Asunto(s)
Blastomicosis/diagnóstico , Sinusitis del Etmoides/diagnóstico , Sinusitis Maxilar/diagnóstico , Adulto , Anfotericina B/uso terapéutico , Blastomicosis/tratamiento farmacológico , Blastomicosis/cirugía , Terapia Combinada , Sinusitis del Etmoides/tratamiento farmacológico , Sinusitis del Etmoides/cirugía , Femenino , Humanos , Sinusitis Maxilar/tratamiento farmacológico , Sinusitis Maxilar/cirugíaRESUMEN
Intravascular (IV) catheter sepsis is a widely recognized complication of IV therapy or monitoring, but little emphasis has been placed on the morbidity and cost associated with this infection. To assess the consequences of IV catheter sepsis, we examined the medical records of 94 patients with 102 episodes of IV catheter sepsis due to percutaneously inserted catheters. Major complications occurred in 33 (32%) of the episodes and included septic shock (12 episodes), sustained sepsis (12), suppurative thrombophlebitis (7), metastatic infection (5), endocarditis (2), and arteritis (2). One patient died due to sepsis, and hospital stay was clearly prolonged in 15 episodes. The risk of major complications was highest in episodes of IV catheter sepsis caused by Candida, Pseudomonas aeruginosa, Staphylococcus aureus, or multiple pathogens, and the most severe complications were usually caused by S. aureus. The hospital cost of IV catheter sepsis was assessed by reviewing medical and billing records to identify extra medical care and then multiplying charges for that care by the appropriate cost-to-charge ratio. The average cost per episode, adjusted to 1991 dollars, was $3,707 for all episodes and $6,064 for episodes caused by S. aureus. The morbidity and cost associated with IV catheter sepsis warrant substantial efforts to minimize the incidence of this complication and especially to prevent cases due to S. aureus.
Asunto(s)
Infecciones Bacterianas/etiología , Cateterismo Venoso Central/efectos adversos , Cateterismo Periférico/efectos adversos , Micosis/etiología , Arteritis/economía , Arteritis/epidemiología , Arteritis/etiología , Infecciones Bacterianas/economía , Infecciones Bacterianas/epidemiología , Distribución de Chi-Cuadrado , Endocarditis/economía , Endocarditis/epidemiología , Endocarditis/etiología , Femenino , Costos de la Atención en Salud , Humanos , Masculino , Persona de Mediana Edad , Morbilidad , Micosis/economía , Micosis/epidemiología , Estudios Retrospectivos , Sepsis/economía , Sepsis/epidemiología , Sepsis/etiología , Choque Séptico/economía , Choque Séptico/epidemiología , Choque Séptico/etiología , Tromboflebitis/economía , Tromboflebitis/epidemiología , Tromboflebitis/etiologíaRESUMEN
Subcutaneous and cerebral cysticercosis, the latter visualized in computer tomography, occurred in a 38 year-old Filipina who had multiple asymptomatic subcutaneous nodules and headache. Treatment with praziquantel was given at 35 mg/day for 10 days, dexamethasone and carbamazepine were also given to reduce side effects. Three months after praziquantel therapy most of the subcutaneous nodules, the headache and the intracranial lesion disappeared and at 9 months 23 of the original 26 subcutaneous nodules had disappeared. Computer tomography is a valuable adjunct to the diagnosis and follow up of cerebral cysticercosis and praziquantel was found to be very effective in the treatment of the parasitoses.