RESUMO
PURPOSE: West Nile virus (WNV) transmission through organ transplantation occurs rarely and screening of organ donors for WNV infection remains controversial. This report describes the case of WNV encephalitis in a kidney recipient and the case of asymptomatic WNV infection in the organ donor, both observed at Treviso Hospital, northeastern Italy. After briefly reviewing the literature, we discuss the implications for WNV screening. METHODS: We reviewed medical, laboratory and epidemiological records at our hospital, and the literature concerning cases of organ-transmitted WNV infections and WNV screening of organ donors in Italy and worldwide. RESULTS: The kidney recipient was the first confirmed case of WNV infection notified in northeastern Italy in 2011, and the first case of WNV infection in a cluster of four transplant recipients who acquired the infection from a common organ donor. The organ donor, whose WNV infection was only retrospectively diagnosed by IgM detection, represents the index case of a WNV outbreak in the Treviso Province. Screening of her blood prior to organ recovery did not show detectable levels of WNV nucleic acid with the use of quantitative real-time polymerase chain reaction. CONCLUSIONS: This report emphasizes that transplant-acquired WNV neuroinvasive disease can be particularly severe. We suggest that pre-procurement screening of organ donors by testing blood with both WNV IgM capture ELISA and a sensitive nucleic acid testing should be adopted during the transmission season in the present Italian epidemiological setting.
Assuntos
Doadores de Tecidos , Transplante , Transplantes/efeitos adversos , Febre do Nilo Ocidental/transmissão , Vírus do Nilo Ocidental/isolamento & purificação , Adulto , Anticorpos Antivirais/sangue , Coma/virologia , Feminino , Humanos , Itália , Masculino , RNA Viral/sangue , Transplantes/virologia , Febre do Nilo Ocidental/diagnóstico , Febre do Nilo Ocidental/virologiaAssuntos
Acetamidas/efeitos adversos , Acetamidas/uso terapêutico , Acidose Láctica/induzido quimicamente , Anti-Infecciosos/efeitos adversos , Discite/tratamento farmacológico , Oxazolidinonas/efeitos adversos , Oxazolidinonas/uso terapêutico , Tuberculose/tratamento farmacológico , Acidose Láctica/terapia , Idoso de 80 Anos ou mais , Discite/microbiologia , Feminino , Humanos , Linezolida , Vértebras Lombares/microbiologia , Vértebras Lombares/patologia , Mycobacterium tuberculosis/isolamento & purificação , Resultado do Tratamento , Tuberculose/microbiologia , Tuberculose/patologiaRESUMO
We have assessed levofloxacin penetration in cerebrospinal fluid (CSF) and the liquor-to-plasma ratio (C(L)/C(P)) at 2 hours after dosing in 5 patients with spontaneous acute bacterial meningitis. CSF levofloxacin concentration at 2 hours after dosing was 1.99+/-0.67 microg/mL, and the C(L)/C(P) at 2 hours after dosing was 0.34+/-0.09.
Assuntos
Anti-Infecciosos/líquido cefalorraquidiano , Levofloxacino , Meningite devida a Escherichia coli/líquido cefalorraquidiano , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Pneumocócica/líquido cefalorraquidiano , Ofloxacino/líquido cefalorraquidiano , Doença Aguda , Adulto , Idoso , Anti-Infecciosos/farmacocinética , Anti-Infecciosos/uso terapêutico , Feminino , Humanos , Masculino , Meningite devida a Escherichia coli/tratamento farmacológico , Meningite Meningocócica/tratamento farmacológico , Meningite Pneumocócica/tratamento farmacológico , Pessoa de Meia-Idade , Ofloxacino/farmacocinética , Ofloxacino/uso terapêuticoAssuntos
Anti-Infecciosos/uso terapêutico , Levofloxacino , Meningites Bacterianas/tratamento farmacológico , Ofloxacino/uso terapêutico , Rhodococcus equi/isolamento & purificação , Derivação Ventriculoperitoneal/efeitos adversos , Infecções por Actinomycetales/tratamento farmacológico , Infecções por Actinomycetales/microbiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , Meningites Bacterianas/microbiologia , Pessoa de Meia-Idade , Derivação Ventriculoperitoneal/instrumentaçãoRESUMO
Cytomegalovirus (CMV)-associated transverse myelitis is rare in immunocompetent patients. The case of a 54-year-old man is reported here who developed acute transverse myelitis with cerebrospinal fluid (CSF) alterations, suggesting a central nervous system infection. CMV-IgM positivity in serum and CMV isolated from blood, positive CMV PCR and positivity for pp65 antigen in blood, without viral antigens in the CSF and a positive response to therapy with ganciclovir (followed by progressive improvement) supported the diagnosis.
Assuntos
Infecções por Citomegalovirus/virologia , Citomegalovirus , Mielite Transversa/virologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Antígenos Virais/imunologia , Citomegalovirus/imunologia , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/imunologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Mielite Transversa/sangue , Mielite Transversa/tratamento farmacológico , Mielite Transversa/imunologia , Fosfoproteínas/imunologia , Proteínas da Matriz Viral/imunologiaRESUMO
We describe patient with Echinococcus granulosus disease primary localized on the back. This case is uncommon because of the lack of risk exposure history and the sole muscular localization. The patient received several surgical operations on the back, without eradication of the infestation. At the end we discuss the clinical considerations that induced the choice of the usual medical therapy