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1.
Article in English | WPRIM | ID: wpr-875507

ABSTRACT

Background/Aims@#The efficacies of lopinavir-ritonavir or hydroxychloroquine remain to be determined in patients with coronavirus disease 2019 (COVID-19). To compare the virological and clinical responses to lopinavir-ritonavir and hydroxychloroquine treatment in COVID-19 patients. @*Methods@#This retrospective cohort study included patients with COVID-19 treated with lopinavir-ritonavir or hydroxychloroquine at a single center in Korea from February 17 to March 31, 2020. Patients treated with lopinavir-ritonavir and hydroxychloroquine concurrently and those treated with lopinavir-ritonavir or hydroxychloroquine for less than 7 days were excluded. Time to negative conversion of viral RNA, time to clinical improvement, and safety outcomes were assessed after 6 weeks of follow-up. @*Results@#Of 65 patients (mean age, 64.3 years; 25 men [38.5%]), 31 were treated with lopinavir-ritonavir and 34 were treated with hydroxychloroquine. The median duration of symptoms before treatment was 7 days and 26 patients (40%) required oxygen support at baseline. Patients treated with lopinavir-ritonavir had a significantly shorter time to negative conversion of viral RNA than those treated with hydroxychloroquine (median, 21 days vs. 28 days). Treatment with lopinavir-ritonavir (adjusted hazard ratio [aHR], 2.28; 95% confidence interval [CI], 1.24 to 4.21) and younger age (aHR, 2.64; 95% CI 1.43 to 4.87) was associated with negative conversion of viral RNA. There was no significant difference in time to clinical improvement between lopinavir-ritonavir- and hydroxychloroquine-treated patients (median, 18 days vs. 21 days). Lymphopenia and hyperbilirubinemia were more frequent in lopinavir-ritonavir-treated patients compared with hydroxychloroquine-treated patients. @*Conclusions@#Lopinavir-ritonavir was associated with more rapid viral clearance than hydroxychloroquine in mild to moderate COVID-19, despite comparable clinical responses. These findings should be confirmed in randomized, controlled trials.

2.
Article | WPRIM | ID: wpr-832330

ABSTRACT

Background@#Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes. @*Methods@#We conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group. @*Results@#Compared with the non-DM group (n=847), patients with DM (n=235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease. @*Conclusion@#DM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.

3.
Article in English | WPRIM | ID: wpr-914589

ABSTRACT

The measles outbreak in Daegu of January 2019 made 6 teaching hospitals' organization test the measles immunity of their healthcare workers (HCWs). We found that 6,935 (75.9%) of 9,132 HCWs tested seropositive for anti-measles immunoglobulin G (IgG), and seropositivity rate was very different between 6 hospitals (range, 59.9–93.1%). The seroprevelence was lowest in the age of twenties, but the rate was different between 6 hospitals (range 47.0–85.5%). Therefore, to prevent measles from spreading to HCWs, each hospital should make their own data periodically about anti-measles IgG seropositivity of their HCWs.

5.
Article in Korean | WPRIM | ID: wpr-105844

ABSTRACT

Candida species cause various invasive fungal diseases, including candidemia, endocarditis, endophthalmitis, peritonitis, osteomyelitis and arthritis, but infected (mycotic) aortic aneurysms caused by Candida species are very rare. So, we report a case of infected thoracic aortic aneurysm concurrent with endophthalmitis by Candida albicans in a 42-year-old man. The patient initially was diagnosed with candidial endophthalmitis and hospitalized for vitrectomy. On admission, he had chest CT taken and infected thoracic aortic aneurysm was detected. He treated with antifungal agent and resection and patch repair of aortic aneurysm. Two months later, a new aneurysm on the patch repair site was detected and thoracic endovascular aortic repair (TEVAR) was performed. After TEVAR and long-term antifungal therapy, his infected aortic aneurysm has been successfully treated.


