Clinical Characteristics and Antibiotic Susceptibility of Staphylococcus lugdunensis Isolated from Skin Diseases: A Retrospective Single-Center Study / 대한피부과학회지

Background@#Staphylococcus lugdunensis is an emerging pathogen in skin and soft tissue infections. However, until recently, the role of S. lugdunensis as a skin pathogen remained underrated. @*Objective@#The purpose of this study was to investigate the clinical characteristics and antibiotic susceptibility of S.lugdunensis isolated from skin diseases. @*Methods@#This is a retrospective chart review of 48 cases in which S. lugdunensis was isolated from bacterial skin cultures between 2016 and 2021. @*Results@#Among the 48 patients, the mean age was 41.0 years, 54.2% were male, and 12.5% of the patients had immunosuppressive diseases. Nearly 87.4% of infections occurred below the waist and the dominant sources of isolation were epidermal cyst (31.3%) and hidradenitis suppurativa (29.2%). The rate of resistance of S. lugdunensis against β-lactam antibiotics were as follows: penicillin, 83.3%; oxacillin, 37.5%; and methicillin, 29.2%. @*Conclusion@# S. lugdunensis is emerging as one of the primary pathogens of skin infections. When S. lugdunensis is isolated, dermatologists should consider that it is not just a component of the skin flora but can also be a pathogen. If S. lugdunensis is identified as the cause of infection, it should be managed with appropriate antibiotic therapy.

Percutaneous Angioplasty and Stenting in Chronic Hemodialysis Patients with Central Venous Stenosis / 대한신장학회잡지

Stenosis of the subclavian vein after cannulation occurs in 15-50% of chronic hemodialysis patients, and impedes the placement of an arteriovenous fistula in the ipsilateral arm. Its natural history and pathogenic mechanism are not well established yet. To investigate the clinical characteristics of the patients and therapeutic effect of percutaneous angioplasty and stenting, 10 consecutive chronic hemodialysis patients(3 men and 7 women; mean 55 year old) from March 1999 to February 2001 who showed subclavian vein stenosis and were treated with above percutaneous procedure were included in this study. The patients were followed for median 15.8(9.3-23.7) months after stenting. The causes of chronic renal failure were hypertension in four, diabetes mellitus in four, and unknown in two patients. Edema was noted on left upper extremity in nine and right in one patient. All cases of stenosis of central vein were found in ipsilateral side. Duration from beginning of hemodialysis to angioplasty and stenting was median 28(0.5-180) months. Duration for keeping subclavian vein catheter was median 35(13-65) days and duration for arteriovenous fistula in ipsilateral arm was median 15.1(1.1-120) months before stenting. All patients were performed stenting successfully and edema of upper extremities began to decreased immediately after the procedure. Involved stenosis lesions were noted on left bracheocephalic vein in seven, left subclavian vein in two, and right bracheocephalic vein in one patient. Restenosis after the procedure occurred in three patients in 1 year after stenting, and percutaneous balloon angioplasty(198, 256, 276 days after initial stenting) was performed again successfully. There was no severe complication during the procedure in all patients. In conclusion, we speculate that percutaneous angioplasty and stenting is a safe and effective therapeutic modality in chronic hemodialysis patients with central vein stenosis.

Minimal Change Nephrotic Syndrome Associated with Mesalazine Treatment in a Patient with Ulcerative Colitis / 대한신장학회잡지

Mesalazine has been widely prescribed for the treatment of inflammatory bowel disease. In renal disease associated with inflammatory bowel disease, nephrolithiasis and amyloidosis are most common, and obstructive uropathy, acute renal failure, glomerular abnormalities and interstitial nephritis due to drug may be occur. However, glomerulonephritis presenting as nephrotic syndrome in patients with ulcerative colitis is very rare. We present a case of minimal change nephrotic syndrome probably associated with mesalazine treatment in patient with ulcerative colitis. A 31-year-old man was admitted with generalized edema and proteinuria. He had been initially treated by sulphasalazine and then received mesalazine for 6 months, recently. Kidney biopsy revealed minimal change disease. Mesalazine was discontinued immediately and prednisolone(1 mg/kg, P.O.) was prescribed. Eight weeks after prednisolone treatment, proteinuria disappeared and patient recovered completely.