Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Medicina (B.Aires) ; 76(5): 317-320, Oct. 2016. mapas, tab
Article in Spanish | LILACS | ID: biblio-841601

ABSTRACT

Al quinto día de retirarse del Parque Nacional El Rey, provincia de Salta, Argentina, donde realizó turismo rural, una mujer italiana de 47 años desarrolló un cuadro febril agudo seguido de un exantema petequial y purpúrico que progresó rápidamente a falla multiorgánica y falleció al sexto día de internación. Existieron referencias a mordeduras por garrapatas y se constató una lesión cutánea similar a la denominada tache noire. La autopsia mostró una vasculitis generalizada, ascitis, edema de pulmón, necrosis tubular aguda y necrosis portal centrolobulillar. Se procesó tejido esplénico y hepático con técnica de PCR para Rickettsia spp, basada en la detección del gen gltA. El resultado fue positivo. Los amplicones obtenidos fueron secuenciados y los resultados se compararon con las secuencias preestablecidas en el programa BLAST, coincidiendo en un 99% con R. rickettsii. La baja sensibilidad del sistema de salud en reconocer la enfermedad y la insuficiente información producida desde los medios relacionados con el turismo, son factores que inciden en el retardo de implementar un tratamiento eficaz y las normas de prevención adecuadas.


On the fifth day after leaving the Parque Nacional El Rey, province of Salta, Argentina, where she made rural tourism, a woman of Italian origin, aged 47, developed an acute fever followed by a petechial and purpuric rash that progressed rapidly to multiorgan failure. She died on the sixth day after hospitalization. There were references to tick bites and a skin lesion similar to tache noire was found. The autopsy showed generalized vasculitis, ascites, pulmonary edema, acute tubular necrosis and portal centrilobular necrosis. Spleen and liver tissue were processed for PCR Rickettsia spp, based on the detection of the gltA gene. The result was positive. The amplicons obtained were sequenced and the results were compared with the preset sequences on the BLAST program, 99% coinciding with R. rickettsii. The low sensitivity of the health system to recognize this disease and the insufficient information generated from tourism-related media are factors that affect the delay to implement effective treatment and appropriate prevention standards.


Subject(s)
Humans , Animals , Female , Middle Aged , Rickettsia rickettsii/isolation & purification , Rocky Mountain Spotted Fever/microbiology , Argentina , Rocky Mountain Spotted Fever/complications , Fatal Outcome , Ixodidae/microbiology , Multiple Organ Failure/microbiology
2.
Clinics ; 71(10): 562-569, Oct. 2016. tab, graf
Article in English | LILACS | ID: lil-796866

ABSTRACT

OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed. RESULTS: Multiple organ dysfunction syndrome developed in 85% of the patients, and acute respiratory failure was the most common organ failure (75%). The most common computed tomographic findings included a feeding vessel sign (90%), peripheral nodules without cavities (80%) or with cavities (65%), and peripheral wedge-shaped opacities (75%). The most common primary source of infection was liver abscess (40%), followed by pneumonia (25%). The two most frequent causative pathogens were Klebsiella pneumoniae (50%) and Staphylococcus aureus (35%). Compared with survivors, nonsurvivors had significantly higher serum creatinine, arterial partial pressure of carbon dioxide, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and they were significantly more likely to have acute kidney injury, disseminated intravascular coagulation and lung abscesses. The in-hospital mortality rate was 30%. Pneumonia was the most common cause of death, followed by liver abscess. CONCLUSIONS: Patients with septic pulmonary embolism who require critical care, especially those with pneumonia and liver abscess, are associated with high mortality. Early diagnosis, appropriate antibiotic therapy, surgical intervention and respiratory support are essential.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Bacteremia/diagnostic imaging , Bacteremia/therapy , Critical Care/methods , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/therapy , Bacteremia/microbiology , Bacteremia/mortality , Bacteria/isolation & purification , Hospital Mortality , Intensive Care Units , Liver Abscess/diagnostic imaging , Liver Abscess/microbiology , Liver Abscess/mortality , Liver Abscess/therapy , Lung/diagnostic imaging , Lung/pathology , Medical Records , Multidetector Computed Tomography/methods , Multiple Organ Failure/microbiology , Multiple Organ Failure/mortality , Pneumonia/diagnostic imaging , Pneumonia/microbiology , Pneumonia/mortality , Pneumonia/therapy , Pulmonary Embolism/microbiology , Pulmonary Embolism/mortality , Retrospective Studies , Statistics, Nonparametric
3.
Article in English | IMSEAR | ID: sea-112466

