RESUMO
OBJECTIVES: We aimed to describe the efficacy and safety of dalbavancin in treatment of patients with diabetes-related foot osteomyelitis with bone culture confirmation. PATIENTS AND METHODS: Between January 2019 and December 2021, all consecutive patients receiving at least one 1500 mg dose of dalbavancin for diabetes-related foot osteomyelitis were included in a retrospective study. Remission was defined as absence of relapsing infection or need for surgery at the initial or a contiguous site during 6-month follow-up from the last dose of dalbavancin. RESULTS: Thirteen patients were included. Eleven (85%) patients were surgically treated. Six (46%) patients received dalbavancin as first-line treatment and 7 (54%) as second-line treatment due to adverse events related to previous treatments. One adverse event was reported. At 6-month follow-up, 11 patients were evaluable and 9 (82%) were in remission. CONCLUSIONS: In the study, dalbavancin was well-tolerated and showed microbiological and clinical efficacy.
Assuntos
Diabetes Mellitus , Osteomielite , Teicoplanina/análogos & derivados , Humanos , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Terapia de Salvação , Osteomielite/tratamento farmacológico , Diabetes Mellitus/induzido quimicamente , Diabetes Mellitus/tratamento farmacológicoRESUMO
INTRODUCTION: Mycobacterium mucogenicum is a rare but emerging cause of infections, especially in immunocompromised patients. CASE PRESENTATION: We describe a new case of M. mucogenicum catheter-related bloodstream infection in a 34-year-old woman with ovarian cancer. M. mucogenicum was at first considered as a contaminant, and susceptibility testing was not performed. Usual susceptibility of M. mucogenicum motivated prescription of clarithromycin and moxifloxacin. Finally, our isolate was confirmed susceptible to both drugs. Clinical outcome was favorable with no relapse of infection after antibiotics discontinuation despite concomitant chemotherapy. CONCLUSION: Our case illustrates the need for a clinician-microbiologist dialogue in case of suspected M. mucogenicum infection to avoid delaying appropriate management.
Assuntos
Bacteriemia/diagnóstico , Infecções Relacionadas a Cateter/diagnóstico , Técnicas de Laboratório Clínico , Infecções por Mycobacterium/diagnóstico , Micobactérias não Tuberculosas/isolamento & purificação , Papel Profissional , Adulto , Antibacterianos/uso terapêutico , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Carcinoma Epitelial do Ovário/complicações , Carcinoma Epitelial do Ovário/tratamento farmacológico , Carcinoma Epitelial do Ovário/microbiologia , Infecções Relacionadas a Cateter/complicações , Infecções Relacionadas a Cateter/tratamento farmacológico , Técnicas de Laboratório Clínico/normas , Diagnóstico Diferencial , Feminino , Humanos , Hospedeiro Imunocomprometido , Testes de Sensibilidade Microbiana , Infecções por Mycobacterium/complicações , Infecções por Mycobacterium/tratamento farmacológico , Micobactérias não Tuberculosas/efeitos dos fármacos , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/microbiologiaRESUMO
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates. Because of its high toxicity, the European Union withdrew it from its market in 2007. The aim of this study is to analyze all cases of paraquat poisoning hospitalized in French Guiana in order to assess their incidence and main characteristics.Medical records of all paraquat intoxicated patients hospitalized from 2008 until 2015 were reviewed in this retrospective study.Demographics, clinical presentation, and laboratory data were evaluated.A total of 62 cases were reviewed. The incidence of paraquat poisoning was 3.8/100,000âinhabitants/year. There were 44 adults and 18 children younger than 16 years of age. The median ages were 31 years [18.08-75.25] in adults and 13.4 years [0.75-15.08] in children, respectively. The median duration of hospitalization was longer in children [15.5 days (1-24)] than in adults [2 days (1-30)], Pâ<â.01. The majority of cases was due to self-poisoning (84%).Children had ingested a lower quantity of paraquat [48.8âmg/kg (10-571.1)] than adults [595.8âmg/kg (6-3636.4), Pâ=â.03]. There were more deaths among adults (65%) than in children (22%), Pâ=â.004. The severity and outcome was determined primarily by the amount of paraquat ingested.In conclusion, French Guiana has the largest cohort of paraquat poisonings in the European Union. The major factor affecting the prognosis of patients was the ingested amount of paraquat. The administration of activated charcoal or Pemba, in situ, within the first hour after ingestion of paraquat is essential.
Assuntos
Overdose de Drogas/diagnóstico , Overdose de Drogas/terapia , Paraquat/intoxicação , Adolescente , Adulto , Idoso , Carvão Vegetal/administração & dosagem , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Overdose de Drogas/mortalidade , Feminino , Guiana Francesa , Humanos , Incidência , Lactente , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tentativa de Suicídio/estatística & dados numéricos , Taxa de Sobrevida , Adulto JovemRESUMO
BACKGROUND: Community-onset candidemia constitute a distinct clinical entity the incidence of which is increasing. Contribution of non-albicans Candida species is rising. CASE PRESENTATION: We describe here the first reported case of community acquired fungemia due to Candida pulcherrima. Identification to the species level was performed by MALDI-TOF mass spectrometry. Treatment with fluconazole was successful. CONCLUSION: This case confirms the pathogenic role of C. pulcherrima and the contribution of MALDI-TOF mass spectrometry for identification of rare Candida species.