RESUMO
Pasteurellosis is a zoonosis often caused by cat or dog bites or scratches, or by direct exposure to their secretions. Pasteurella multocida is the main pathogen involved in infections through domestic animal bites; generally a local infection characterized by its particular virulence with consequent rapid onset. Serious infection has also been reported in persons affected by comorbidity without domestic animal bite injuries. Here we report the case of a woman with lower limb exudating vesicular skin ulcers affected by liver cirrhosis, bilateral knee arthritis, septicemia with positive blood culture and synovial fluid culture for Pasteurella multocida. The etiology of Pasteurella multocida must be borne in mind in cases of sepsis in immunodeficient individuals, such as the cirrhotic patient, as well as exposure to domestic animals.
Assuntos
Hospedeiro Imunocomprometido , Cirrose Hepática/complicações , Infecções por Pasteurella/complicações , Pasteurella multocida , Úlcera Cutânea/complicações , Idoso , Animais , Animais Domésticos/microbiologia , Antibacterianos/uso terapêutico , Artrite Infecciosa/microbiologia , Cães , Evolução Fatal , Feminino , Humanos , Cirrose Hepática/microbiologia , Extremidade Inferior , Infecções Oportunistas/transmissão , Infecções por Pasteurella/tratamento farmacológico , Infecções por Pasteurella/imunologia , Sepse/etiologia , Úlcera Cutânea/microbiologia , Líquido Sinovial/microbiologiaRESUMO
The frequency of early-onset neonatal sepsis without prophylaxis is 1-5/1.000 live births. Since year '70 the most frequent causative microorganism is the group B Streptococcus (S. agalactiae, GBS), followed by Escherichia coli. The mortality rate is now reduced to 4% due to the improvement of neonatal intensive care. In the USA, the incidence of GBS early-onset neonatal sepsis has been markedly reduced by the application of the guidelines released by the Centers for Disease Control (CDC). This strategy, however, is not effective on occurrence of late-onset neonatal group B streptococcal disease. In Italy, the application of CDC guidelines is not customary, and different, often complex, protocols of obstetrical-neonatological integrated approach are applied. The frequency of infectious risk has made the GBS a paramount problem for the neonatologist, even for the legal responsibility issues resulting from the multiplicity of possible options. To reach the best level of protection of the newborn against early-onset GBS infection, the working group of providers of prenatal, obstetric, and neonatal care of the functional area of Cuneo issued an integrated protocol, in order to perform the GBS screening with the optimal culture method suggested by CDC guidelines in the highest possible number of pregnant women, and to standardize the obstetrical and neonatal management.
Assuntos
Complicações Infecciosas na Gravidez/diagnóstico , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae , Adulto , Fatores Etários , Algoritmos , Antibacterianos/farmacologia , Clindamicina/farmacologia , Protocolos Clínicos , Eritromicina/farmacologia , Feminino , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Itália , Testes de Sensibilidade Microbiana , Guias de Prática Clínica como Assunto , Gravidez , Prevalência , Reto/microbiologia , Fatores de Risco , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/transmissão , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/isolamento & purificação , Estados Unidos , Vagina/microbiologiaRESUMO
An early presentation of heparan N-sulphatase (SGSH) deficiency (mucopolysaccharidosis IIIA, MPS IIIA) with a prominent and isolated hepato-splenomegaly is described. Molecular analysis detected a nonsense mutation (Y40X) and two de novo missense mutations (E300V; Q307P).
Assuntos
Códon sem Sentido , Mucopolissacaridose III/diagnóstico , Mucopolissacaridose III/genética , Mutação de Sentido Incorreto , Sulfatases/deficiência , Sulfatases/genética , Ecocardiografia , Feminino , Hepatomegalia/diagnóstico , Hepatomegalia/genética , Humanos , Lactente , Piperazinas/farmacologia , Purinas , Citrato de Sildenafila , Esplenomegalia/diagnóstico , Esplenomegalia/genética , Sulfonas , Fatores de Tempo , Vasodilatadores/farmacologiaRESUMO
We report two cases of Acremonium fungemia with proven involvement of the skin and probably of the lung in patients who were both undergoing chemotherapy, one for mantle cell lymphoma and the other for acute lymphoblastic leukemia. Both patients failed amphotericin B deoxycholate treatment and were successfully treated with voriconazole with very mild toxicity.
Assuntos
Acremonium/efeitos dos fármacos , Antifúngicos/uso terapêutico , Fungemia/tratamento farmacológico , Infecções Oportunistas/tratamento farmacológico , Pirimidinas/uso terapêutico , Triazóis/uso terapêutico , Anfotericina B/farmacologia , Anfotericina B/uso terapêutico , Antifúngicos/administração & dosagem , Antifúngicos/farmacologia , Antineoplásicos/uso terapêutico , Feminino , Fungemia/microbiologia , Humanos , Linfoma de Célula do Manto/complicações , Linfoma de Célula do Manto/tratamento farmacológico , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Pirimidinas/administração & dosagem , Pirimidinas/farmacologia , Triazóis/administração & dosagem , Triazóis/farmacologia , VoriconazolRESUMO
The management of invasive aspergillosis in patients with hematological malignancies remains controversial. A major problem is how to manage patients who had invasive aspergillosis during remission induction and consolidation therapy and then undergo SCT. Indeed in these patients the mortality rate related to invasive aspergillosis recurrence remains unacceptably high. We report two cases of patients who underwent remission induction for AML, developed invasive aspergillosis during antifungal prophylaxis with itraconazole, failed amphotericin B deoxycholate and liposomal amphotericin B treatment, were successfully treated with voriconazole and eventually underwent SCT with voriconazole prophylaxis without reactivation of invasive aspergillosis.