Assuntos
Perna (Membro) , Faringite , Febre/etiologia , Humanos , Dor/etiologia , Faringite/etiologiaAssuntos
Penfigoide Bolhoso/epidemiologia , Pênfigo/epidemiologia , Centros Médicos Acadêmicos , Comorbidade , Humanos , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/etnologia , Penfigoide Bolhoso/mortalidade , Pênfigo/tratamento farmacológico , Pênfigo/etnologia , Pênfigo/mortalidade , Estudos RetrospectivosAssuntos
Diabetes Mellitus/epidemiologia , Glucocorticoides/efeitos adversos , Hiperglicemia/epidemiologia , Penfigoide Bolhoso/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/etiologia , Relação Dose-Resposta a Droga , Feminino , Glucocorticoides/administração & dosagem , Humanos , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Hiperglicemia/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/sangue , Penfigoide Bolhoso/complicações , Penfigoide Bolhoso/mortalidade , Estudos Retrospectivos , Fatores de Risco , Singapura/epidemiologiaAssuntos
Diagnóstico Diferencial , Linfoma Difuso de Grandes Células B/diagnóstico , Paniculite/diagnóstico por imagem , Biópsia , Antígenos CD79/metabolismo , Sistema Nervoso Central , Feminino , Humanos , Imuno-Histoquímica , Inflamação , Antígeno Ki-67/metabolismo , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , PrognósticoRESUMO
Multidrug-resistant Salmonella is a well-recognised problem worldwide, especially in developing countries such as India, where non-typhoidal Salmonella infections and enteric fever are endemic. Antimicrobial resistance, particularly to fluoroquinolones, is common and leads to the frequent use of alternative agents, such as azithromycin. We herein describe the first reported case of azithromycin-resistant Salmonella gastroenteritis in a Singaporean patient.
Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Farmacorresistência Bacteriana , Fluoroquinolonas/uso terapêutico , Infecções por Salmonella/tratamento farmacológico , Salmonella enterica/isolamento & purificação , Idoso , Gastroenterite/tratamento farmacológico , Gastroenterite/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Salmonella enterica/efeitos dos fármacos , SingapuraRESUMO
BACKGROUND: Infections are common in bullous pemphigoid and contribute to significant mortality. OBJECTIVES: We sought to define the spectrum of infectious complications and to identify associated risk factors in a bullous pemphigoid cohort. DESIGN: A retrospective cohort study conducted at an academic medical center. RESULTS: In all, 97 patients were included. Infectious complications occurred in 54 patients (56%) and the median duration from diagnosis to first episode of infection was 3 months. Bacteremia occurred in 14 patients (26%) and 26 of 30 deaths (87%) were attributable to infections. On univariate analysis, significant risk factors include low Karnofsky score (<60) (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.5-8.3; P < .01), high Charlson comorbidity index score (≥6) (OR 2.4, 95% CI 1.1-5.5; P = .04), and dementia (OR 4.9, 95% CI 1.5-15.8; P = .01). On multivariate analysis, low Karnofsky score and dementia remained significant with an OR of 3.3 (95% CI 1.1-10.0; P = .03) and OR of 4.2 (95% CI 1.2-14.7; P = .03), respectively. LIMITATIONS: Limitations include potential selection bias as a result of study design and primary outcome measures focused on significant infections requiring hospitalizations. Minor infections were not included. CONCLUSIONS: Identified risk factors for infectious complications include functional impairment and the presence of dementia, which may allow for better risk stratification and individualized treatment of bullous pemphigoid.
