RESUMO
A 65-year old diabetic male presented with progressive bone destruction of thoracic spine (T-11&12) with cord compression. Candida albicans was isolated from aspirated materials pre-and intra-operative. Two weeks of fluconazole was given prior to surgical debridement, and fixation of the lesion. C. albicans isolated pre-and 2-weeks after fluconazole treatment were DNA-typed using AP-PCR. MIC was 2-4 mg/l in all isolates tested. The pre-and post treatment isolates had two DNA patterns, indicating the existence of two different strains. Surgical treatment was necessary for patient recovery.
Assuntos
Antifúngicos/uso terapêutico , Candida albicans/genética , Candidíase/terapia , Fluconazol/uso terapêutico , Osteomielite/terapia , Espondilite/terapia , Vértebras Torácicas , Idoso , Candidíase/complicações , Candidíase/microbiologia , Impressões Digitais de DNA , DNA Fúngico , Desbridamento , Diabetes Mellitus Tipo 1/complicações , Humanos , Masculino , Osteomielite/complicações , Osteomielite/microbiologia , Compressão da Medula Espinal/complicações , Espondilite/complicações , Espondilite/microbiologiaRESUMO
Percutaneous biliary drainage was performed in 18 patients with biliary sepsis due to acute obstructive cholangitis and postoperative complications. Internal drainage could be established in 78% of patients, and 22% were managed on external drainage. Nine patients were managed on long-term internal drainage, six underwent uneventful surgery after successful percutaneous decompression, and three died as a result of septic shock. Percutaneous biliary drainage procedures can be lifesaving in biliary sepsis. Once infection and the hyperbilirubinemia are controlled, rational therapy plans can be formulated on the basis of the anatomy and natural history of the underlying disease.