Subject(s)
Adult , Aneurysm , Aortic Aneurysm , Aortic Aneurysm, Thoracic , Arthritis , Candida albicans , Candida , Candidemia , Endocarditis , Endophthalmitis , Humans , Osteomyelitis , Peritonitis , Tomography, X-Ray Computed , Vitrectomy
6.
Korean Leprosy Bulletin ; : 43-47, 2017.
Article in Korean | WPRIM | ID: wpr-741534

ABSTRACT

Hansen's disease(HD) is a chronic infectious disorder acquired by inoculation of Mycobacterium leprae. With the establishment of complex multidrug therapy, the incidence rate of leprosy patients has continually shown to decline by 90% compared to the incidence rate in the 1990s. However, the prevalence of the disease still remains high in southeast asian countries. Due to the rarity and diverse nature of cutaneous presentation, HD is often misdiagnosed with other dermatoses or infectious conditions. Especially, when a patient presents with unusual presentation with leprosy reaction with no classical feature such as sensory disorders and skin lesion, the diagnosis is further delayed with misguided treatments. Herein we present a 27-year-old Indonesian immigrant who displayed clinical features mimicking that of orbital cellulitis who was later diagnosed with borderline lepromatous leprosy through histologic and PCR confirmation, in light of alerting the probability of leprosy in immigrants with intractable skin presentations.


Subject(s)
Adult , Asians , Diagnosis , Emigrants and Immigrants , Humans , Incidence , Leprosy , Leprosy, Borderline , Leprosy, Multibacillary , Mycobacterium leprae , Orbit , Orbital Cellulitis , Polymerase Chain Reaction , Prevalence , Sensation Disorders , Skin , Skin Diseases
7.
Article in English | WPRIM | ID: wpr-84887

ABSTRACT

Calcium pyrophosphate dihydrate crystal deposition disease is associated with an acute mono- or pauciarthritis, termed "pseudogout" in elderly patients, involving a large joint (including the knees, ankles) or a chronic arthropathy manifesting as mild joint pain and stiffness. Pseudogout is a crystal-deposition disease of peripheral joints, usually encountered in elderly patients. However, acute presentation of pseudogout around the odontoid process comprises a "crowned-dens" appearance, and requires contemplation of differential diagnoses. We recently experienced a case of pseudogout in the cervical spine presenting with fever and acute neck pain that was successfully treated with a colchicine and low-dose oral steroid. We reported this case with a review of the relevant literature.


Subject(s)
Aged , Arthralgia , Calcium Pyrophosphate , Chondrocalcinosis , Colchicine , Diagnosis, Differential , Fever , Humans , Joints , Knee , Neck Pain , Neck , Odontoid Process , Spine
8.
Korean Journal of Medicine ; : 334-340, 2016.
Article in Korean | WPRIM | ID: wpr-165894

ABSTRACT

Rarely, a paraganglioma can lead to disastrous cardiac complications such as heart failure, cardiomyopathy, or myocardial infarction and inflammatory complications such as sepsis. We describe a 41-year-old man who developed severe dilated cardiomyopathy with cardiogenic shock and sepsis who had a paraganglioma in the retroperitoneum. Echocardiography showed extensive global hypokinesia with severe left ventricular systolic dysfunction. In addition, leukocytosis with elevated inflammatory markers and positive blood cultures indicated sepsis. Abdominal enhanced computed tomography and magnetic resonance imaging showed a large heterogeneous mass with cystic changes in the retroperitoneum. Serum and urine samples indicated elevated levels of catecholamine and its metabolites, and a 131I-meta-iodobenzylguanidine (MIBG) scan indicated uptake of MIBG. After intensive medical treatment and surgical removal of the paraganglioma, the dilated cardiomyopathy and sepsis resolved. The diagnosis of paraganglioma should be considered in patients presenting with acute heart failure or sepsis of nonspecific origin.


Subject(s)
3-Iodobenzylguanidine , Adult , Cardiomyopathies , Cardiomyopathy, Dilated , Diagnosis , Echocardiography , Heart Failure , Humans , Hypokinesia , Leukocytosis , Magnetic Resonance Imaging , Myocardial Infarction , Paraganglioma , Pheochromocytoma , Sepsis , Shock, Cardiogenic
9.
Infection and Chemotherapy ; : 223-223, 2015.
Article in English | WPRIM | ID: wpr-71158

ABSTRACT

We found an error in our published article. Author name should be corrected.

10.
Infection and Chemotherapy ; : 137-141, 2015.
Article in English | WPRIM | ID: wpr-148270

ABSTRACT

Toxocariasis is a parasitic infection caused by the roundworms Toxocara canis or Toxocara cati, mostly due to accidental ingestion of embryonated eggs. Clinical manifestations vary and are classified as visceral larva migrans or ocular larva migrans according to the organs affected. Central nervous system involvement is an unusual complication. Here, we report a case of multiple cerebral infarction and concurrent multi-organ involvement due to T. canis infestation of a previous healthy 39-year-old male who was admitted for right leg weakness. After treatment with albendazole, the patient's clinical and laboratory results improved markedly.


