen F, Shu X, Lu X, Peng Q, Wang G. Spontaneous pneumomediastinum in anti-MDA5-positive dermatomyositis: Prevalence, risk factors, and prognosis. Semin Arthritis Rheum 2024; 65:152352. [PMID: 38185078 DOI: 10.1016/j.semarthrit.2023.152352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/15/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To depict the clinical panorama of spontaneous pneumomediastinum (SPM) in anti-MDA5 antibody-positive dermatomyositis (anti-MDA5+ DM). METHODS A total of 1352 patients with idiopathic inflammatory myopathy (IIM), including 384 anti-MDA5+ DM patients were retrospectively enrolled. The clinical profiles of anti-MDA5+ DM-associated SPM were analyzed. RESULTS We identified that 9.4 % (36/384) of anti-MDA5+ DM patients were complicated with SPM, which was significantly higher than that of non-anti-MDA5+ DM and other IIM subtypes (P all <0.001). SPM developed at a median of 5.5 (3.0, 12.0) months after anti-MDA5+ DM onset. Anti-MDA5+ DM patients complicated with SPM showed a significantly higher frequency of fever, dyspnea, and pulmonary infection including viral and fungal infections compared to those without SPM (P all < 0.05). Cytomegalovirus (CMV) and fungal infections were identified to be independent risk factors for SPM development in the anti-MDA5+ DM. SPM and non-SPM patients in our anti-MDA5+ DM cohort showed comparable short-term and long-term survival (P = 0.236). Furthermore, in the SPM group, we found that the non-survivors had a lower peripheral lymphocyte count, higher LDH level, and higher frequency of intensification of immunosuppressive treatment (IST) than survivors. The elevated LDH level and intensification of IST were independent risk factors for increased mortality in anti-MDA5+ DM-associated SPM patients. CONCLUSIONS Nearly one-tenth of patients with anti-MDA5+ DM develop SPM. Both CMV and fungal infections are risk factors for SPM occurrence. The development of SPM does not worsen the prognosis of anti-MDA5+ DM patients, and the intensification of IST does harm to the SPM prognosis.
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Affiliation(s)
- Qiwen Jin
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Sang Lin
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xixia Chen
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Yuetong Xu
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaolan Tian
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Linrong He
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Wei Jiang
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Fang Chen
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoming Shu
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xin Lu
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Qinglin Peng
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China.
| | - Guochun Wang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China; Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China; Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China.
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Bhanuman R, Varadharajan S, Kumar K, Shah VM. Lethal mycotic pseudoaneurysm presenting as isolated sixth nerve palsy. Digit J Ophthalmol 2024; 30:19-21. [PMID: 38601898 PMCID: PMC11001566 DOI: 10.5693/djo.02.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Pseudoaneurysm of the internal carotid artery caused by skull base osteomyelitis (SBO) is a lethal condition seen in immunocompromised patients, predominantly those with diabetes mellitus. Cranial nerve involvement is a common complication and generally indicates a poor prognosis. We report the case of a 62-year-old diabetic patient who presented with isolated sixth cranial nerve palsy. She had uncontrolled blood sugar levels and high erythrocyte sedimentation rate, and she suffered from pyelonephritis. Neuroimaging detected SBO with multiple secondary mycotic pseudoaneurysms prominent at the petrocavernous junction. Ischemia is the most common etiology for an isolated abducens nerve palsy, but in certain cases neuroimaging is warranted to prevent life-threatening complications. This case highlights the importance and urgency of identifying and managing such conditions.
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Affiliation(s)
- Rasna Bhanuman
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Shriram Varadharajan
- Radiology Department, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | - Karthik Kumar
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Virna M. Shah
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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López-Herrero R, Sánchez-de Prada L, Tamayo-Velasco A, Heredia-Rodríguez M, Bardají Carrillo M, Jorge Monjas P, de la Varga-Martínez O, Resino S, Sarmentero-López de Quintana G, Gómez-Sánchez E, Tamayo E. Epidemiology of fungal infection in COVID 19 in Spain during 2020 and 2021: a nationwide study. Sci Rep 2024; 14:5203. [PMID: 38433130 PMCID: PMC10909879 DOI: 10.1038/s41598-024-54340-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
We realize a nationwide population-based retrospective study to analyze the characteristics and risk factors of fungal co-infections in COVID-19 hospitalized patients as well as describe their causative agents in the Spanish population in 2020 and 2021. Data were obtained from records in the Minimum Basic Data Set of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health, and annually published with two years lag. The assessment of the risk associated with the development of healthcare-associated fungal co-infections was assessed using an adjusted logistic regression model. The incidence of fungal co-infection in COVID-19 hospitalized patients was 1.41%. The main risk factors associated were surgery, sepsis, age, male gender, obesity, and COPD. Co-infection was associated with worse outcomes including higher in-hospital and in ICU mortality, and higher length of stay. Candida spp. and Aspergillus spp. were the microorganisms more frequent. This is the first study analyzing fungal coinfection at a national level in hospitalized patients with COVID-19 in Spanish population and one of the few studies available that demonstrate that surgery was an independent risk factor of Aspergillosis coinfection in COVID-19 patients.
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Affiliation(s)
- R López-Herrero
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - L Sánchez-de Prada
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Microbiology Department, Hospital Universitario Río Hortega, 47012, Valladolid, Spain
| | - A Tamayo-Velasco
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain.
- Haematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - M Heredia-Rodríguez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Complejo Asistencial Universitario de Salamanca, 37007, Salamanca, Spain
| | - M Bardají Carrillo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
| | - P Jorge Monjas
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - O de la Varga-Martínez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Department of Anesthesiology, Hospital Universitario Infanta Leonor, 28031, Madrid, Spain
| | - S Resino
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - G Sarmentero-López de Quintana
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
| | - E Gómez-Sánchez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - E Tamayo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
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Jana M, Sinha P, Garg P, Naranje P, Kabra SK, Bhalla AS. Imaging Findings in Chronic Granulomatous Disease (CGD). Indian J Pediatr 2024; 91:242-247. [PMID: 36454508 DOI: 10.1007/s12098-022-04350-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To describe prevalence of various imaging findings in chronic granulomatous disease (CGD) patients; and find imaging biomarkers for differentiating chest infections caused by different micro-organisms. METHODS A retrospective study was conducted on 15 patients (49 scans) with proven CGD. Scans which had a correlative microbiological diagnosis for organisms were included in the analysis. The scans were reviewed by 3 radiologists on a predefined proforma, under the lung parenchymal, airway, pleural, mediastinal, and extrathoracic abnormalities. Analysis of various imaging parameters on a semiquantitative scale was performed, followed by a correlation of each imaging findings with causative organisms. RESULT The mean age of presentation was nearly 7 y, with a male preponderance. Definitive proof of causative organisms was obtained in 22 scans. Bacterial infection was found in 7, fungal in 12, tubercular in 2, and viral in 1 scan. Most prevalent thoracic imaging manifestations included lymphadenopathy (commonest), consolidation, nodules, air trapping, and bronchiectasis. Fungal infections showed necrotic conglomerate lymphadenopathy, cavitating nodules, and multilobar consolidation more frequently than bacterial infections (though not statistically significant). Abscesses and lymphadenopathy were the most common extrathoracic manifestations. CONCLUSION In patients with CGD, multifocal or multilobar consolidation, mass-like consolidation, cavitating nodules, and conglomerate necrotic lymphadenopathy should alert the radiologist to a possible fungal cause.
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Affiliation(s)
- Manisha Jana
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Pallavi Sinha
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Palak Garg
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Priyanka Naranje
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sushil K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Laghlam D, Giraud F, Benghanem S. Severe Pulmonary and Nasopharyngeal Candida krusei Infection in Cocaine-induced Vasculopathy. Am J Respir Crit Care Med 2024; 209:587-589. [PMID: 38207072 DOI: 10.1164/rccm.202305-0828im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/10/2024] [Indexed: 01/13/2024] Open
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8
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Salem Y, Rahman SM, Shalabi M, Hussain A. Prayer-Related Dermatoses in Muslims. Dermatitis 2024; 35:132-137. [PMID: 37651213 DOI: 10.1089/derm.2023.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Prayer rituals are an integral part of the daily lives of Muslims worldwide. This comprehensive review aims to explore the common dermatoses associated with prayer among Muslims and provide insights for dermatologists to facilitate accurate diagnosis and reduce unnecessary investigations. A systematic literature search returned 367 published articles, of which 21 met the inclusion criteria. Friction-induced dermatitis was the most frequently reported dermatosis, primarily affecting the forehead, knees, dorsum of the feet, and lateral malleoli. Friction-related marks often present as hyperpigmented lichenified plaques, and are more common in elderly individuals and males. Cases of contact dermatitis and fungal infections were also reported. Allergic contact dermatitis was linked to perfume application before Friday prayers, whereas fungal infections were attributed to increased water retention between toe webs, possibly related to communal ablution and prayer areas. Awareness of these prayer-related dermatoses enables dermatologists to provide holistic care for diverse populations and targeting specific interventions with respect for patients' religious beliefs. For example, Muslim patients with symptomatic frictional dermatoses may benefit from use of padded prayer rugs, especially diabetic patients whose lesions carry an increased risk of progressing to neuropathic ulcers.
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Affiliation(s)
- Yousef Salem
- From the University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Syed Minhaj Rahman
- University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Mojahed Shalabi
- Baylor Scott & White Health Department of Dermatology, Temple, Texas, USA
| | - Aamir Hussain
- Galaria Plastic Surgery & Dermatology, LLC, Chantilly, Virginia, USA
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Seijas Betolaza I, Higuera Lucas J, Barrios Andres JL, López Soria LM, Boado Varela V. Resistant fungal infection: a matter of importance not only in critical COVID patients. Minerva Anestesiol 2024; 90:213-214. [PMID: 37987994 DOI: 10.23736/s0375-9393.23.17681-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
| | - Juan Higuera Lucas
- Intensive Care Unit, Hospital Universitario Cruces, Barakaldo, Bilbao, Spain -
| | | | - Leyre M López Soria
- Department of Microbiology, Hospital Universitario Cruces, Barakaldo, Bilbao, Spain
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Baliga S, Yadav S, Sagdeo P, Balakrishnan C. Invasive fungal infection in ANCA-associated vasculitis: Between the Devil and Deep blue sea. Case series and review of the literature. Clin Rheumatol 2024; 43:785-797. [PMID: 37798405 DOI: 10.1007/s10067-023-06785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are susceptible to opportunistic infections, including invasive fungal infections (IFI). This is due to many factors, including prolonged immunosuppressive therapy. The treatment of AAV with such IFIs is challenging. METHODS A descriptive analysis of 5 patients with AAV complicated by concomitant invasive fungal infections was performed. We also have done a comprehensive literature review of IFIs in AAV using PubMed and Google Scholar databases. RESULTS All 5 patients initially received immunosuppressive medication but subsequently acquired IFI. One patient had sphenoid sinus involvement, and four had lung parenchymal involvement. Aspergillus infection was diagnosed in three patients, Cryptococcus infection in one patient and mixed infection with Aspergillus and Mucor infection in one patient. All our patients were on low doses of corticosteroids for several months to years or had received high-dose pulse steroids with cyclophosphamide in the last few weeks before being diagnosed with IFI. It was difficult to distinguish disease activity from IFI in all the cases. Two of the five patients died despite antifungal therapy. The literature review revealed a prevalence of IFIs ranging from 1 to 9.6% (excluding pneumocystis pneumonia). Aspergillosis was the predominant type of IFI, affecting 46 of 86 patients. Most of these patients (40/46) had pulmonary involvement. The prognosis for patients with IFI was consistently poor, as evidenced by 19 deaths out of 29 reported outcomes. CONCLUSION Overall, IFIs have a poor prognosis in patients with AAV. Differentiating disease activity from IFI is difficult because of similar organ distribution, imaging lesions, and histopathological characteristics. A high suspicion index and good-quality microbiology are needed for early treatment and prevention of mortality.
