RESUMO
We report the first case of brucellosis caused by an isolate whose genome is identical that of a frog isolate from Texas, demonstrating the zoonotic potential of amphibian-type Brucella. Importantly, with such atypical Brucella, correct diagnosis cannot be performed using routine serological tests or identification methods.
Assuntos
Brucella , Brucelose , Anfíbios , Animais , Brucella/genética , Brucelose/diagnóstico , Humanos , Testes Sorológicos , TexasRESUMO
We report the case of a 79-year-old patient, admitted to the department of infectious diseases at Bretagne Sud Hospital Center for a right calcaneal osteitis, complicated by a pacemaker leads infectious endocarditis. Meticillin sensitive Staphylococcus aureus was documented by blood culture. Antibiotic treatment was established using intravenous cefazolin for an initial 6 weeks period. Prothrombin time (PT) decreased as well as vitamin K dependent factors, without anticoagulation therapy, at day 7 of cefazolin treatment. After bleeding occurred on calcaneal osteitis, the VAC® therapy system was removed and intravenous vitamin K 10 mg (then 5 mg per day for 5 days per os) was administered. Vitamin K allowed PT and vitamin K dependent factors to return to normal values. Literature review does not explicitly mention the effects on vitamin K dependent factors after cefazolin administration. Four severe haemorrhagic episodes under cefazolin have been declared in France so far since February 2017. The goal of this article is to alert clinicians and clinical pathologists from the potential appearance of coagulation disorders in patients treated by cefazolin.
Assuntos
Transtornos da Coagulação Sanguínea/induzido quimicamente , Cefazolina/efeitos adversos , Sepse/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Idoso , Transtornos da Coagulação Sanguínea/diagnóstico , Substituição de Medicamentos , Hemorragia/induzido quimicamente , Humanos , Masculino , Marca-Passo Artificial/microbiologia , Penicilinas/uso terapêutico , Infecções Relacionadas à Prótese/complicações , Infecções Relacionadas à Prótese/tratamento farmacológico , Sepse/complicações , Sepse/microbiologia , Infecções Estafilocócicas/complicaçõesRESUMO
Seven patients from a group of 16 travelers were diagnosed at our institution with one or more sand fleas on their toes, 1 day to 3 weeks after returning from Madagascar. A questionnaire was sent to the whole group to collect clinical and epidemiological information, which showed that 9 of 13 (69%) had received pre-travel medical advice, but none were aware of sand flea; thus prevention measures were rarely applied. Five of seven (71%) patients wore open sandals throughout the trip. Overall, 10 sand fleas were extracted.