Subject(s)
Adult , Albendazole , Central Nervous System , Cerebral Infarction , Eating , Eggs , Humans , Larva Migrans , Larva Migrans, Visceral , Leg , Male , Ovum , Toxocara , Toxocara canis , Toxocariasis
12.
Article in English | WPRIM | ID: wpr-116725

ABSTRACT

BACKGROUND/AIMS: Increased resting energy expenditure (REE) in rheumatoid arthritis (RA) patients is thought to be caused by hypermetabolism associated with production of proinflammatory cytokines. Our aim in the present study was to explore the possible association between REE and disease activity in females with RA. METHODS: A total of 499 female RA patients were recruited to this cross-sectional study assessing REE scores on disease activity indices (the routine assessment of patient index data 3 [RAPID3], the disease activity score 28, and the clinical/simplified disease activity index [CDAI/SDAI]) and the levels of RA-associated autoantibodies (rheumatoid factor and anticyclic citrullinated peptide [anti-CCP] antibodies). Age-matched healthy female controls (n = 131) were also enrolled. RESULTS: REE did not differ between RA patients (all patients, and those in remission or not) and controls, or between RA patients in remission or not (p > 0.05 for all comparisons). Increased REE in total RA patients was associated with younger age and a higher body mass index (BMI) (p < 0.001 and p < 0.001, respectively), but not with disease activity index scores on any of RAPID3, CDAI, or SDAI. BMI was the only clinical parameter exhibiting a significant relationship with REE quartiles (Q1 to Q4; p < 0.001); none of disease duration, functional status, or anti-CCP antibody titer in RA patients was significantly related to REE, based on analysis of covariance. CONCLUSIONS: We found no association between REE and disease activity in RA patients, implying that energy metabolism in RA patients might be independent of RA-associated systemic inflammation.


Subject(s)
Adult , Age Factors , Aged , Arthritis, Rheumatoid/blood , Biomarkers/blood , Body Mass Index , Case-Control Studies , Cross-Sectional Studies , Energy Metabolism , Female , Humans , Inflammation Mediators/blood , Middle Aged , Peptides, Cyclic/immunology , Predictive Value of Tests , Rest , Rheumatoid Factor/blood , Severity of Illness Index
13.
Article in English | WPRIM | ID: wpr-105911

ABSTRACT

BACKGROUND/AIMS: We evaluated changes of causative pathogen in acute cholangitis and their antimicrobial susceptibility over six years and differences between community-acquired and hospital-acquired acute cholangitis at our institution. METHODS: Medical records of 1,596 patients with acute cholangitis and biliary drainage between August 2006 and August 2012 were reviewed retrospectively. Cases were divided according to time: period 1 (August 2006-December 2008, n=645, 40.4%), period 2 (January 2009-August 2012, n=951, 59.6%). Cases were divided according to community-acquired cholangitis (n=1,397, 87.5%) and hospital-acquired cholangitis (n=199, 12.5%). Causative pathogens and antimicrobial susceptibility were investigated in each group. RESULTS: Causative pathogen was isolated from bile culture in 1,520 out of 1,596 cases (95.2%). The three most frequently isolated Gram-negative bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n=485, 30.4%), E. coli (n=237, 13.2%), and Citrobacter freundii (n=110, 6.9%). Between periods 1 and 2, prevalence of ESBL-producing E. coli and Klebsiella pneumoniae did not show significant change (36.7% vs. 32.1%, p=0.073; 6.6% vs. 6.2%, p=0.732). C. freundii showed a significant increase from period 1 to period 2 (1.7% vs. 13.2%, p=0.000). In both time periods, imipenem was the antimicrobial agent showing the highest rate of susceptibility (93.3% vs. 93.9%, p=0.783). Higher prevalence of ESBL-producing E. coli and C. freundii was observed in the hospital-acquired cholangitis group (52.1% vs. 31.2%, p=0.000; 15.9% vs. 7.3%, p=0.001). CONCLUSIONS: The most common causative pathogen of acute cholangitis was ESBL-producing E. coli. Prevalence of C. freundii increased over the time period. Imipenem should be reserved as an alternative for resistant pathogens.


