ABSTRACT
Serious infections in the critical care unit are commonplace. However, distinguishing true infection from mere colonization is a difficult and often uncertain process that has been shown to result in both over- and under-treatment of patients. Antimicrobial agents used in the CCU setting are expensive and not without toxicities. This article discusses methods to differentiate colonization from infection.
Subject(s)
Colony Count, Microbial , Communicable Diseases/diagnosis , Communicable Diseases/etiology , Cross Infection/diagnosis , Cross Infection/etiology , Diagnosis, Differential , Humans , Intensive Care Units , Pneumonia/diagnosis , Pneumonia/etiology , Risk Factors , Sepsis/diagnosis , Sepsis/epidemiology , Sepsis/etiology , Urinary Tract Infections/diagnosis , Urinary Tract Infections/etiologyABSTRACT
Parvovirus B19 infection in the transplant patient is rarely reported, although cases have occurred in patients with bone marrow, liver, and renal transplants and in children undergoing heart transplantation. We present the first reported case of an orthotopic heart transplant recipient with aplastic crisis caused by parvovirus B19. The infection was diagnosed by bone marrow biopsy, confirmed by serologic studies and polymerase chain reaction, and successfully treated with intravenous immunoglobulin.
Subject(s)
Anemia, Aplastic/virology , Heart Transplantation , Parvoviridae Infections/complications , Anemia, Aplastic/drug therapy , Anemia, Aplastic/pathology , Biopsy , Bone Marrow/pathology , DNA, Viral/analysis , Female , Humans , Immunoenzyme Techniques , Immunoglobulin M/immunology , Immunoglobulins, Intravenous/therapeutic use , Middle Aged , Parvoviridae Infections/drug therapy , Parvoviridae Infections/pathology , Parvovirus B19, Human/genetics , Parvovirus B19, Human/immunology , Polymerase Chain ReactionABSTRACT
A variety of etiologies may produce pulmonary infiltrates in a patient with cancer. Infectious etiologies, of an ever-increasing number, are always of paramount concern due to their high mortality in this patient population. Patients may be rendered immunosuppressed for prolonged periods of time and therefore are highly susceptible to infection. We present an overview of the many causes of pulmonary infiltrates in the cancer patient and an approach to diagnosis and treatment.
Subject(s)
Infections/complications , Lung Diseases/complications , Neoplasms/complications , Animals , Bacterial Infections/complications , Heart Failure/diagnosis , Hemorrhage/diagnosis , Humans , Infant, Newborn , Leukostasis/diagnosis , Leukostasis/therapy , Mycoses/complications , Pneumonia/chemically induced , Pneumonia/diagnosis , Pneumonia/diagnostic imaging , Prognosis , Protozoan Infections/complications , Pulmonary Embolism/diagnosis , Radionuclide Imaging , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/mortality , Respiratory Distress Syndrome, Newborn/therapy , Virus Diseases/complicationsABSTRACT
Influenza is an epidemic respiratory illness caused by one of three viral subtypes: A, B, or C. Influenza A causes higher mortality than influenza B and C and is often responsible for pandemics and yearly epidemics of this common, infectious disease. Clinically, patients with influenza present with an abrupt onset of fever, malaise, headache, and a dry, hoarse cough. These symptoms usually last three to five days. Amantadine and rimantadine may be used to prevent and to treat influenza A infection, but not B or C. Ribavirin, however, may be effective treatment for severe influenza pneumonia caused by either A or B subtype, although it is not FDA approved for this application. Annual influenza vaccination should be administered between mid-October and mid-November to any person at increased risk for complications. Health-care workers, those in close contact with high-risk individuals, and personnel vital to community function should also be immunized.
Subject(s)
Influenza, Human , Antiviral Agents/therapeutic use , Humans , Influenza A virus , Influenza B virus , Influenza Vaccines , Influenza, Human/diagnosis , Influenza, Human/drug therapy , Influenza, Human/physiopathology , Influenza, Human/virology , Gammainfluenzavirus , Pneumonia, Viral/drug therapyABSTRACT
Diagnostic molecular biology is at the forefront in the diagnosis of infectious diseases. Through the use of deoxyribonucleic acid (DNA) probes in conjunction with other molecular techniques such as polymerase chain reaction (PCR), physicians will be able to more rapidly and accurately diagnose causative agents in a variety of infectious diseases. This article will focus on the molecular basis of these techniques, how they may aid the physician in patient diagnosis, and the shortcomings of this new and exciting technology.