ABSTRACT

A total of 2400 patients with pyrexia of unknown origin and or suspected leptospirosis were included in this study. Dark field microscopy detected Leptospira in 690 cases, Leptospira serological Investigations proved positive in 570 out of these 690 patients. Among them 212 had the classical icteric and the other 358 had anicteric type of presentation. Notably eptospira interrogans serovar ictero haemorrhagiae infection was encountered in 212 patients. In 30 patients, who had multi organ dysfunction which included renal failure, hepatic dysfunction or meningitis was due to Leptospira interrogans Serovar cannicola. Coexsistense of leptospirosis and hepatitis B virus infection were noted in 15 patients. Antibody to Leptospira interrogans was demonstrated by Micro agglutination test (MAT) in addition to dark field microscopy positivity in these cases. Similarly HIV antibody was demonstrated in 30 of the 330 anicteric patients. 554 out of 570 cases responded to intra venous penicillin (216), and oral Doxycycline (182) and Augmentin (156), and the remaining 16 patients succumbed to death.


Subject(s)
Adolescent , Adult , Aged , Animals , Child , Child, Preschool , Female , Humans , Leptospira/classification , Leptospira interrogans/classification , Leptospirosis/drug therapy , Male , Middle Aged , Multiple Organ Failure/microbiology , Prevalence , Weil Disease/drug therapy , Zoonoses
4.
Rev. chil. infectol ; 23(1): 69-72, mar. 2006. ilus
Article in Spanish | LILACS | ID: lil-426159

ABSTRACT

La aspergilosis invasora es una patología grave, con una incidencia en aumento, que generalmente afecta a pacientes con inmunosupresión, existiendo escasa información en pacientes pediátricos inmunocompetentes. Reportamos el caso de un escolar de 8 años, previamente sano, que cursó con una aspergilosis invasora multisistémica de origen abdominal, en relación a una laparotomía contenida, evolucionando hacia una falla orgánica múltiple, con un desenlace fatal, a pesar de recibir terapia con anfotericina B deoxicolato más voriconazol y drenaje quirúrgico amplio. El estudio anátomo-patológico reveló elementos de hifas características dentro de diversos parénquimas e invasión vascular. La aspergilosis invasora debe tenerse presente entre las causas de infecciones emergentes en pacientes críticos, incluso en inmunocompetentes; se asocia a una elevada mortalidad a pesar de un adecuado y oportuno tratamiento.


Subject(s)
Humans , Male , Child , Aspergillosis/complications , Aspergillosis/therapy , Multiple Organ Failure/microbiology , Antifungal Agents/therapeutic use , Aspergillus fumigatus/isolation & purification , Aspergillosis/diagnosis , Fatal Outcome , Respiratory Insufficiency/microbiology , Peritonitis/microbiology , Lung , Shock, Septic/microbiology
5.
Rev. chil. infectol ; 22(4): 356-360, dic. 2005. ilus
Article in Spanish | LILACS | ID: lil-427725

ABSTRACT

Reportamos el primer caso de fusariosis diseminada en un paciente adulto en Chile, con una neoplasia hematológica y tratamiento quimioterápico, quien evolucionó con neutropenia febril prolongada, refractaria, fuera tratado con un amplio esquema antibacteriano y desarrollara una infección multisistémica, con compromiso cutáneo, sinusal y pulmonar por Fusarium oxysporum. Cursó con refractariedad al tratamiento antifúngico con anfotericina B deoxicolato y caspofungina, utilizados en forma secuencial. El desenlace fatal de este paciente se asoció a la persistencia de la neutropenia y a la infección por un hongo filamentoso habitualmente resistente a terapia antifúngica.


Subject(s)
Male , Humans , Middle Aged , Fusarium , Leukemia, Myeloid/complications , Mycoses , Neutropenia/complications , Skin Diseases/microbiology , Fatal Outcome , Fever , Fungemia , Immunocompromised Host , Opportunistic Infections/microbiology , Multiple Organ Failure/microbiology
6.
Article in English | IMSEAR | ID: sea-36150

ABSTRACT

Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.


Subject(s)
Adult , Aged , Animals , Arachnid Vectors/microbiology , Aspartate Aminotransferases/blood , Bilirubin/blood , Blood Urea Nitrogen , Creatinine/blood , Disseminated Intravascular Coagulation/microbiology , Dyspnea/microbiology , Endemic Diseases/statistics & numerical data , Female , Fever/microbiology , Headache/microbiology , Hematocrit , Hospitalization/statistics & numerical data , Humans , Hypoalbuminemia/microbiology , Leukocytosis/microbiology , Lymphatic Diseases/microbiology , Male , Middle Aged , Mites/microbiology , Multiple Organ Failure/microbiology , Prospective Studies , Respiratory Insufficiency/microbiology , Scrub Typhus/blood , Shock, Septic/blood , Thailand/epidemiology , Thrombocytopenia/microbiology
SELECTION OF CITATIONS
SEARCH DETAIL