Subject(s)
Acute Disease , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Cholangitis/diagnosis , Citrobacter freundii/drug effects , Community-Acquired Infections/microbiology , Cross Infection/microbiology , Drug Resistance, Bacterial , Escherichia coli/drug effects , Female , Humans , Imipenem/pharmacology , Klebsiella pneumoniae/drug effects , Male , Microbial Sensitivity Tests , Middle Aged , Retrospective Studies , Time Factors , beta-Lactamases/metabolism
14.
Article in Korean | WPRIM | ID: wpr-50816

ABSTRACT

OBJECTIVE: We investigated the efficacy and safety of pandemic H1N1 vaccine in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients, and evaluated its correlation with serum cytokine level. METHODS: A total of 43 RA patients and 31 SLE patients were enrolled in the study and were compared with age, sex-matched 40 healthy controls (HC). The blood samples drawn from selected patients before vaccination and in post-vaccination at week 4 were assayed in one session to measure the titers of antibodies against haemagglutinin specific for influenza virus strains: A/California/7/2009 NYMC X-179A (H1N1). Serum IL17 and CXCL13 levels were measured in the same session by enzyme-linked immunosorbent assay. The association of serum cytokine level with anti-influenza antibody titer and mean fold increase (MFI) was investigated. Each specific side effect after vaccination was monitored in both the patients and control groups. RESULTS: The geometric mean antibody titer (GMT) for pre- and post-vaccination at week 4 was not significantly different between RA and HC, SLE and HC. The seroconversion rate in HC and RA was not significantly different, whereas the seroprotection rate is significantly higher in HC (82.5%) than RA (55.8%) (p<0.05). MFI in HC, RA, SLE were 19.65, 6.00 and 6.06, which were significantly higher in HC. Serum IL17 level was 6.28+/-2.89 pg/mL and 7.56+/-3.34 pg/mL in pre-, post-vaccination SLE patients, 33.85+/-15.62 pg/mL and 38.04+/-18.60 pg/mL in RA patients and was significantly lower in SLE patients. Serum CXCL13 level was 518.73+/-720.29 pg/mL and 431.53+/-601.23 pg/mL in pre-, post-vaccination SLE patients, which was significantly higher than HC (149.64+/-248.81 pg/mL and 147.36+/-213.92 pg/mL in each pre-, post-vaccination) and was not significantly different with the level of RA patients. In SLE patients, significant correlations were detected between cytokine level and post-vaccination antibody titer (r=0.22 p=0.026 between IL 17 and GMT; r=0.44, p<0.05 between CXCL13 and GMT). CONCLUSION: The increase in post-vaccination antibody titer is weaker in both RA and SLE patients group than the HC group. Post-vaccination antibody titer was positively correlated with B lymphocyte chemoattractant and CXCL13 in SLE patients, but not in RA patients.


Subject(s)
Antibodies , Arthritis, Rheumatoid , Enzyme-Linked Immunosorbent Assay , Humans , Influenza, Human , Interleukin-17 , Lupus Erythematosus, Systemic , Lymphocytes , Orthomyxoviridae , Pandemics , Vaccination
15.
Infection and Chemotherapy ; : 282-288, 2012.
Article in Korean | WPRIM | ID: wpr-166987

