Analysis of Candida auris candidemia cases in an Intensive Care Unit of a tertiary hospital.

Candida auris is a multi-resistant emerging fungus. OBJECTIVES: To analyze the relationship between colonization by C. auris and the appearance of invasive candidiasis. Description of the sample of colonized patients, risk factors for colonization and/or infection, and calculation of mortality rates. METHODOLOGY: Longitudinal observational study in an anesthesia intensive care unit in 2018. RESULTS: 2130 patients were admitted. Surveillance studies were positive in 124 patients; 118 cases involved skin colonization and 52 were pharyngeal. Patients with a positive blood culture were identified. A statistically significant association was found between pharyngeal colonization and the appearance of a positive blood culture. There were significant differences between patients with a high Candida Score as a risk factor for candidemia. In total, 67% of pharyngeal carriers negativized at 1 month compared to 21% of cutaneous carriers, who negativized after 3-4 months. Of the patients with positive blood cultures, 70% of non-survivors received only monotherapy, although this difference was not statistically significant due to the small sample size. CONCLUSIONS: The incidence of C. auris, a multi-resistant pathogen that is difficult to diagnose, treat and eradicate, is steadily increasing among critically ill patients. Its status as an emerging threat to global health calls for the urgent implementation of early in-hospital detection systems.

Long-term allergic dermatitis caused by sevoflurane: a clinical report.

BACKGROUND: Allergy to volatile anaesthetics is extremely rare, but capable of damaging the professional career. METHODS: This article presents the case of a 60-year-old surgeon who developed a skin rash on the reverse of hands, which progressively worsened and extended to distant fold areas. Blood tests were normal but for eosinophilia and risen total IgE, with normal specific globulins and skin prick tests for common allergens. After 8 years, a malfunction in the anaesthetic gas scavenging system was found, and symptoms remitted within a week following its replacement. Repeated open application test with sevoflurane led to the appearance of the same lesions in the tested areas and in distant body folds. RESULTS: We hypothesize that the most probable mechanism for the reaction in our patient is systemic allergic contact dermatitis, which is caused by repeated systemic exposure to a hapten that reaches the skin through haematogenous transport in a sensitized patient. CONCLUSIONS: The report aims to warn about the potential aetiological relationship between exposure to inhaled anaesthetics and allergic manifestations with cutaneous symptoms.

[Application of laser CO2 for the treatment of xanthelasma palpebrarum]. / Aplicación de láser CO2 para el tratamiento de xantelasmas palpebrales.

METHOD: We treated 12 patients with bilateral xanthelasmas using an ultra-pulse CO2 laser. They were all extirpated, with no differences between the upper and lower eyelids. There were no cases of ectropion or bleeding. All the patients expressed a high level of satisfaction. DISCUSSION: The use of the laser CO2 is a good therapeutic option for treating xanthelasmas especially those located in the lower eyelid, and in young people. It is a safe treatment for delicate periorbital regions, with a low risk of visible scars, and fewer recurrences. The technique can be performed outside the operating room avoiding the anxiety that is created by surgical intervention.

[Unsuccessful treatment with OK-432 picibanil for orbital lymphangioma]. / Resultado sin éxito en el tratamiento de un linfangioma orbitario con OK-432. Picibanil.

INTRODUCTION: Lymphangioma is a malformation of the lymphatic system. The classic approach is surgery. We report a case of orbital lymphangioma in a girl who was given OK-432 to avoid surgery and its complications. DISCUSSION: OK-432 is a lyophilized mixture of group A Streptococcus pyogenes which produces a fibrosis limited to the lesion with a high cure rate. The main advantages are the easy intra-lesional application. with no scars and or damage of closed areas. Its main disadvantage is a significant local inflammatory reaction.