RESUMO
Spontaneous retroperitoneal hemorrhage is a distinct clinical entity that can present in the absence of specific underlying pathology or trauma and is typically associated with anticoagulation therapy. We report a case of a 74-year-old female patient with a cerebral infarction related to atrial fibrillation who developed a spontaneous lumbar arterial hemorrhage complicating heparin therapy. The diagnosis was suggested by a computed tomography scan and confirmed by angiography. She was treated successfully with transcatheter embolization.
Assuntos
Idoso , Feminino , Humanos , Anticoagulantes/efeitos adversos , Embolização Terapêutica , Hemorragia/etiologia , Heparina/efeitos adversos , Vértebras Lombares/irrigação sanguínea , Espaço Retroperitoneal , Terapêutica , Tomografia Computadorizada por Raios XRESUMO
Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Assuntos
Humanos , Bacteriemia , Toxinas Bacterianas , Ciprofloxacina , Clindamicina , Atenção à Saúde , Exotoxinas , Gentamicinas , Incidência , Leucocidinas , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina , Osteomielite , Fatores de Risco , Tetraciclina , Combinação Trimetoprima e SulfametoxazolRESUMO
Recent reports have described an increasing incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in patients who do not exhibit established risk factors for healthcare exposure. We report two cases of CA-MRSA bacteremia complicated by vertebral osteomyelitis. Both of CA-MRSA isolates were resistant to beta-lactam agents, but susceptible to clindamycin, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and tetracycline. Both isolates carried staphylococcal cassette chromosome mec (SCCmec) type IVA, and were identified as sequence type (ST) 72 by mlultilocus sequence typing (MLST). However, the Panton-Valentine leukocidin (PVL) gene was not identified.
Assuntos
Humanos , Bacteriemia , Toxinas Bacterianas , Ciprofloxacina , Clindamicina , Atenção à Saúde , Exotoxinas , Gentamicinas , Incidência , Leucocidinas , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina , Osteomielite , Fatores de Risco , Tetraciclina , Combinação Trimetoprima e SulfametoxazolRESUMO
BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.