A 7-y-old boy with relapsed acute lymphatic leukaemia developed fungaemia due to Acremonium strictum, a fungus belonging to the group of the hyaline hyphomycetes. Initially, the fungus ras misdiagnosed as Candida sp, ...
详细信息
A 7-y-old boy with relapsed acute lymphatic leukaemia developed fungaemia due to Acremonium strictum, a fungus belonging to the group of the hyaline hyphomycetes. Initially, the fungus ras misdiagnosed as Candida sp, due to the presence of abundant adventitious forms. At the time of diagnosis the patient was neutropenic and had a central venous catheter (CVC) in situ, The formation of an occlusive thrombotic mass in the v. subclavia dextra complicated the infection. Treatment consisted of amphotericin B, fluconazole, granulocyte colony-stimulating factor (C-CSF) and removal of the CVC. However the patient responded clinically only. after the intravascular thrombus had been removed surgically. Ampbotericin B, voriconazole and terbinafine showed high activity in vitro against the Acremonium isolate. A literature review revealed 5 other immunocompromised paediatric patients with a systemic or localized infection due to Acremonium spp.
In order to evaluate the epidemiology of candidemia in Brazil, we performed a prospective multicenter study conducted in six general hospitals from Sao Paulo and Rio de Janeiro. We enrolled a total of 145 candidemic p...
详细信息
In order to evaluate the epidemiology of candidemia in Brazil, we performed a prospective multicenter study conducted in six general hospitals from Sao Paulo and Rio de Janeiro. We enrolled a total of 145 candidemic patients (85 males) with a median age of 32 years. Non-albicans species accounted for 63% of all episodes and the species most frequently causing candidemia were C. albicans (37%), C. parapsilosis (25%), C. tropicalis (24%), C. rugosa (5%), and C. glabrata (4%). Systemic azoles were used before the onset of candidemia in only six patients. There were no differences in the coexisting exposures or underlying diseases associated with the species most frequently causing candidemia. The overall crude mortality rate was 50%. Nosocomial candidemias in our tertiary hospitals are caused predominantly by non-albicans species, which are rarely fluconazole resistant. This predominance of non-albicans species could not be related to the previous use of azoles. (C) 1999 Elsevier Science Inc.
Three cases of Clavispora lusitaniae invasive fungal infections are reported. All three infections appeared in cancer patients presented with fungaemia, one additionally with meningitis. Two of them were breakthrough ...
详细信息
Three cases of Clavispora lusitaniae invasive fungal infections are reported. All three infections appeared in cancer patients presented with fungaemia, one additionally with meningitis. Two of them were breakthrough - they developed during therapy with conventional amphotericin B with a dose of 0.5 mg kg(-1) day(-1). All three were cured: two with intravenous fluconazol and one with an increasing dose (1 mg kg(-1) day(-1)) of amphotericin B. Ln one of two breakthrough cases the sensitivity of the strain to antifungals was tested against antifungal agents and showed in vitro resistance to amphotericin B (MIC 2 eta g ml(-1)). (C) 1999 Federation of European Microbiological Societies. Published by Elsevier Science B.V. All rights reserved.
Describes an incident of community-acquired Candida tropicalis fungemia where the patients remained candidemic despite high-dose fluconazole therapy. Laboratory findings; Administration of amphotericin B lipid complex...
详细信息
Describes an incident of community-acquired Candida tropicalis fungemia where the patients remained candidemic despite high-dose fluconazole therapy. Laboratory findings; Administration of amphotericin B lipid complex; Strain delineation of the C. tropicales isolates; Importance of developing molecular techniques to identify organisms that may be resistant to antifungals.
Vascular catheters are the most frequently used indwelling devices. Infections are potentially life-threatening complications of their use, and account for an important proportion of nosocomial infections. Diagnostic ...
详细信息
Vascular catheters are the most frequently used indwelling devices. Infections are potentially life-threatening complications of their use, and account for an important proportion of nosocomial infections. Diagnostic methods include essentially semi-quantitative culture of catheter tip and blood culture. For treatment of most catheter-related infections, the catheter should be removed, and antibiotics should be associated in case of systemic infection. Surgically inserted central venous catheter may be maintained in some conditions depending both from the nature of the pathogen and the severity of the infection. These different aspects of catheter infections are reviewed.
暂无评论