ABSTRACT

BACKGROUND: Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in immunocompromised patients. However, few data on clinical characteristics and outcomes of IPA in Korea have been reported. We conducted a nationwide multicenter study in Korea for evaluation of the epidemiology and clinical outcomes of invasive pulmonary aspergillosis. MATERIALS AND METHODS: A retrospective cohort study was conducted in 10 hospitals in Korea. We reviewed all adult patients who met the revised EORTC/MSG definitions between 2008 and 2010. RESULTS: A total of 334 cases, which included proven (26, 8%), probable (159, 48%), or possible (149, 44%) IPA, were identified. Patients with proven or probable IPA were evaluated, and, of these 185 IPA patients, 105 (57%) had neutropenia, 30 (16%) underwent hematopoietic stem cell transplantation, 25 (14%) underwent solid organ transplantation, and 32 (17%) without neutropenia and transplantation received immunosuppressive agents or corticosteroid. Aspergillus spp. were isolated from 42 patients (23%), and positive fungal culture rates from sterile fluid, sputum, and bronchoalveolar lavage fluid (BAL) were 67% (6/9), 21% (32/150), and 20% (9/44), respectively. Results of assays for sensitivity of serum and BAL galactomannan were 84% (155/184) and 89% (25/28), respectively. Amphotericin-B deoxycholate and itraconazole were most commonly administered as a primary therapy in 107 (58%) and 34 (19%) patients, respectively. Of 133 patients (73%) who received salvage therapy after primary antifungal therapy for a median period of six days (IQR 3-12), 82 (62%) patients were treated with voriconazole. Of 185 patients, 82 (44%) died within three months after diagnosis of IPA. CT findings, including small airway lesions and micronodules, ground glass opacities, and pleural effusion and persistent positive galactomannan status showed an independent association with worse outcome, while proven diagnosis of IPA showed an independent association with better outcome. CONCLUSIONS: Microbiologic confirmation of IPA was low in Korea; therefore, many Korean physicians were dependent on the galactomannan assay for microbiologic diagnosis. Primary therapy with Amphotericin-B deoxycholate followed by salvage therapy with voriconazole was the most common antifungal strategy for treatment of patients with IPA in Korea. Overall mortality and IPA-related mortality were comparable with data from Western clinical trials.


Subject(s)
Adult , Aspergillus , Bronchoalveolar Lavage Fluid , Cohort Studies , Deoxycholic Acid , Glass , Hematopoietic Stem Cell Transplantation , Humans , Immunocompromised Host , Immunosuppressive Agents , Invasive Pulmonary Aspergillosis , Itraconazole , Korea , Mannans , Neutropenia , Organ Transplantation , Pleural Effusion , Pyrimidines , Retrospective Studies , Salvage Therapy , Sputum , Transplants , Triazoles
16.
Article in Korean | WPRIM | ID: wpr-182258

ABSTRACT

Disseminated cryptococcosis mainly occurs in immunocompromised patients. It enters the body through the respiratory tract and spreads to the lungs, skin, liver and lymphoid organs. Among cryptococcosis, cryptococcal meningitis is a relatively frequent manifestation and causes serious morbidity and mortality. It needs urgent diagnosis and initiation of effective antifungal therapy. It is difficult to differentiate cryptococcal meningitis from neuropsychiatric lupus due to similar clinical symptoms, laboratory and cerebrospinal fluid findings. We report a case of disseminated cyrptococcosis in a patient with systemic lupus erythematosus being managed with mycophenolate mofetil, prednisolone and hydroxychloroquine.


Subject(s)
Cryptococcosis , Humans , Hydroxychloroquine , Immunocompromised Host , Liver , Lung , Lupus Erythematosus, Systemic , Meningitis, Cryptococcal , Mycophenolic Acid , Prednisolone , Respiratory System , Skin
17.
Infection and Chemotherapy ; : 103-106, 2010.
Article in Korean | WPRIM | ID: wpr-164533

ABSTRACT

In April 2009, the first swine origin pandemic influenza (H1N1 2009) infection was reported in Mexico and United states and has since spread rapidly worldwide. Finally on June 11, 2009, WHO officially declared the first pandemic of the 21st century. Until March 2010, more than 213 countries reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 16,931 deaths. The drug of choice for treatment and prophylaxis of pandemic (H1N1) 2009 influenza are the neuraminidase inhibitor (oseltamivir and Zanamivir). However, increased use of these drugs lead to the emergence of oseltamivir-resistant strains. We report a case of oseltamivir-resistant pandemic influenza (H1N1 2009) virus infection in a patient who were initially started with oseltamivir for laboratory-confirmed influenza. Patient's symptoms worsened despite the use of high-dose oral oseltamivir, and antiviral susceptibility test showed oseltamivir resistance (H275Y mutation). The patient resolved after treatment with zanamivir.


Subject(s)
Humans , Influenza, Human , Mexico , Neuraminidase , Oseltamivir , Pandemics , Swine , United States , Viruses , Zanamivir
18.
Article in Korean | WPRIM | ID: wpr-722088

ABSTRACT

Nontuberculous mycobacteria are ubiquitous organisms that are frequently present in the water, soil and animal reservoirs. Nontuberculous mycobacterial infections of the musculoskeletal system are rare and usually associated with predisposing factors, such as prior joint disease, trauma, use of intraarticular or oral corticosteroids, or an immunocompromised state. A sixty five-year-old patient with rheumatoid arthritis was hospitalized due to swelling on the left wrist. M. intracellulare was cultured from the aspirated joint fluid. The patient was successfully treated with clarithromycin, ethambutol, and rifampin. We report this case with review, emphasizing high suspicion for nontuberculous mycobacterial infection in patients with predisposing risk factors.