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Affiliation(s)
- Sahana Baliga
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, 400016, India.
| | - Sandeep Yadav
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Room No. 1107, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, 400016, India
| | - Parikshit Sagdeo
- Medicure Multispeciality Clinic, Ramdas Peth, Nagpur, Maharashtra, 440012, India
| | - Canchi Balakrishnan
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Room no. 2414, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, 400016, India
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Clemente D, Cuadros EN, Lovillo MC, Hernández JC, Martín SG, Silveira LF, Cruz MJL, Tagarro A, Rueda RMA, López López A, Aritziturri MS, Calvo C. Position statement on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies, part 3: precautions in situations of surgery, fever, and opportunistic infections. Eur J Pediatr 2024; 183:915-927. [PMID: 38047962 PMCID: PMC10912362 DOI: 10.1007/s00431-023-05295-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 12/05/2023]
Abstract
The objective of this study is to provide practical recommendations on the management of pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The recommendations specifically address the cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, invasive fungal disease). A qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using MeSH terms and free text to identify publications on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The results were presented and discussed in a nominal group meeting, comprising a committee of 12 pediatric rheumatologists from the Infection Prevention and Treatment Working Group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process; this was extended to members of the Spanish Society of Pediatric Rheumatology and Spanish Society of Pediatric Infectious Disease of the Spanish Association of Pediatrics. Participants produced a score ranging from 0 (totally disagree) to 10 (totally agree). Agreement was defined as a vote ≥ 7 by at least 70% of participants. The literature review included more than 400 articles. Overall, 63 recommendations (19 on surgery, fever, and opportunistic infections) were generated and voted by 59 pediatric rheumatologists and other pediatric specialists. Agreement was reached for all 63 recommendations. The recommendations on special situations cover management in cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, and invasive fungal disease). Conclusions: Hereby, we provided consensus and updated of recommendations about the management of special situations such as surgery, fever, and opportunistic in children with immune-mediated rheumatic diseases receiving immunosuppressive therapies. Several of the recommendations depend largely on clinical judgement and specific balance between risk and benefit for each individual and situation. To assess this risk, the clinician should have knowledge of the drugs, the patient's previous situation as well as the current infectious disease, in addition to experience. What is Known: • Infectious diseases and related complications are a major cause of morbidity and mortality in patients with immune-mediated rheumatic diseases. • Information on how to manage the treatment in situations of fever, opportunistic infections, and surgery in children is limited, and guidelines for action are often extrapolated from adults. What is New: • In the absence of strong evidence, a literature review and a Delphi survey were conducted to establish a series of expert recommendations that could support the clinical practice, providing a practical and simple day-to-day approach to be used by pediatric rheumatologists.
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Affiliation(s)
- Daniel Clemente
- Pediatric Rheumatology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Esmeralda Núñez Cuadros
- Pediatric Rheumatology Unit, UGC Pediatría, Hospital Regional Universitario de Málaga, Instituto de investigación biomédica de Málaga (IBIMA), Málaga, Spain
| | - Marisol Camacho Lovillo
- Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Reumatología e Infectología pediátricas, Seville, Spain
| | - Joan Calzada Hernández
- Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Sara Guillén Martín
- Department of Pediatrics, Hospital Universitario de Getafe, CIBERINFEC ISCIII, Carretera de Toledo Km 12, 500, 28905, Getafe, Madrid, Spain.
| | - Laura Fernández Silveira
- Servicio de Inmunología, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS), Reumatología e Infectología pediátricas, Seville, Spain
| | | | - Alfredo Tagarro
- Pediatrics Department. Hospital Universitario Infanta Sofía, Instituto de Investigación 12 de Octubre (imas12), Universidad Europea, Madrid, Spain
| | | | - Agustín López López
- Department of Paediatrics, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Cristina Calvo
- Department of Pediatrics, Infectious and Tropical Diseases, Hospital Universitario La Paz, La Paz Research Institute (IdiPaz), Translational Research Network of Pediatric Infectious Diseases (RITIP), CIBERINFEC ISCIII, Madrid, Spain
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12
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Franklin F, Rajamanikam A, Phang WK, Raju CS, Gill JS, Francis B, Sy-Cherng Woon L, Govind SK. Establishing associated risk factors, including fungal and parasitic infections among Malaysians living with schizophrenia. Sci Rep 2024; 14:385. [PMID: 38172146 PMCID: PMC10764362 DOI: 10.1038/s41598-023-50299-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
The aetiology of schizophrenia is multifactorial, and the identification of its risk factors are scarce and highly variable. A cross-sectional study was conducted to investigate the risk factors associated with schizophrenia among Malaysian sub-population. A total of 120 individuals diagnosed with schizophrenia (SZ) and 180 non-schizophrenic (NS) individuals participated in a questionnaire-based survey. Data of complete questionnaire responses obtained from 91 SZ and 120 NS participants were used in statistical analyses. Stool samples were obtained from the participants and screened for gut parasites and fungi using conventional polymerase chain reaction (PCR). The median age were 46 years (interquartile range (IQR) 37 to 60 years) and 35 years (IQR 24 to 47.75 years) for SZ and NS respectively. Multivariable binary logistic regression showed that the factors associated with increased risk of SZ were age, sex, unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week. These factors, except sex, were positively associated with the severity of SZ. Breastfed at infancy as well as vitamin and supplement consumption showed a protective effect against SZ. After data clean-up, fungal or parasitic infections were found in 98% (39/42). of SZ participants and 6.1% (3/49) of NS participants. Our findings identified non-modifiable risk factors (age and sex) and modifiable lifestyle-related risk factors (unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week) associated with SZ and implicate the need for medical attention in preventing fungal and parasitic infections in SZ.
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Affiliation(s)
- Freddy Franklin
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, Malaysia
- Department of Medical Microbiology, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | | | - Wei Kit Phang
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | | | - Jesjeet Singh Gill
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Benedict Francis
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Luke Sy-Cherng Woon
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Bangi, Malaysia
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Chaudhari V, Vairagade V, Thakkar A, Shende H, Vora A. Nanotechnology-based fungal detection and treatment: current status and future perspective. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:77-97. [PMID: 37597093 DOI: 10.1007/s00210-023-02662-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/02/2023] [Indexed: 08/21/2023]
Abstract
Fungal infections impose a significant impact on global health and encompass major expenditures in medical treatments. Human mycoses, a fungal co-infection associated with SARS-CoV-2, is caused by opportunistic fungal pathogens and is often overlooked or misdiagnosed. Recently, there is increasing threat about spread of antimicrobial resistance in fungus, mostly in hospitals and other healthcare facilities. The diagnosis and treatment of fungal infections are associated with several issues, including tedious and non-selective detection methods, the growth of drug-resistant bacteria, severe side effects, and ineffective drug delivery. Thus, a rapid and sensitive diagnostic method and a high-efficacy and low-toxicity therapeutic approach are needed. Nanomedicine has emerged as a viable option for overcoming these limitations. Due to the unique physicochemical and optical properties of nanomaterials and newer biosensing techniques, nanodiagnostics play an important role in the accurate and prompt differentiation and detection of fungal diseases. Additionally, nano-based drug delivery techniques can increase drug permeability, reduce adverse effects, and extend systemic circulation time and drug half-life. This review paper is aimed at highlighting recent, promising, and unique trends in nanotechnology to design and develop diagnostics and treatment methods for fungal diseases.
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Affiliation(s)
- Vinay Chaudhari
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
| | - Vaishnavi Vairagade
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
| | - Ami Thakkar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
| | - Himani Shende
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
| | - Amisha Vora
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India.
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14
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Zhao Q, Jin K, Hu Y. Logistic Regression Analysis of Factors Associated with the Diagnosis of Fungal Bulbar Sinusitis in Western Yunnan. Altern Ther Health Med 2024; 30:220-225. [PMID: 37773680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Objective Fungal bulb sinusitis (FBS) is mainly caused by fungal infection. Due to its similar clinical symptoms to other sinus diseases such as chronic sinusitis and sinus tumors, it is very easy to have adverse events such as missed diagnosis and misdiagnosis during diagnosis, which further affects patients' negative emotions of quality of life. Therefore, this study investigated the differences between FBS and CRS in Yunnan and western Yunnan, and analyzed the independent risk factors for the diagnosis of FBS, so as to predict the probability of diagnosis of FBS in patients with inflammatory diseases of nasal cavity and sinuses. Methods A total of 128 FBS patients diagnosed in the First Affiliated Hospital of Dali University from January 2015 to December 2019 were retrospectively selected as the study objects, and 112 FBS patients eligible for this study were selected according to the inclusion and exclusion criteria such as Otolaryngology, Head and Neck Surgery and were set as the study group. And 112 patients with CRS diagnosed in the same period were selected as the control group. Single factor analysis (χ2 test) was applied to screen out the factors with significant differences in the preoperative clinical data of the two diseases, which were incorporated into the multivariate Logistic regression model to find independent risk factors for the diagnosis of FBS, establish the diagnosis prediction equation of the disease, and verify the sensitivity and specificity of the equation by using the collected clinical data. Results Multifactorial analysis indicated that age, blood in aspirin, calcified spots, unilateral or bilateral lesions, single or multiple sinus tract lesions, and osteophytes were influential as independent risk factors for diagnosing FBS. The O.R.s for unilateral or bilateral lesions, calcified points, single or multiple sinus tract lesions, and blood in aspirin correlated stronger than 10 with the diagnosis of FBS. Based on these results, a logistic regression prediction equation for the diagnosis of FBS was developed: y = -6.879 + 1.295x1 + 2.519x2 + 3.010x3 + 3.605x4 + 2.977x5 + 1.596x6. P = exp(y)/[1 + exp(y)]. Validation revealed that 91.1% of FBS patients had a diagnostic probability of P>0.5 and 79.5% had a diagnostic probability of P > .9. In contrast, only 4.5% of CRS patients had a diagnostic probability of P > .5 and 0 patients had a diagnostic probability of P > .9. Conclusions FBS remains diagnostic in unilateral or bilateral lesions, calcified spots, single or multiple sinus lesions, and aspirin-containing blood. In addition, the multifactorial regression prediction equation can calculate the probability of a preoperative diagnosis of FBS in patients with inflammatory nasal and sinus diseases, and the prediction efficacy of the established prediction model is good. In addition, the multifactor regression prediction equation has a wide range of applications and can also be used to verify the correlation of other subsequent experiments.
