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1.
BMJ Case Rep ; 15(3)2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260408

RESUMO

Nocardiosis is a rare opportunistic gram-positive bacterial infection. The genus Nocardia consists of non-motile, aerobic, non-spore-forming, catalase-positive, filamentous-branching bacteria with fragmentation into coccoid or bacillary forms. Opportunistic infections due to Nocardia are reported in immunocompromised patients. Aspergillus fumigatus is a conidia forming fungus that can be found in soil, plant matter and dust, causing invasive pulmonary and disseminated infection in immunocompromised patients. Both Nocardia cyriacigeorgica and A. fumigatus are known to cause pulmonary infection with metastatic dissemination to the central nervous system. We present a case of Nocardia and Aspergillus co-infection in a patient who presented within a few days of initiation of immunosuppressants for suspected systemic lupus erythematosus.


Assuntos
Nocardiose , Nocardia , Aspergillus fumigatus , Sistema Nervoso Central/patologia , Humanos , Hospedeiro Imunocomprometido , Pulmão/patologia , Nocardiose/complicações , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológico
2.
PLoS One ; 12(2): e0171074, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28170436

RESUMO

Initial antimicrobial treatment of patients with deep seated or invasive infections is typically empiric. Usually, cultures of specimens obtained from the suspected source of infection are performed to identify pathogens and guide continued antimicrobial treatment. When patients present with signs and symptoms of infection, but sterile body fluid or tissue specimens cannot be obtained in a timely fashion, growth of bacterial pathogens in culture may be inhibited following initiation of empiric antibiotic treatment. To address this clinical dilemma, we performed a prospective evaluation of conventional culture vs. PCR coupled to electrospray ionization mass spectrometry (PCR/ESI-MS) on sterile body fluids and tissues submitted to the diagnostic microbiology lab following initiation of empiric antibiotic treatment for patients with suspected infection. In this series of surgical samples, PCR/ESI-MS identified bacterial pathogen(s) in 56% (49/87) of patients with non-diagnostic cultures. Examination of patients stratified by antibiotic treatment duration demonstrated that PCR/ESI-MS sustains high rates of bacterial DNA detection over time by generalized estimating equation models (p<0.0001).


Assuntos
Antibacterianos/uso terapêutico , Bactérias/efeitos dos fármacos , Bactérias/genética , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , DNA Bacteriano , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/cirurgia , Carga Bacteriana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Reação em Cadeia da Polimerase , Espectrometria de Massas por Ionização por Electrospray , Resultado do Tratamento , Adulto Jovem
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