Subject(s)
Adrenal Cortex Hormones , Animals , Arthritis, Rheumatoid , Causality , Clarithromycin , Ethambutol , Humans , Joint Diseases , Joints , Musculoskeletal System , Mycobacterium avium Complex , Mycobacterium , Nontuberculous Mycobacteria , Rifampin , Risk Factors , Soil , Tenosynovitis , Wrist
19.
Infection and Chemotherapy ; : 133-141, 2007.
Article in English | WPRIM | ID: wpr-722074

ABSTRACT

BACKGROUND: Vancomycin resistant enterococcal (VRE) bacteremia is increasing among patients with hematologic malignancies. Our study was to determine the clinical characteristics, risk factors for mortality, and effect of adequate antimicrobial therapy on outcome in patients with hematologic malignancies who developed VRE bacteremia. MATERIALS AND METHODS: we retrospectively reviewed episodes of VRE bacteremia in 90 patients with hematologic malignancices from January 1997 to December 2006. Adequate antimicrobial therapy was defined as the use of linezolid or quinupristin/dalfopristin, initiated within 72 hours of initial positive blood culture and continuing for at least 48 hours. Outcome was evaluated at 14 and 28 days after onset of bacteremia. RESULTS: The overall 14-day and 28-day mortality rates were 44.4% (40/90) and 54.4% (49/90) respectively. Failure of neutrophil recovery (odds ratio [OR], 40.29; 95% confidence interval [CI], 6.22 to 260.72; P< or =0.001) and increased APACHE II score (OR, 1.30; 95% CI, 1.07 to 1.58; P=0.008) were independent risk factors for 14-day as well as for 28-day mortality. To specifically examine the effects of adequate antimicrobial therapy, we performed a separate analysis of the 14-day mortality, after excluding 6 patients who died within 48 hours of bacteremia onset. Multivariate analysis showed that failure of neutrophil recovery (OR, 42.10; 95% CI, 5.77 to 307.00; P< or =0.001) and increased APACHE II score (OR, 1.25; 95% CI, 1.02 to 1.53; P=0.026) were still independently associated with mortality. Adequate antimicrobial therapy, however, did not have a protective effect (OR, 1.91; 95% CI, 0.50 to 7,22; P= 0.338). Of the 65 patients with monomicrobial bacteremia, 30 (46.2%) received adequate antimicrobial therapy and 35 (53.8%) did not: their 14-day mortality rates were 40.0% (12/30) and 42.9% (15/35), respectively (P=0.816). CONCLUSION: In conclusion, severity of underlying illness was associated with mortality. Adequacy of antimicrobial therapy did not improve survival, this may be due to low virulence of enterococci and severity of underlying disease.


Subject(s)
APACHE , Bacteremia , Enterococcus , Hematologic Neoplasms , Hematology , Humans , Linezolid , Mortality , Multivariate Analysis , Neutrophils , Retrospective Studies , Risk Factors , Vancomycin , Virulence
20.
Article in Korean | WPRIM | ID: wpr-721583

ABSTRACT

Nontuberculous mycobacteria are ubiquitous organisms that are frequently present in the water, soil and animal reservoirs. Nontuberculous mycobacterial infections of the musculoskeletal system are rare and usually associated with predisposing factors, such as prior joint disease, trauma, use of intraarticular or oral corticosteroids, or an immunocompromised state. A sixty five-year-old patient with rheumatoid arthritis was hospitalized due to swelling on the left wrist. M. intracellulare was cultured from the aspirated joint fluid. The patient was successfully treated with clarithromycin, ethambutol, and rifampin. We report this case with review, emphasizing high suspicion for nontuberculous mycobacterial infection in patients with predisposing risk factors.


Subject(s)
Adrenal Cortex Hormones , Animals , Arthritis, Rheumatoid , Causality , Clarithromycin , Ethambutol , Humans , Joint Diseases , Joints , Musculoskeletal System , Mycobacterium avium Complex , Mycobacterium , Nontuberculous Mycobacteria , Rifampin , Risk Factors , Soil , Tenosynovitis , Wrist
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