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15
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Aliakbarian M, Khodashahi R, Rezayat KA, Naderi HR, Khodashahi M, Pasand MM, Khaleghi E, Moghaddam MD. Manifestations, Prevalence, Management and Outcome of Invasive Aspergillosis in Post-Liver Transplant Patients. Curr Drug Saf 2024; 19:61-69. [PMID: 36475348 DOI: 10.2174/1574886318666221206102653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/03/2022] [Accepted: 10/19/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Aspergillosis is a severe and fatal complication that causes infection in transplant recipients and patients with immunodeficiency syndrome, neutropenia, chronic granulomatosis, and hematologic malignancies. Invasive Aspergillosis has been reported as one of the fungal infections with high mortality in transplant recipients. This study aimed to describe the manifestations, prevalence, management and outcome of invasive Aspergillosis fungal infections in liver transplant patients. METHODS This descriptive cross-sectional study was conducted on patients with liver transplantation who were infected with invasive Aspergillosis fungal infections. The data were extracted from the medical records of the archive of Montasryieh Hospital, Mashhad, Iran, between August 2019 and August 2020. RESULTS In general, 86 patients who had liver transplantation were hospitalized at Montasryieh Hospital from August 2019 to August 2020. Among them, 10 patients were infected with invasive Aspergillosis. Only 6.7% of the patients were categorized under late-onset (> 90 days after liver transplantation), and 93.3% of them were early-onset (< 90 days after liver transplantation). Invasive Aspergillosis fungal infections were suspected based on clinical or radiological signs (possible in 30% of cases; n = 3). The probable diagnosis was reported in 60% (n = 6), and the proven diagnosis was observed only in one patient. In addition, 80% of the patients were diagnosed with Pulmonary Aspergillosis, and two patients had pulmonary Aspergillosis in combination with the central nervous system and cutaneous Aspergillosis. A correlation was found between a comorbid disease and the type of Aspergillosis (r = 0.69; P = 0.02). Voriconazole was effective to treat invasive Aspergillosis in all patients. CONCLUSION The prevalence rate of Aspergillosis is relatively high among liver transplant recipient populations (11%). All recipients infected with Aspergillosis had at least one risk factor, including an underlying disease. It seems that Voriconazole therapy is effective among transplant patients with pulmonary Aspergillosis.
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Affiliation(s)
- Mohsen Aliakbarian
- Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rozita Khodashahi
- Fellowship in IC Host and Transplant, Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kambiz Akhavan Rezayat
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Naderi
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mandana Khodashahi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maziar Mortazavi Pasand
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ebrahim Khaleghi
- Organ Procurement and Transplant Center of Mashhad University of Medical Sciences, Montasryieh Hospital, Mashhad, Iran
| | - Maliheh Dadgar Moghaddam
- Community Medical Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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16
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Peng X, Yan B, Yang X. Cavernous Sinus Syndrome Caused by Noninvasive Fungal Maxillary Sinusitis. J Craniofac Surg 2024; 35:e102-e103. [PMID: 37983056 DOI: 10.1097/scs.0000000000009905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/20/2023] [Indexed: 11/21/2023] Open
Abstract
It is rare that cavernous sinus complications are caused by maxillary sinus lesions because the locations of these lesions are some distant from each other. The authors describe an unusual presentation that the primary lesion was located in the maxillary sinus and triggered cavernous sinus syndrome and optic nerve symptoms. The most likely possibility was that the infection traveled retrograde along the vascular plexus. Removal of maxillary sinus lesions and establishment ventilation may achieve source control.
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Affiliation(s)
- XiaoLin Peng
- Department of Otolaryngology-Head and Neck Surgery, Xuanwu Hospital Capital Medical University, Beijing, China
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17
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Zawitkowska J, Drabko K, Lejman M, Kowalczyk A, Czyżewski K, Dziedzic M, Jaremek K, Zalas-Więcek P, Szmydki-Baran A, Hutnik Ł, Czogała W, Balwierz W, Żak I, Salamonowicz-Bodzioch M, Kazanowska B, Wróbel G, Frączkiewicz J, Kałwak K, Tomaszewska R, Szczepański T, Zając-Spychała O, Wachowiak J, Płonowski M, Krawczuk-Rybak M, Królak A, Ociepa T, Urasiński T, Pierlejewski F, Młynarski W, Urbańska-Rakus J, Machnik K, Pająk S, Badowska W, Brzeski T, Mycko K, Mańko-Glińska H, Urbanek-Dądela A, Karolczyk G, Mizia-Malarz A, Stolpa W, Skowron-Kandzia K, Musiał J, Chaber R, Irga-Jaworska N, Bień E, Styczyński J. Incidence of bacterial and fungal infections in Polish pediatric patients with acute lymphoblastic leukemia during the pandemic. Sci Rep 2023; 13:22619. [PMID: 38114744 PMCID: PMC10730514 DOI: 10.1038/s41598-023-50093-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023] Open
Abstract
The most common complications related to the treatment of childhood acute lymphoblastic leukemia (ALL) are infections. The aim of the study was to analyze the incidence and mortality rates among pediatric patients with ALL who were treated in 17 Polish pediatric hematology centers in 2020-2021 during the pandemic. Additionally, we compared these results with those of our previous study, which we conducted in the years 2012-2017. The retrospective analysis included 460 patients aged 1-18 years with newly diagnosed ALL. In our study, 361/460 (78.5%) children were reported to have microbiologically documented bacterial infections during chemotherapy. Ten patients (2.8%) died due to sepsis. Fungal infections were reported in 99 children (21.5%), of whom five (5.1%) died due to the infection. We especially observed an increase in bacterial infections during the pandemic period compared to the previous study. The directions of our actions should be to consider antibiotic prophylaxis, shorten the duration of hospitalization, and educate parents and medical staff about complications (mainly infections) during anticancer therapy. It is necessary to continue clinical studies evaluating infection prophylaxis to improve outcomes in childhood ALL patients.
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Affiliation(s)
- Joanna Zawitkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland.
| | - Katarzyna Drabko
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | - Monika Lejman
- Independent Laboratory of Genetic Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Adrian Kowalczyk
- Student Scientific Society of Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Czyżewski
- Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Magdalena Dziedzic
- Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Kamila Jaremek
- Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Patrycja Zalas-Więcek
- Department of Microbiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Anna Szmydki-Baran
- Department of Hematology and Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Hutnik
- Department of Hematology and Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Czogała
- Department of Pediatric Oncology and Hematology, Intitute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Intitute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Iwona Żak
- Department of Microbiology, University Children's Hospital, Jagiellonian University Medical College, Kraków, Poland
| | | | - Bernarda Kazanowska
- Department of Pediatric Bone Marrow Transplantation, Oncology and Haematology, Wroclaw Medical University, Wroclaw, Poland
| | - Grażyna Wróbel
- Department of Pediatric Bone Marrow Transplantation, Oncology and Haematology, Wroclaw Medical University, Wroclaw, Poland
| | - Jowita Frączkiewicz
- Department of Pediatric Bone Marrow Transplantation, Oncology and Haematology, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kałwak
- Department of Pediatric Bone Marrow Transplantation, Oncology and Haematology, Wroclaw Medical University, Wroclaw, Poland
| | - Renata Tomaszewska
- Department of Pediatrics, Hematology and Oncology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Szczepański
- Department of Pediatrics, Hematology and Oncology, Medical University of Silesia, Katowice, Poland
| | - Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Płonowski
- Department of Pediatric Oncology, Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology, Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Aleksandra Królak
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Ociepa
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Urasiński
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Filip Pierlejewski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Wojciech Młynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | | | - Katarzyna Machnik
- Unit of Pediatric Hematology and Oncology, City Hospital, Chorzow, Poland
| | - Sonia Pająk
- Unit of Pediatric Hematology and Oncology, City Hospital, Chorzow, Poland
| | - Wanda Badowska
- Collegium Medicum University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Tomasz Brzeski
- Collegium Medicum University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Katarzyna Mycko
- Collegium Medicum University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Hanna Mańko-Glińska
- Collegium Medicum University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Agnieszka Urbanek-Dądela
- Department of Pediatric Oncology and Hematology, Collegium Medium of Jan Kochanowski University in Kielce, Kielce, Poland
| | - Grażyna Karolczyk
- Department of Pediatric Oncology and Hematology, Collegium Medium of Jan Kochanowski University in Kielce, Kielce, Poland
| | - Agnieszka Mizia-Malarz
- Department of Oncology, Hematology and Chemotherapy, Upper Silesia Children's Care Health, Medical University of Silesia, Katowice, Poland
| | - Weronika Stolpa
- Department of Oncology, Hematology and Chemotherapy, Upper Silesia Children's Care Health, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Skowron-Kandzia
- Department of Oncology, Hematology and Chemotherapy, Upper Silesia Children's Care Health, Medical University of Silesia, Katowice, Poland
| | - Jakub Musiał
- Clinic of Pediatric Oncology and Hematology, Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
| | - Radosław Chaber
- Clinic of Pediatric Oncology and Hematology, Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
| | - Ninela Irga-Jaworska
- Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Gdańsk, Poland
| | - Ewa Bień
- Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Gdańsk, Poland
| | - Jan Styczyński
- Student Scientific Society of Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
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Zhang Y, Li H, Chen L, Feng F, Liu L, Guo Q. Severe influenza A virus pneumonia complicated with Curvularia lunata infection: Case Report. Front Cell Infect Microbiol 2023; 13:1289235. [PMID: 38162579 PMCID: PMC10757332 DOI: 10.3389/fcimb.2023.1289235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
Human infection with Curvularia lunata (C. lunata) is exceptionally rare. A 23-year-old female patient contracted both bacterial and Curvularia lunata infections during influenza A virus infection. Multiple etiological tests were performed repeatedly during hospitalization due to fluctuations in condition. On the 17th day after hospital admission, mold hyphae were discovered in the pathogen culture of the patient's bronchoalveolar lavage fluid during one of these examinations. The patient was suspected to have a filamentous fungal infection. Consequently, we further obtained sputum samples for fungal culture, which confirmed the diagnosis of Curvularia infection. The patient, in this case, was in a critical condition, experiencing complications of lung abscess, pneumothorax, sepsis, and multiorgan failure. Despite prompt initiation of antifungal therapy including amphotericin B cholesteryl sulfate complex and isavuconazole upon detection of the fungal infection and concurrent administration of active organ function support treatment, the patient's condition rapidly deteriorated due to compromised immune function. Ultimately, on the 27th day of treatment, the patient succumbed to septic shock and multiple organ dysfunction syndrome. This is the first case of Curvularia lunata infection in our hospital. In this paper, we aim to raise awareness of Curvularia lunata infection and to emphasize that the possibility of this fungal infection should be considered in patients with severe pneumonia caused by influenza A virus and that empirical antifungal therapy should be given promptly when the patient has invasive lung damage.
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Affiliation(s)
- Yanqing Zhang
- Key Laboratory of Gastrointestinal Diseases of Gansu Province, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Haixia Li
- Emergency Intensive Care Unit, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Ling Chen
- Emergency Intensive Care Unit, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Fei Feng
- Emergency Intensive Care Unit, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Liping Liu
- Emergency Intensive Care Unit, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Qinghong Guo
- Key Laboratory of Gastrointestinal Diseases of Gansu Province, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
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Saillard C, Bisbal M, Avenin M, Lehmann P, Sannini A, Chow-Chine L, Servan L, Gonzalez F, d'Incan E, Vey N, Mokart D. Disseminated Scedosporium Invasive Fungal Infection in Critically ill Newly Diagnosed Acute Myeloid Leukemia Patient Complicated with Cerebritis. Mycopathologia 2023; 188:1099-1101. [PMID: 37815689 DOI: 10.1007/s11046-023-00800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Colombe Saillard
- Hematology Department, Institut Paoli Calmettes, Marseille, France
| | - Magali Bisbal
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
| | - Morgan Avenin
- Pathology Department, Institut Paoli Calmettes, Marseille, France
| | - Pierre Lehmann
- Neuroradiology Department, Hôpital de La Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Antoine Sannini
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
| | - Laurent Chow-Chine
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
| | - Luca Servan
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
| | - Frederic Gonzalez
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France
| | - Evelyne d'Incan
- Hematology Department, Institut Paoli Calmettes, Marseille, France
| | - Norbert Vey
- Hematology Department, Institut Paoli Calmettes, Marseille, France
| | - Djamel Mokart
- Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, 13009, Marseille Cedex 09, France.
