Disseminated Cryptococcosis Incorrectly Managed: a Case Report / 대한의진균학회지

Disseminated cryptococcosis is a rare fungal infection, which mainly occurs in immunocompromised patients, and the diagnosis is difficult. Therefore, it is less likely to be considered in immunocompetent patients. Here, we present a case of fatal cryptococcal infection of the pleural fluid and ascites in a patient seronegative for HIV. The patient was a 45-year old man who was followed for Crohn's disease and treated with steroids and an immunosuppressant (azathioprine). The culture of pleural and ascites fluids showed the presence of yeasts colonies identified as Cryptococcus neoformans. Bacteriological examination of the blood culture or cerebrospinal fluid (CSF) was not prescribed. The HIV serology was negative. At the fourth day of treatment, the patient died because of the deterioration of neurological and hepatocellular functions. The main diagnostic problems that led to this fatal outcome were non-suspicion of an at-risk patient, lack of microbiological analysis of the blood or CSF, and inadequate antifungal therapy.

Profile and Antibiotic Susceptibility of Bacteria Isolates in Burn Patients Hospitalized in a Moroccan Hospital: A Cross-sectional Study.

OBJECTIVE: The aim of this cross-sectional study is to assess the epidemiological profile and antibiotic susceptibility of bacteria isolates in burn patients hospitalized from 2007 to 2015 in a Moroccan hospital. MATERIALS AND METHODS: Of 627 samples, 451 wounds, 126 blood cultures, and 50 catheter samples were analyzed. A total of 610 microorganisms were isolated from a total of 108 patients. RESULTS: The most prevalent isolates were Pseudomonas aeruginosa (18.5%), Acinetobacter baumannii (14.7%), and Staphylococcus aureus (14.5%); a high prevalence (31.1%) of methicillin-resistant S aureus also was found. Imipenem followed by piperacillin/tazobactam performed best against P aeruginosa. A baumannii isolates showed a very high resistance to imipenem and all beta-lactams antibiotics but were sensitive to colistin. CONCLUSIONS: The profile of this bacterial ecology shows there are resistant species requiring frequent use of second-line antibiotics and strengthening of aseptic procedures in burn treatments.