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Dubois A, Simon F, Alanio A, Guillonnet A, Kaci R, Herman P, Lecanu JB, Verillaud B. Allergic fungal rhinosinusitis and eosinophilic mucin chronic rhinosinusitis: Differential diagnostic criteria. A two-center comparative study following STROBE methodology. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:267-270. [PMID: 37833161 DOI: 10.1016/j.anorl.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
OBJECTIVES Allergic fungal rhinosinusitis (AFRS) and eosinophilic mucin chronic rhinosinusitis (EMRS) are two forms of chronic sinusitis distinguished by the presence (AFRS) or absence (EMRS) of fungal elements in sinus mucin. Detection of the fungal elements, however, is complex and it is difficult to say whether EMRS is in fact an entity distinct from AFRS. The aim of the present study, based on a retrospective series of AFRS and EMRS, was to identify the specific clinical and radiological elements distinguishing between the two. MATERIALS AND METHODS A 2-center retrospective observational study following STROBE guidelines included patients managed for AFRS or EMRS between 2009 and 2022. Clinical, mycological, pathologic and radiological data were collected. Type of treatment and disease progression were also analyzed. Intergroup comparison used Student's test for mean values of quantitative variables, with calculation of P-values, and Pearson's Chi2 test or Fisher's exact test for categoric variables, with calculation of relative risk and 95% confidence intervals. RESULTS The AFRS group comprised 41 patients and the EMRS group 34. Demographic data were comparable between groups. EMRS showed a higher rate of asthma (79.4 vs. 31.4%; P<0.001), more severe nasal symptomatology (rhinorrhea, P=0.01; nasal obstruction, P=0.001), and more frequent bilateral involvement (85.3 vs. 58.5%; P=0.021). AFRS showed more frequent complications (19 vs. 0%; P=0.006). Radiologically, mucin accumulation was greater in AFRS, filling the sinus in 84.2% of cases, versus 26.3% (P<0.001), with more frequent sinus wall erosion (19 vs. 5.8%; P=0.073). The recurrence rate was higher in EMRS: 38.2 vs.21.9% (P=0.087). CONCLUSION The present retrospective study found a difference in clinical and radiological presentation between AFRS and EMRS, with EMRS more resembling the presentation of severe nasal polyposis.
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Affiliation(s)
- A Dubois
- Service d'ORL et chirurgie cervico-faciale, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris, France; Service d'ORL et chirurgie cervico-faciale, institut Arthur-Vernes, Paris, France
| | - F Simon
- Service d'ORL pédiatrique et chirurgie cervico-faciale, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, Paris, France; Université Paris Cité, Paris, France
| | - A Alanio
- Université Paris Cité, Paris, France; Laboratoire de parasitologie-mycologie, groupe hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance publique-Hôpitaux de Paris, Paris, France; Molecular Mycology Unit, CNRS UMR2000, Institut Pasteur, Paris, France; National Reference Center for Invasive Mycoses and Antifungals, Institut Pasteur, Paris, France; IHU Imagine, Paris, France
| | - A Guillonnet
- Service de neuroradiologie diagnostique et interventionnelle, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris, France
| | - R Kaci
- Service d'anatomopathologie, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris, France
| | - P Herman
- Service d'ORL et chirurgie cervico-faciale, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris, France; Université Paris Cité, Paris, France; Inserm U1131, Paris, France
| | - J-B Lecanu
- Service d'ORL et chirurgie cervico-faciale, institut Arthur-Vernes, Paris, France
| | - B Verillaud
- Service d'ORL et chirurgie cervico-faciale, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris, France; Université Paris Cité, Paris, France; Inserm U1131, Paris, France.
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Shi M, Qin Y, Chen S, Wei W, Meng S, Chen X, Li J, Li Y, Chen R, Su J, Yuan Z, Wang G, Qin Y, Ye L, Liang H, Xie Z, Jiang J. Characteristics and risk factors for readmission in HIV-infected patients with Talaromyces marneffei infection. PLoS Negl Trop Dis 2023; 17:e0011622. [PMID: 37816066 PMCID: PMC10564132 DOI: 10.1371/journal.pntd.0011622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/28/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES Talaromyces marneffei (T. marneffei) is an opportunistic fungal infection (talaromycosis), which is common in subtropical regions and is a leading cause of death in HIV-1-infected patients. This study aimed to determine the characteristics and risk factors associated with hospital readmissions in HIV patients with T. marneffei infection in order to reduce readmissions. METHODS We conducted a retrospective study of admitted HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China, from 2012 to 2019. Kaplan-Meier analyses and Principal component analysis (PCA) were used to evaluate the effects of T. marneffei infection on patient readmissions. Additionally, univariate and multifactorial analyses, as well as Propensity score matching (PSM) were used to analyze the factors associated with patient readmissions. RESULTS HIV/AIDS patients with T. marneffei-infected had shorter intervals between admissions and longer lengths of stay than non-T. marneffei-infected patients, despite lower readmission rates. Compared with non-T. marneffei-infected patients, the mortality rate for talaromycosis patients was higher at the first admission. Among HIV/AIDS patients with opportunistic infections, the mortality rate was highest for T. marneffei at 16.2%, followed by cryptococcus at 12.5%. However, the readmission rate was highest for cryptococcus infection (37.5%) and lowest for T. marneffei (10.8%). PSM and Logistic regression analysis identified leukopenia and elevated low-density lipoprotein (LDL) as key factors in T.marneffei-infected patients hospital readmissions. CONCLUSIONS The first admission represents a critical window to intervene in the prognosis of patients with T. marneffei infection. Leukopenia and elevated LDL may be potential risk factors impacting readmissions. Our findings provide scientific evidence to improve the long-term outcomes of HIV patients with T. marneffei infection.
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Affiliation(s)
- Minjuan Shi
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yaqin Qin
- The fourth People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Shanshan Chen
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Wudi Wei
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Sirun Meng
- The fourth People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Xiaoyu Chen
- The fourth People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Jinmiao Li
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yueqi Li
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Rongfeng Chen
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Jinming Su
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Zongxiang Yuan
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Gang Wang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yingmei Qin
- The fourth People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Liang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhiman Xie
- The fourth People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Crucial Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
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McCarty Walsh E, Hanson MB. Fungal Infections of the External Auditory Canal and Emerging Pathogens. Otolaryngol Clin North Am 2023; 56:909-918. [PMID: 37553272 DOI: 10.1016/j.otc.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Fungal infections of the external auditory canal can range from common (otomycosis) to life threatening (necrotizing otitis externa). Proper identification of fungal pathogens is necessary to guide appropriate therapy, and a high index of suspicion for fungal causes of ear canal disease is critical. Fungal pathogens may be an especially important cause of ear canal disease in certain populations, including patients with diabetes, patients recently treated with antibiotics, and immunosuppressed patients. Opportunistic fungal infections of the ear canal are an emerging concern.
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Affiliation(s)
- Erika McCarty Walsh
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Matthew B Hanson
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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23
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Amirizad K, Ghazanfari M, Javidnia J, Abastabar M, Haghi Ashtiani MT, Sotoudeh Anvari M, Fathi M, Espahbodi A, Badali H, Hedayati MT, Haghani I, Seyedmousavi S. Central nervous system Aspergillus quadrilineatus infection in a COVID-19 patient, a case report and literature review. J Clin Lab Anal 2023; 37:e24971. [PMID: 37798858 PMCID: PMC10681513 DOI: 10.1002/jcla.24971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/28/2023] [Accepted: 09/24/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Viral pneumonia such as COVID-19-associated aspergillosis could increase susceptibility to fungal super-infections in critically ill patients. METHODS Here we report a pediatric case of Aspergillus quadrilineatus cerebral infection in a recently diagnosed COVID-19-positive patient underlying acute lymphocytic leukemia. Morphological, molecular methods, and sequencing were used to identify this emerging species. RESULTS Histopathological examination showed a granulomatous necrotic area containing dichotomously branching septate hyphae indicating a presumptive Aspergillus structure. The species-level identity of isolate growing on brain biopsy culture was confirmed by PCR sequencing of the β-tubulin gene as A. quadrilineatus. Using the CLSI M38-A3 broth microdilution methodology, the in vitro antifungal susceptibility testing demonstrated 0.032 μg/mL MIC for posaconazole, caspofungin, and anidulafungin and 8 μg/mL against amphotericin B. A combination of intravenous liposomal amphotericin B and caspofungin therapy for 8 days did not improve the patient's condition. The patient gradually continued to deteriorate and expired. CONCLUSIONS This is the first COVID-19-associated cerebral aspergillosis due to A. quadrilineatus in a pediatric patient with acute lymphocytic leukemia. However, comprehensive screening studies are highly recommended to evaluate its frequency and antifungal susceptibility profiles. Before being recommended as first-line therapy in high-risk patients, more antifungal susceptibility data are needed.
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Affiliation(s)
- Kazem Amirizad
- Department of Mycology, Faculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Mona Ghazanfari
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Javad Javidnia
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Mahdi Abastabar
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | | | - Maryam Sotoudeh Anvari
- Department of Surgical and Clinical Pathology, Cardiac Research, Tehran Heart CenterTehran University of Medical Sciences; TehranIran
| | - Maryam Fathi
- Department of Parasitology, Faculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Amirreza Espahbodi
- Student Research Committee, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
| | - Hamid Badali
- Department of Molecular Microbiology & Immunology, South Texas Center for Emerging Infectious DiseasesThe University of Texas at San AntonioSan AntonioTexasUSA
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Iman Haghani
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariMazandaranIran
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Seyedmojtaba Seyedmousavi
- Department of Laboratory Medicine, Microbiology Service, Clinical CenterNational Institutes of HealthBethesdaMarylandUSA
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Shope C, Cotton CH, Wine Lee L. Congenital erosive and vesicular dermatosis healing with reticulated and supple scarring: Two cases secondary to fungal infection. Pediatr Dermatol 2023; 40:900-903. [PMID: 36813738 DOI: 10.1111/pde.15286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
Congenital erosive and vesicular dermatosis (CEVD) is a rare skin condition that most commonly presents as erosive and vesicular lesions on the trunk and extremities in premature infants and heals with characteristic reticulated and supple scarring (RSS). The exact pathogenesis of CEVD is unknown and is typically a diagnosis of exclusion. We present the cases of two extremely premature neonates with Candida septicemia who were found to have diffuse, erythematous skin eruptions shortly after birth that ultimately healed with RSS. Through these cases, we highlight the importance of including fungal infection in the work-up of CEVD healing with RSS.
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Affiliation(s)
- Chelsea Shope
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Colleen H Cotton
- Division of Dermatology, Children's National Hospital, Washington, DC, USA
- Department of Dermatology, George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
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25
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Sk A, Vijayakumar C, Nelson T, Balasubramanian G, Kumar NR, Singh R. A study on prevalence, profile, and risk factors of developing fungal infection in patients with diabetic foot ulcer. Wound Manag Prev 2023; 69:11-17. [PMID: 38055621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND Many chronic nonhealing diabetic foot ulcers (DFUs) with increased rates of amputation are frequently associated with fungal infections. PURPOSE To evaluate the prevalence, profile, and risk factors of developing a fungal infection in patients with DFU. METHODS This prospective observational study was carried out from October 2018 to July 2020. All adult patients with DFUs admitted to the surgery ward were recruited. Patients on antifungal therapy or who received such therapy within 6 weeks prior to admission were excluded. Three deep tissue samples were sent for bacterial culture, fungal culture, and histopathological examination of fungal elements. RESULTS A total of 251 patients were enrolled in the study. Of the 23.3% of patients with positive fungal growth (n = 47/202), 2% (n = 4/202) had pure fungal growth and 21.3% (n = 43/202) had mixed growth with bacteria in their ulcers (ie, non-contaminated samples). A significant association was found between wound grade (P = .027), ulcer duration (P = .028), and positive fungal growth in DFUs. CONCLUSIONS In this study, the prevalence of fungal infection in DFUs was 23.3%; Candida tropicalis (27.08%) was the most common isolate, followed by C. albicans (20.83%). The rate of fungal infections was high in patients with mild diabetic foot infection or DFU of 7 to 14 days' duration.
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Affiliation(s)
- Azharuddin Sk
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Chellappa Vijayakumar
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Thirugnanasambandam Nelson
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Gopal Balasubramanian
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nagarajan Raj Kumar
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rakesh Singh
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Dillon B, Wothe J, Evans D, Damroth K, Bohman J, Saavedra-Romero R, Prekker M, Brunsvold M. Use of Venovenous Extracorporeal Membrane Oxygenation in Patients With Acute Respiratory Distress Syndrome Caused by Fungal Pneumonia. Surg Infect (Larchmt) 2023; 24:632-636. [PMID: 37594771 DOI: 10.1089/sur.2023.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Background: Patients with fungal pneumonias sometimes progress to acute respiratory distress syndrome (ARDS). Mortality has been reported as high as 60% to 90% in this group. Venovenous extracorporeal membrane oxygenation (VV-ECMO) can be used to support such patients, however, outcomes are not well understood. Patients and Methods: This was a retrospective study across the four adult ECMO centers in Minnesota for one decade (2012-2022). The outcomes of interest were duration of ECMO, survival rate, and complications. Data were extracted from the electronic medical record and analyzed using descriptive statistics. Results: Fungal pneumonia was the etiology of ARDS in 22 of 422 (5%) adults supported with VV-ECMO during the 10-year study period. Median patient age was 43 years (interquartile range [IQR], 35-56) and 68% were male. By type of fungal infection, 16 (72%) had blastomycosis, five (22%) had pneumocystis, and one (5%) had cryptococcus. Of the 16 patients with blastomycosis two were immunosuppressed whereas all five of the pneumocystis patients were immunosuppressed. The overall survival rate was 73%; most patients with blastomycosis (67%) and pneumocystis (80%) survived to hospital discharge. The duration of ECMO support was greater for the pneumocystis group (median, 30 days; IQR, 21-43) compared with blastomycosis (median, 10 days; IQR, 8-18). Conclusions: Our findings support the use of VV-ECMO for ARDS caused by fungal pneumonias in select immunocompetent and immunocompromised patients. Although survival was high, patients with pneumocystis required longer ECMO runs.
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Affiliation(s)
- Bridget Dillon
- Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jillian Wothe
- Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Critical Care, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
- Department of Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Danika Evans
- Department of Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Karl Damroth
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - John Bohman
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Matthew Prekker
- Department of Internal Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Melissa Brunsvold
- Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Long F, Li T, Zhang Y, Gao X, Huang X. Disseminated Talaromyces marneffei infection in a child with HIV infection. J Hematop 2023; 16:181-183. [PMID: 38175399 DOI: 10.1007/s12308-023-00551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/08/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Fang Long
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, 610000, Sichuan Province, China
| | - Ting Li
- Department of Laboratory Medicine, Beijing Ludaopei Hospital, Beijing, 100176, China
| | - Yun Zhang
- Department of Clinical Laboratory, The District People's Hospital of Zhangqiu, Jinan, 250200, Shandong Province, China
| | - Xiaopeng Gao
- Department of Clinical Laboratory, Xi'an Children's Hospital, Xi'an, 710002, Shaanxi Province, China
| | - Xingqin Huang
- Department of Hematology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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乔 婕, 芦 丽, 何 玉, 门 春, 楚 新, 武 蓓, 赵 慧, 王 梅. [Fungal peritoneal dialysis catheter-related exit-site infection combined with tunnel infection: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:748-754. [PMID: 37534662 PMCID: PMC10398773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 08/04/2023]
Abstract
Peritoneal dialysis (PD) catheter-related infection (i.e. exit-site infection and tunnel infection) is one of the main causes of PD-related peritonitis. If it cannot be controlled effectively, it could lead to PD technique failure. Therefore, timely and effective diagnosis and treatment and active prevention so as to reduce PD catheter-related infection is an important treatment goal in PD patients. PD catheter exit-site infection (ESI) and tunnel infection can be caused by a variety of microorganisms, mainly bacteria, while fungi are very rare. Few public data can be used to guide treatment of PD catheter-related fungal infection, and there is no related report in China till now. Once fungal peritonitis occurred, the patient can only withdraw from PD treatment. Here, we report a case of fungal PD catheter ESI combined with tunnel infection which was successfully diagnosed and treated in our PD center. A 71-year-old woman came to clinic because of "PD for 5 years, secretions from exit site for 8 days and aggravation for 1 day". The patient suffered from peritonitis, ESI and tunnel infection for many times in the past 5 years, involving a variety of pathogens. Eight days before, she found white viscous discharge from exit site. The subcutaneous cuff completely came out of it and rubbed its skin. The Schaefer exit-site score was 3 points. Due to the suspected ESI 2 months before, the discharge swab for bacterial culture was positive for Pseudomonas aeruginosa, so the exit site swab for bacterial culture was done again, and gentamicin injection was applied topically once a day for empirical treatment. The exit site was evaluated one day before: The subcutaneous tunnel was significantly swollen and slightly tender at 2.5 cm away from the exit site, and with white medium amount of viscous secretions. The exit-site score increased to 4 points. Routine test of dialysis effluent was (-). The bacterial culture of the exit-site discharge was rechecked twice, and Candida parapsilosis was positive for two times, so the diagnosis of fungal PD catheter ESI combined with tunnel infection was clear. Immediately we searched for the causes of ESI and tunnel infection. We found that the patient had a suspicious history of gray toenail on the foot. The toenail smear was positive for fungi and visible hyphae. She washed feet with hands every day, and washed clothes on a low bench every day, which made the exit-site and tunnel squeezed for a long time. Based on the above causes, we gave her comprehensive treatment as follows: For ESI and tunnel fungal infections, fluco-nazole was used systemically according to the drug sensitivity results, and miconazole cream was applied to the exit-site locally. For the subcutaneous cuff that came out completely, daily iodophor disinfection was given locally. At the same time, local antifungal treatment was given to the foot. We followed up closely during treatment, evaluated the exit-site every 2-3 days, and took photos of the exit-site to dynamically observe the effect. After 14 days of treatment, the exit-site score continued to be 0-1, the bacterial culture of the exit-site was negative, the cuff culture was negative, and the tunnel B-ultrasound was normal. The patient had been followed up regularly once a month for 60 months, no ESI and tunnel infection occurred. Fungal PD catheter ESI and tunnel infection are rare complications of PD. When the standard anti-infection treatment is ineffective, the possibility of fungal infection should be considered, so as to avoid prolonged use of antibiotics, aggravating fungal infection, and even progressing to fungal peritonitis, leading to withdrawal from PD. Accurate exit-site evaluation is helpful for timely diagnosis and early treatment of ESI and tunnel infection. The exit-site discharge culture and drug sensitivity test before treatment are helpful to identify the pathogen and adjust subsequent treatment. At the same time, repeated discharge culture is required in order to exclude positive fungal culture results caused by contamination. Once fungal catheter-related infection is diagnosed, we should search for possible causes actively, subsequent targeted and comprehensive treatment plays a decisive role for the prognosis of patients.
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Affiliation(s)
- 婕 乔
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 丽霞 芦
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 玉婷 何
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 春翠 门
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 新新 楚
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 蓓 武
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 慧萍 赵
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
| | - 梅 王
- />北京大学人民医院肾内科,北京 100044Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
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Qiu Y, Liu AL, Huang J, Zeng W, Yang ZM, Fang GN, Li Y, Zhang YZ, Liang JK, Liu J, Liao SH, Cheng XX, Chen YJ, Ye F, Li ZT, Zhang JQ. Comparison of the clinical features of HIV-positive and HIV-negative hosts infected with Talaromyces marneffei: A multicenter, retrospective study. Int J Infect Dis 2023; 132:93-98. [PMID: 37072056 DOI: 10.1016/j.ijid.2023.04.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/07/2023] [Accepted: 04/13/2023] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVES Talaromyces marneffei is an emerging pathogen, and the number of infections in HIV-negative individuals is rapidly increasing. Nevertheless, there is no sufficient comprehensive report on this issue, and awareness needs to be raised among clinicians. METHODS We analyzed the differences in the clinical data of patients who are HIV-negative and HIV-positive with Talaromyces marneffei infection (TMI) from 2018 to 2022. RESULTS A total of 848 patients were included, among whom 104 were HIV-negative. The obvious differences between the HIV-positive and HIV-negative groups were as follows: (i) the patients who are HIV-negative were older and more likely to exhibit cough and rash, (ii) the time in days from symptom onset to diagnosis among patients who are HIV-negative was longer, (iii) the laboratory findings and radiological presentations seemed more severe in patients who are HIV-negative, (iv) differences were observed regarding the underlying conditions and co-infection pathogens, and correlation analysis showed that correlations existed for many indicators, (v) and persistent infection was more likely to occur in patients who are HIV-negative. CONCLUSION TMI in patients who are HIV-negative differs from that in patients who are HIV-positive in many aspects, and more investigations are needed. Clinicians should be more aware of TMI in patients who are HIV-negative.
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Affiliation(s)
- Ye Qiu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; The Eighth Affiliated Hospital, Sun Yat-Sen University, Department of Respiratory and Critical Medicine, Shenzhen, Guangdong, China; Guangxi Medical University Cancer Hospital, Department of Internal Medicine, Nanning, Guangxi, China
| | - An-Lin Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Jie Huang
- Guangxi Nanning Fourth People's Hospital, Department of Tuberculosis Ward, Nanning, Guangxi, China
| | - Wen Zeng
- The First Affiliated Hospital of Guangxi Medical University, Department of Respiratory and Critical Medicine, Nanning, China
| | - Zhen-Ming Yang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Department of Respiratory and Critical Medicine, Shenzhen, Guangdong, China; Guangxi Medical University Cancer Hospital, Department of Internal Medicine, Nanning, Guangxi, China
| | - Gao-Neng Fang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Department of Respiratory and Critical Medicine, Shenzhen, Guangdong, China; The First Affiliated Hospital of Guangxi Medical University, Department of Respiratory and Critical Medicine, Nanning, China
| | - Ya Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Yu-Zhuo Zhang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Department of Respiratory and Critical Medicine, Shenzhen, Guangdong, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Jin-Kai Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Jiong Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Shu-Hong Liao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Xiao-Xue Cheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Medical University, Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Yi-Jun Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Zheng-Tu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jian-Quan Zhang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Department of Respiratory and Critical Medicine, Shenzhen, Guangdong, China.
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Kim MG, Kang MG, Lee MG, Yang SJ, Yeom SW, Lee JH, Choi SM, Yoon JH, Lee EJ, Noh SJ, Kim MS, Kim JS. Periodontitis is associated with the development of fungal sinusitis: A nationwide 12-year follow-up study. J Clin Periodontol 2023; 50:440-451. [PMID: 36415182 DOI: 10.1111/jcpe.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
AIM The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. We investigate the effect of periodontitis on the incidence of fungal sinusitis over a 12-year follow-up period using nationwide population-based data. MATERIALS AND METHODS The periodontitis group was randomly selected from the National Health Insurance Service database. The non-periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls (SFBs) and invasive fungal sinusitis (IFS). RESULTS The periodontitis and non-periodontitis groups included 12,442 and 12,442 individuals, respectively. The overall adjusted hazard ratio (aHR) for SFBs in the periodontitis group was 1.46 (p = .002). In subgroup analysis, the aHR for SFBs was 1.59 (p = 0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p = .022) for those with underlying atopic dermatitis, 1.48 (p = .019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p = .030) for those with diabetes mellitus (DM), but these values are applicable only when considering the relationship between periodontitis and SFB. The aHR for IFS in the periodontitis group was higher than in the non-periodontitis group (2.80; p = .004). CONCLUSIONS The risk of SFBs and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is applicable only when considering the association between periodontitis and fungal sinusitis.
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Affiliation(s)
- Min Gul Kim
- Department of Pharmacology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Min Gu Kang
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gyu Lee
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Seong J Yang
- Department of Statistics (Institute of Applied Statistics), Jeonbuk National University, Jeonju, Republic of Korea
| | - Sang Woo Yeom
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jong Hwan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | | | - Ji Hyun Yoon
- Sae Bom Dental Clinic, Jeonju, Republic of Korea
| | - Eun Jung Lee
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang Jae Noh
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Forensic Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min-Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Bundang, Republic of Korea
| | - Jong Seung Kim
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
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Zhao Y, Ye L, Zhao F, Zhang L, Lu Z, Chu T, Wang S, Liu Z, Sun Y, Chen M, Liao G, Ding C, Xu Y, Liao W, Wang L. Cryptococcus neoformans, a global threat to human health. Infect Dis Poverty 2023; 12:20. [PMID: 36932414 PMCID: PMC10020775 DOI: 10.1186/s40249-023-01073-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL, Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections. METHODS We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keyword Cryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance of C. neoformans to approved antifungal drugs. RESULTS There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden. CONCLUSION The rising threat of C. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden.
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Affiliation(s)
- Youbao Zhao
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China.
| | - Leixin Ye
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Fujie Zhao
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Lanyue Zhang
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Zhenguo Lu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Tianxin Chu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Siyu Wang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Zhanxiang Liu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Yukai Sun
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046, Henan, China
| | - Min Chen
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, 200003, China
| | - Guojian Liao
- The Medical Research Institute, College of Pharmaceutical Sciences, Southwest University, Chongqing, 400715, China
| | - Chen Ding
- College of Life and Health Sciences, Northeastern University, Shenyang, 110819, Liaoning, China
| | - Yingchun Xu
- Department of Laboratory Medicine, and Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Wanqing Liao
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, 200003, China
| | - Linqi Wang
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100039, China.
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Flechas SV, Urbina J, Crawford AJ, Gutiérrez K, Corrales K, Castellanos LA, González MA, Cuervo AM, Catenazzi A. First evidence of ranavirus in native and invasive amphibians in Colombia. Dis Aquat Organ 2023; 153:51-58. [PMID: 36794841 DOI: 10.3354/dao03717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Ranaviruses can cause mass mortality events in amphibians, thereby becoming a threat to populations that are already facing dramatic declines. Ranaviruses affect all life stages and persist in multiple amphibian hosts. The detrimental effects of ranavirus infections to amphibian populations have already been observed in the UK and in North America. In Central and South America, the virus has been reported in several countries, but the presence of the genus Ranavirus (Rv) in Colombia is unknown. To help fill this knowledge gap, we surveyed for Rv in 60 species of frogs (including one invasive species) in Colombia. We also tested for co-infection with Batrachochytrium dendrobatidis (Bd) in a subset of individuals. For Rv, we sampled 274 vouchered liver tissue samples collected between 2014 and 2019 from 41 localities covering lowlands to mountaintop páramo habitat across the country. Using quantitative polymerase chain reaction (qPCR) and end-point PCR, we detected Rv in 14 individuals from 8 localities, representing 6 species, including 5 native frogs of the genera Osornophryne, Pristimantis and Leptodactylus, and the invasive American bullfrog Rana catesbeiana. Bd was detected in 7 of 140 individuals, with 1 co-infection of Rv and Bd in an R. catesbeiana specimen collected in 2018. This constitutes the first report of ranavirus in Colombia and should set off alarms about this new emerging threat to amphibian populations in the country. Our findings provide some preliminary clues about how and when Rv may have spread and contribute to understanding how the pathogen is distributed globally.
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Affiliation(s)
- Sandra V Flechas
- Instituto de Investigación de Recursos Biológicos Alexander von Humboldt, Bogotá, 110321, Colombia
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Fernández Vecilla D, Urrutikoetxea Gutiérrez MJ, Ugalde Zárraga E, Urizar Gorosarri M, Rodríguez Iriarte ML, Díaz de Tuesta Del Arco JL. Mycotic pseudoaneurysm and aortitis caused by Candida sake. Rev Esp Cardiol (Engl Ed) 2022; 75:1077-1079. [PMID: 35718724 DOI: 10.1016/j.rec.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Domingo Fernández Vecilla
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain.
| | - Mikel Joseba Urrutikoetxea Gutiérrez
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
| | - Estíbaliz Ugalde Zárraga
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
| | - Maite Urizar Gorosarri
- Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain; Servicio de Radiodiagnóstico, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - María Luisa Rodríguez Iriarte
- Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain; Servicio de Medicina Nuclear, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - José Luis Díaz de Tuesta Del Arco
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
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Itoh K, Shigemi H, Kinoshita K, Tsukasaki H, Imamura S, Morinaga K, Yoshio N, Nakayama T, Inoue H, Ueda T, Yamauchi T, Iwasaki H. Efficacy and Safety of Caspofungin Treatment in Febrile Neutropenic Patients with Hematological Disorders: A Multicenter Consecutive Case Series. Intern Med 2022; 61:3037-3044. [PMID: 35314551 PMCID: PMC9646351 DOI: 10.2169/internalmedicine.9070-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Invasive fungal infections have been attracting attention as significant fatal complications in patients with febrile neutropenia (FN) who undergo intensive chemotherapy or hematopoietic stem cell transplantation to treat hematological malignancies. Although clinical trials are already underway in other countries, evidence supporting the use of caspofungin (CAS) in FN patients in Japan is still insufficient. Methods A retrospective study of patients treated with CAS for FN associated with hematological diseases between April 2015 and March 2018 was conducted to determine the treatment efficacy and safety. The study was conducted as a multicenter collaboration, and the data of 52 patients who met all of the inclusion criteria were analyzed. A five-composite-endpoint method was used, and the treatment was judged to be effective when all five endpoints (defervescence during neutropenia; no breakthrough fungal infections; resolution of baseline fungal infections; a survival for seven days or more after the completion of therapy; and no discontinuation of therapy due to side effects or invalidity) were met. Results The efficacy rate was 53.8% (28/52), which is close to the average reported efficacy rate. Adverse events included liver dysfunction and electrolyte abnormalities, but no renal dysfunction or serious events were seen. Conclusion These results suggest that the use of CAS in FN patients with hematological diseases is effective and well-tolerated, and we believe that the use of CAS could become a significant treatment in Japan.
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Affiliation(s)
- Kazuhiro Itoh
- Department of Internal Medicine, National Hospital Organization Awara Hospital, Japan
| | - Hiroko Shigemi
- Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, Japan
| | | | | | - Shin Imamura
- Department of Hematology, Red Cross Fukui Hospital, Japan
| | - Koji Morinaga
- Department of Hematology and Oncology, Fukui Prefectural Hospital, Japan
| | - Nobuyuki Yoshio
- Department of Hematology, National Hospital Organization Kanazawa Medical Center, Japan
| | - Takashi Nakayama
- Department of Oncology and Hematology, Fukui-ken Saiseikai Hospital, Japan
| | - Hitoshi Inoue
- Department of Internal Medicine, National Hospital Organization Tsuruga Medical Center, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hiromichi Iwasaki
- Department of Infection Control and Prevention, University of Fukui Hospital, Japan
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Yan L, Li Y, Wu C, Shi Y, Kong C. Clinical Value of sTREM-1, PCT, and 1,3- β-D Glucan in Diagnosis of Immune-Associated Pulmonary Interstitial Disease with Fungal Infection. Biomed Res Int 2022; 2022:6095441. [PMID: 35937405 PMCID: PMC9348935 DOI: 10.1155/2022/6095441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/08/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
Background Fungal infection in the lungs can cause fungal infectious diseases. This disease develops rapidly and involves a wide range. Pathogenic fungi are also more serious types of pathogenic bacteria. If it invades deep organs and tissues, it will endanger life, so it needs timely diagnosis. Aim To investigate the diagnostic value of serum soluble myeloid cell triggering receptor-1 (sTREM-1), procalcitonin (PCT), and 1,3-β-D glucan detection in immune related lung disease complicated with fungal infection. Methods In this study, a case-control study was conducted. 50 patients with immune-related pulmonary disease complicated with fungal infection (infection group) diagnosed by sputum culture in our hospital from January 2017 to December 2021 were selected as the control group, and 50 patients with immune-related pulmonary disease without fungal infection were selected as the control group. The levels of sTREM-1, PCT, and 1,3-β-D glucan were compared in the two groups. The receiver operating characteristic (ROC) was used to analyze the value of the three indicators in the diagnosis of immune-related pulmonary disease complicated with fungal infection, and the changes of the three indicators before and after treatment were compared. Results The levels of sTREM-1, PCT, and 1,3-β-D glucan in the infection group were higher than those in the control group (P < 0.05). The levels of sTREM-1, PCT, and 1,3-β-D glucan in the infection group after treatment were significantly lower than those before treatment (P < 0.05). The AUC value of sTREM-1 in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.980, the sensitivity was 97.11%, and the specificity was 83.06%. The AUC value of PCT in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.860, the sensitivity was 80.00%, and the specificity was 72.41%. The AUC value of 1,3-β-D glucan in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.993, the sensitivity was 98.74%, and the specificity was 99.16%. The levels of sTREM-1, PCT, and 1,3-β-D glucan in the infection group after treatment were considerably lower than those before treatment, and the difference was statistically significant (P < 0.05). Conclusion The detection of sTREM-1, PCT, and 1,3-β-D glucan levels has high clinical value for the diagnosis of immune-related pulmonary diseases complicated with fungal infection.
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Affiliation(s)
- Lei Yan
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Yuan Li
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Chunye Wu
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Yuquan Shi
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Chunyu Kong
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China
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Yang JL, Qiu YL, Wang WL, Zhu Y, Cai XY, Liu JF, Zhang HT, Chen YF. [Clinicopathological Characteristics of Lymphadenitis Caused by Talaromyces marneffei Diagnosed by Core Needle Biopsy]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:440-445. [PMID: 35791942 DOI: 10.3881/j.issn.1000-503x.14639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective To analyze the clinicopathological characteristics of lymphadenitis caused by Talaromyces marneffei (TM).Method s The clinical data,pathological features,pathogen examination,and treatment of 15 cases of TM-caused lymphadenitis were analyzed retrospectively.Results The 15 cases included 14 males and 1 females,who were aged 26-67 years,with an average age of (49.1±11.87) years.The 15 cases,including 13 cases of acquired immunodeficiency syndrome and 2 cases of diabetes mellitus,were accompanied by superficial lymph node enlargement in the neck and supraclavicular,axillary,and inguinal regions.The structure of cord-like lymph node tissue punctured by thick needle was completely or partially replaced by inflammatory lesions. Under microscope,8 cases showed mainly diffuse infiltration of phagocytes with pathogens;5 cases presented mainly extensive coagulation necrosis with a small amount of pathogens and nuclear debris;2 cases were characterized by small nodular hyperplasia of fibroblasts,formation of granulomatous structure,and scattered distribution of a few multinucleated giant cells.The pathogens were relatively consistent in size and shape,which were round,oval or sausage-shaped and clustered like mulberry.Diastase periodic acid-Schiff staining and hexamine silver staining highlighted the bacterial structure with transverse septum.TM growth was detected in the blood,alveolar lavage fluid,sputum or lymph node extract fungal culture of the 15 patients.Owing to the adequate antifungal treatment in time,these 15 patients were discharged after their conditions were improved.Conclusion Lymphadenitis is one of the major manifestations of the systemic invasion of TM at the late stage,which is tended to be misdiagnosed.Through core needle biopsy of lymph node,it can be diagnosed as soon as possible to avoid delayed treatment and improve the cure rate.
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Affiliation(s)
- Jin-Ling Yang
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Yi-Li Qiu
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Wan-Ling Wang
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Yan Zhu
- Department of Laboratory,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Xue-Yu Cai
- Medical Record Department,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Jiang-Fu Liu
- Department of Infectious Diseases,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
| | - Hong-Tu Zhang
- Department of Pathology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,CAMS and PUMC,Beijing 100021,China
| | - Yi-Feng Chen
- Department of Pathology,,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China
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Krzych ŁJ, Putowski Z, Gruca K, Pluta MP. Mortality in critically ill COVID-19 patients with fungal infections: a comprehensive systematic review and meta-analysis. Pol Arch Intern Med 2022; 132. [PMID: 35238324 DOI: 10.20452/pamw.16221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Patients with COVID-19 may develop concomitant viral, bacterial or fungal infections. Such patients have a higher risk of death, especially in critical illness. Although much attention has been recently given to fungal infections that may have devastating consequences, data on this issue is scarce. METHODS We systematically searched for studies that focused on critically ill adults who were diagnosed with COVID-19 and fungal co-infection. Mortality was the outcome of interest. The search was conducted within MEDLINE, Web of Science, clinicaltrials.gov, Embase and Cochrane Library on 8 January 2022. RESULTS We reviewed 38 papers covering 17,695 patients, 1182 (6.7%) of whom had an acquired fungal infection. The overall mortality in papers retrieved for a systematic review (n=38) varied from 29 to 100% (median=56%; IQR 40-77%). In a meta-analysis (19 studies), patients with fungal infection were more likely to die than the controls (OR=2.987; 95% CI 2.369 - 3.767; p<0.001; I2 = 26.63%). Subgroup analyses showed that COVID-19-associated pulmonary aspergillosis (CAPA) increased mortality by 3 times (OR=3.279; 95%CI 2.692 - 3.994; p<0.001; I2 = 0%) and that COVID-19-associated candidiasis (CAC) increased mortality by 2 times (OR=2.254; 95%CI 1.322- 3.843; I2=26.14%). CONCLUSIONS In critically ill patients with COVID-19, CAPA is rather common and significantly increases mortality. The evidence regarding other fungal infections is weaker, however, CAC occurs less frequently but impacts mortality. Therefore, clinical awareness and screening are needed, followed by personalized antifungal therapy stewardship, which is strongly recommended in order to improve patients' prognosis.
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Affiliation(s)
- Łukasz J Krzych
- Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Putowski
- Student Scientific Society, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Karol Gruca
- Student Scientific Society, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland.
| | - Michał P Pluta
- Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
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Myroshnychenko MS, Kalashnyk-Vakulenko YM, Kapustnyk NV, Babycheva OO, Yurevych NO, Bondarenko OV, Kalashnyk MV, Torianyk II, Shapkin AS, Lupyr AV. RHINOSINUSITIS IN PATIENTS IN POST-COVID-19 PERIOD: ETIOLOGY, CLINICAL AND MORPHOLOGICAL CHARACTERISTICS. Wiad Lek 2022; 75:1945-1953. [PMID: 36129076 DOI: 10.36740/wlek202208201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. PATIENTS AND METHODS Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. RESULTS Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). CONCLUSION Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.
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Affiliation(s)
| | | | - Nataliia V Kapustnyk
- MUNICIPAL NONPROFIT ORGANIZATION OF THE KHARKIV DISTRICT COUNCIL «REGIONAL CLINICAL PERINATAL CENTRE», KHARKIV, UKRAINE
| | | | | | | | - Mykhailo V Kalashnyk
- MUNICIPAL NONPROFIT ORGANIZATION OF THE KHARKIV DISTRICT COUNCIL «REGIONAL CLINICAL HOSPITAL», KHARKIV, UKRAINE
| | - Inna I Torianyk
- STATE INSTITUTION «INSTITUTE OF MICROBIOLOGY AND IMMUNOLOGY NAMED BY I.I. МЕCHNIKOV NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE», KHARKIV, UKRAINE
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Liu HH, Yaron D, Piraino AS, Kapelusznik L. Bacterial and fungal growth in sputum cultures from 165 COVID-19 pneumonia patients requiring intubation: evidence for antimicrobial resistance development and analysis of risk factors. Ann Clin Microbiol Antimicrob 2021; 20:69. [PMID: 34563202 PMCID: PMC8465781 DOI: 10.1186/s12941-021-00472-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 09/03/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Coronavirus SARS-CoV-2 causes COVID-19 illness which can progress to severe pneumonia. Empiric antibacterials are often employed though frequency of bacterial coinfection superinfection is debated and concerns raised about selection of bacterial antimicrobial resistance. We evaluated sputum bacterial and fungal growth from 165 intubated COVID-19 pneumonia patients. Objectives were to determine frequency of culture positivity, risk factors for and outcomes of positive cultures, and timing of antimicrobial resistance development. METHODS Retrospective reviews were conducted of COVID-19 pneumonia patients requiring intubation admitted to a 1058-bed four community hospital system on the east coast United States, March 1 to May 1, 2020. Length of stay (LOS) was expressed as mean (standard deviation); 95% confidence interval (95% CI) was computed for overall mortality rate using the exact binomial method, and overall mortality was compared across each level of a potential risk factor using a Chi-Square Test of Independence. All tests were two-sided, and significance level was set to 0.05. RESULTS Average patient age was 68.7 years and LOS 19.9 days. Eighty-three patients (50.3% of total) originated from home, 10 from group homes (6.1% of total), and 72 from nursing facilities (43.6% of total). Mortality was 62.4%, highest for nursing home residents (80.6%). Findings from 253 sputum cultures overall did not suggest acute bacterial or fungal infection in 73 (45%) of 165 individuals sampled within 24 h of intubation. Cultures ≥ 1 week following intubation did grow potential pathogens in 72 (64.9%) of 111 cases with 70.8% consistent with late pneumonia and 29.2% suggesting colonization. Twelve (10.8% of total) of these late post-intubation cultures revealed worsened antimicrobial resistance predominantly in Pseudomonas, Enterobacter, or Staphylococcus aureus. CONCLUSIONS In severe COVID-19 pneumonia, a radiographic ground glass interstitial pattern and lack of purulent sputum prior to/around the time of intubation correlated with no culture growth or recovery of normal oral flora ± yeast. Discontinuation of empiric antibacterials should be considered in these patients aided by other clinical findings, history of prior antimicrobials, laboratory testing, and overall clinical course. Continuing longterm hospitalisation and antibiotics are associated with sputum cultures reflective of hospital-acquired microbes and increasing antimicrobial resistance. TRIAL REGISTRATION Not applicable as this was a retrospective chart review study without interventional arm.
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Affiliation(s)
- Hans H Liu
- Division of Infectious Diseases, Department of Medicine, Bryn Mawr Hospital, Main Line Health System, Bryn Mawr, PA, USA.
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
- , 219 Garnet Lane, Bala Cynwyd, PA, 19004, USA.
| | - David Yaron
- Department of Family Medicine, Bryn Mawr Hospital, Main Line Health System, Bryn Mawr, PA, USA
| | - Amanda Stahl Piraino
- Department of Family Medicine, Bryn Mawr Hospital, Main Line Health System, Bryn Mawr, PA, USA
| | - Luciano Kapelusznik
- Division of Infectious Diseases, Department of Medicine, Bryn Mawr Hospital, Main Line Health System, Bryn Mawr, PA, USA
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Abstract
This evidence-based review highlights cutaneous infections of bacterial, viral, and fungal origin that are frequently encountered by clinicians in all fields of practice. With a focus on treatment options and management, the scope of this article is to serve as a reference for physicians, regardless of field of specialty, as they encounter these pathogens in clinical practice.
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Affiliation(s)
- Ana Preda-Naumescu
- School of Medicine, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Boni Elewski
- Department of Dermatology, University of Alabama at Birmingham, 510 20th Street South, FOT Suite 858, Birmingham, AL 35233, USA
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, 510 20th Street South, FOT Suite 858, Birmingham, AL 35233, USA.
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Abstract
Patients with severe coronavirus disease (COVID-19) may have COVID-19–associated invasive mold infection (CAIMI) develop. We report 16 cases of CAIMI among 146 nonimmunocompromised patients with severe COVID-19 at an academic hospital in Santiago, Chile. These rates correspond to a CAIMI incidence of 11%; the mortality rate for these patients was 31.2%.
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Jawanda MK, Narula R, Gupta S, Sharma V, Gupta P, Kaur M. Dual Fungal Infections (Aspergillosis and Mucormycosis) in a Diabetic Mellitus Patient Leading to Maxillary Sinusitis as a Post-COVID Manifestation: First Case Report. Acta Medica (Hradec Kralove) 2021; 64:227-231. [PMID: 35285446 DOI: 10.14712/18059694.2022.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Coronavirus infectious disease-19 caused by Severe acute respiratory distress syndrome-coronavirus-2 has emerged to be an emergency global health crisis for more than a year. And, as the disease has spread, a number of new clinical features have been observed in these patients. Immunosuppression caused by this disease results in an exacerbation of pre-existing infections. While corticosteroids are considered a life-saving therapeutic intervention for this pandemic, they have proved to be a double-edged sword and their indiscriminate use has produced some deleterious results. Recently, in the backdrop of this expression, a notable rise in invasive fungal infections has been identified even in the post-remission phase. Mucormycosis, Aspergillosis, and Candidiasis are the three most common opportunistic fungal infections among those observed. COVID-19 patients with diabetes mellitus are already at a higher risk of developing such secondary infections due to impaired immunity. Here we present a rare case report of a 50-year old male diabetic mellitus patient diagnosed with dual fungal infections (Aspergillosis along with Mucormycosis) leading to maxillary sinusitis as a post-COVID manifestation. To our knowledge, this is the first such case reported till date.
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Affiliation(s)
- Manveen Kaur Jawanda
- Department of Oral Pathology & Microbiology and Forensic Odontology. Laxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
| | - Ravi Narula
- Department of Oral and Maxillofacial surgery, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
| | - Sonia Gupta
- Department of Oral Pathology and Microbiology & Forensic Odontology, Rayat and Bahra dental college and hospital, Mohali, Punjab, India.
| | - Vineet Sharma
- Department of Conservative Dentistry, Laxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
| | - Priya Gupta
- Department of Oral and Maxillofacial Pathology & Microbiology, Laxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
| | - Manpreet Kaur
- Department of Oral and Maxillofacial Pathology & Microbiology, Laxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
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Ezeokoli OT, Pohl CH. Opportunistic pathogenic fungal co-infections are prevalent in critically ill COVID-19 patients: Are they risk factors for disease severity? S Afr Med J 2020; 110:1081-1085. [PMID: 33403982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 06/12/2023] Open
Abstract
Fungal co-infections, especially with Aspergillus and Candida species, are prevalent in hospitalised COVID-19 patients, and could influence patient outcomes and hamper treatment efforts. However, information about and elucidation of the causal relationship between fungal co-infections and COVID-19 disease outcomes or severity in patients are still lacking. Such information, if and when available, will help facilitate appropriate case management.
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Affiliation(s)
- O T Ezeokoli
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, Faculty of Natural and Agricultural Sciences, University of the Free State, Bloemfontein, South Africa.
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Abstract
Signs and symptoms representative of a systemic condition can manifest in the oral cavity and orofacial region. Such conditions may be previously diagnosed, or the orofacial manifestation may be the presenting sign of an acute or chronic systemic condition not previously diagnosed. Pathologic processes in the mouth, jaws, and contiguous structures could have a direct and indirect impact on the patient's overall systemic condition. Moreover, systemic conditions may result in compromised function of the orofacial region or impact patients' oral health profile. This article reviews selected systemic conditions that present or impact on the oral cavity and orofacial region.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Atrium Health's Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA.
| | - Michael T Brennan
- Department of Oral Medicine, Atrium Health's Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Sharon Elad
- Division of Oral Medicine, Hospital Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Avenue, Rochester, NY 14620, USA
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Abstract
OBJECTIVES In previous influenza pandemics, bacterial co-infections have been a major cause of mortality. We aimed to evaluate the burden of co-infections in patients with COVID-19. METHODS We systematically searched Embase, Medline, Cochrane Library, LILACS and CINAHL for eligible studies published from 1 January 2020 to 17 April 2020. We included patients of all ages, in all settings. The main outcome was the proportion of patients with a bacterial, fungal or viral co-infection. . RESULTS Thirty studies including 3834 patients were included. Overall, 7% of hospitalised COVID-19 patients had a bacterial co-infection (95% CI 3-12%, n=2183, I2=92·2%). A higher proportion of ICU patients had bacterial co-infections than patients in mixed ward/ICU settings (14%, 95% CI 5-26, I2=74·7% versus 4%, 95% CI 1-9, I2= 91·7%). The commonest bacteria were Mycoplasma pneumonia, Pseudomonas aeruginosa and Haemophilus influenzae. The pooled proportion with a viral co-infection was 3% (95% CI 1-6, n=1014, I2=62·3%), with Respiratory Syncytial Virus and influenza A the commonest. Three studies reported fungal co-infections. CONCLUSIONS A low proportion of COVID-19 patients have a bacterial co-infection; less than in previous influenza pandemics. These findings do not support the routine use of antibiotics in the management of confirmed COVID-19 infection.
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Affiliation(s)
- Louise Lansbury
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
| | - Benjamin Lim
- Faculty of Biology (School of Medicine), University of Cambridge, Cambridge, UK.
| | - Vadsala Baskaran
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Wei Shen Lim
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Lao M, Li C, Li J, Chen D, Ding M, Gong Y. Opportunistic invasive fungal disease in patients with type 2 diabetes mellitus from Southern China: Clinical features and associated factors. J Diabetes Investig 2020; 11:731-744. [PMID: 31758642 PMCID: PMC7232281 DOI: 10.1111/jdi.13183] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION A retrospective study was carried out to investigate the clinical characteristics and associated factors for invasive fungal disease in patients with type 2 diabetes mellitus. MATERIALS AND METHODS Demographic and clinical data were recorded. Associated factors were analyzed by logistic regression analysis. RESULTS Invasive fungal disease was diagnosed in 120 patients with type 2 diabetes mellitus (prevalence, 0.4%). Yeast infection (56/120, 46.7%), including candidiasis (31/56, 55.4%) and cryptococcosis (25/56, 44.6%), was the most common. The urinary tract was mainly involved in candidiasis (12/31, 38.7%). More than half of the cryptococcosis (16/25, 64.0%) presented as pneumonia. Mold infection accounted for 40.8% of the cases, and predominantly involved the lung (34/49, 69.4%). A total of 15 (12.5%) patients had mixed fungal infection. Candida albicans (24/111, 21.6%), Cryptococcus neoformans (19/111, 17.1%) and Aspergillus fumigatus (14/111, 12.6%) were the leading agents. Co-infection occurred in 58 (48.3%) patients, mainly presenting as pneumonia caused by Gram-negative bacteria. The inpatient mortality rate of invasive fungal disease was 23.3% (28/120). Glycated hemoglobin levels were higher in non-survivors than survivors (8.8 ± 2.5 vs 7.7 ± 2.1%, P = 0.02). Anemia (adjusted odds ratio, 3.50, 95% confidence interval 1.95-6.27, P < 0.001), hypoalbuminemia (adjusted odds ratio, 5.42, 95% confidence interval 3.14-9.36, P < 0.001) and elevated serum creatinine (adjusted odds ratio, 2.08, 95% confidence interval 1.07-4.04, P = 0.03) were associated with invasive fungal disease in type 2 diabetes mellitus patients. CONCLUSIONS Invasive fungal disease is a life-threatening complication in type 2 diabetes mellitus patients. C. a albicans, C. neoformans, and A. fumigatus are the leading agents. Prolonged hyperglycemia results in unfavorable outcomes. Correction of anemia and hypoalbuminemia might improve prognosis.
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Affiliation(s)
- Minxi Lao
- Department of GeriatricsThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Chen Li
- Department of GeriatricsThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Jin Li
- Department of GeriatricsThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of EndocrinologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Dubo Chen
- Department of Laboratory MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Meilin Ding
- Department of GeriatricsThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yingying Gong
- Department of GeriatricsThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of EndocrinologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
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Djenontin E, Lebeaux D, Acikgoz H, Rammaert B, Bougnoux ME, Rouzaud C, Bouyer B, Champigneulle B, Dannaoui E. Post-traumatic Curvularia sp. arthritis in an immunocompetent adult. J Mycol Med 2020; 30:100967. [PMID: 32321676 DOI: 10.1016/j.mycmed.2020.100967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/08/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
A 44-year-old woman, victim of a road accident in Mali was diagnosed with left knee arthritis. Joint effusion aspiration and subcutaneous surgical biopsies were positive for a melanized asexual ascomycete. Using microscopy and molecular biology, the fungus was identified as Curvularia sp. In vitro antifungal susceptibility was determined by the EUCAST broth microdilution reference technique and by E-test. The patient was treated with liposomal amphotericin B before posaconazole relay. Mycological samples obtained 10 days after starting the antifungal therapy by liposomal amphotericin B were negative in culture. Curvularia spp. are environmental fungi which can under certain conditions be pathogenic for humans.
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Affiliation(s)
- E Djenontin
- Unité de parasitologie-mycologie, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - D Lebeaux
- Unité mobile de microbiologie clinique, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - H Acikgoz
- Service d'anesthésie-réanimation, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - B Rammaert
- Inserm U1070, service de maladies infectieuses et tropicales, faculté de médecine et pharmacie, université Poitiers, CHU de Poitiers, Poitiers, France
| | - M-E Bougnoux
- Unité de parasitologie-mycologie, service de microbiologie, hôpital Necker-Enfants-Malades, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - C Rouzaud
- Centre d'infectiologie Necker-Pasteur and Institut Imagine, hôpital Necker-Enfants-Malades, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - B Bouyer
- Service d'orthopédie et de traumatologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - B Champigneulle
- Service d'anesthésie-réanimation, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - E Dannaoui
- Unité de parasitologie-mycologie, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France.
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Zhao J, Shi Y, Yuan D, Shi Q, Wang W, Su X. A case report of fungal infection associated acute fibrinous and organizing pneumonitis. BMC Pulm Med 2020; 20:98. [PMID: 32312262 PMCID: PMC7171735 DOI: 10.1186/s12890-020-1145-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acute fibrinous and organizing pneumonitis (AFOP) is an uncommon variant of acute lung injury, characterized by intra-alveolar fibrin and organizing pneumonia. Proposed etiologies include connective tissue diseases, infections, occupational exposure, drug reactions, and autoimmune disease. Here we present a rare case of fungal infection associated AFOP in patient with diabetes mellitus (DM) and review the relevant literature. CASE PRESENTATION A 67-year-old man complained of cough, fever, dyspnea and hemoptysis. Patient experienced a rapidly progressive course exhibit diffuse predominant consolidation, ground glass opacities, and multifocal parenchymal abnormalities on chest computed tomography (CT). Antibacterial, antifungal, and antiviral treatments were ineffective. A CT-guided percutaneous lung biopsy was performed. Histologically, the predominant findings were as follows: alveolar spaces filled with fibrin and organizing loose connective tissues involving 70% of the observed region, pulmonary interstitial fibrosis, and small abscesses and epithelioid cell granuloma in the focal area. Result of periodic acid-silver methenamine stain was positive. The fungal pathogen from the sputum culture was identified as P. citrinum repeatedly over 3 times. Patient was diagnosed with DM during hospitalization. Corticosteroids combined with an antifungal therapy were effective. Follow-up for 4 months showed complete radiological resolution. CONCLUSIONS As this common "contaminant" can behave as a pathogen in the immunocompromised host, both clinicians and microbiologists should consider the presence of a serious and potentially fatal fungal infection on isolation of P. citrinum. Based on this case, it could be speculated that AFOP may be associated with fungal infection including P. citrinum.
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Affiliation(s)
- Jiangnan Zhao
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Yi Shi
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Dongmei Yuan
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Qunli Shi
- Department of Pathology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Weiping Wang
- Department of Clinical Laboratory, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Xin Su
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China.
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Renaud L, da Silveira WA, Takamura N, Hardiman G, Feghali-Bostwick C. Prominence of IL6, IGF, TLR, and Bioenergetics Pathway Perturbation in Lung Tissues of Scleroderma Patients With Pulmonary Fibrosis. Front Immunol 2020; 11:383. [PMID: 32210969 PMCID: PMC7075854 DOI: 10.3389/fimmu.2020.00383] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/18/2020] [Indexed: 12/21/2022] Open
Abstract
Scleroderma-associated pulmonary fibrosis (SSc-PF) and idiopathic pulmonary fibrosis (IPF) are two of many chronic fibroproliferative diseases that are responsible for nearly 45% of all deaths in developed countries. While sharing several pathobiological characteristics, they also have very distinct features. Currently no effective anti-fibrotic treatments exist that can halt the progression of PF or reverse it. Our goal is to uncover potential gene targets for the development of anti-fibrotic therapies efficacious in both diseases, and those specific to SSc-PF, by identifying universal pathways and molecules driving fibrosis in SSc-PF and IPF tissues as well as those unique to SSc-PF. Using DNA microarray data, a meta-analysis of the differentially expressed (DE) genes in SSc-PF and IPF lung tissues (diseased vs. normal) was performed followed by a full systems level analysis of the common and unique transcriptomic signatures obtained. Protein-protein interaction networks were generated to identify hub proteins and explore the data using the centrality principle. Our results suggest that therapeutic strategies targeting IL6 trans-signaling, IGFBP2, IGFL2, and the coagulation cascade may be efficacious in both SSc-PF and IPF. Further, our data suggest that the expression of matrikine-producing collagens is also perturbed in PF. Lastly, an overall perturbation of bioenergetics, specifically between glycolysis and fatty acid metabolism, was uncovered in SSc-PF. Our findings provide insights into potential targets for the development of anti-fibrotic therapies that could be effective in both IPF and SSc-PF.
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Affiliation(s)
- Ludivine Renaud
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Willian A. da Silveira
- School of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, United Kingdom
| | - Naoko Takamura
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Gary Hardiman
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
- School of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, United Kingdom
| | - Carol Feghali-Bostwick
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
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