RESUMO
Febrile neutropenia remains a major cause of morbidity and mortality in patients receiving chemotherapy. Major prophylactic strategies include granulocyte colony-stimulating factor and antibiotics, the most widely used of which are fluoroquinolones. While fluoroquinolone prophylaxis has been shown to be effective in areas where fluoroquinolone resistance is low, this same efficacy has not been proven in areas where resistance is high, such as in Asia. Given the increase in antimicrobial resistance with the use of prophylaxis, the risks and benefits of this strategy need to be carefully considered. This review presents the evidence for and against fluoroquinolone prophylaxis in areas of high fluoroquinolone resistance.
Assuntos
Antibacterianos/uso terapêutico , Febre/prevenção & controle , Fluoroquinolonas/uso terapêutico , Neutropenia/prevenção & controle , Antibioticoprofilaxia , Ásia , Povo Asiático , Resistência a Medicamentos , HumanosAssuntos
Anemia Ferropriva/complicações , Doença de Depósito de Glicogênio/complicações , Gota/complicações , Hepatomegalia/complicações , Adulto , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico por imagem , Colchicina/uso terapêutico , Doença de Depósito de Glicogênio/diagnóstico por imagem , Doença de Depósito de Glicogênio/dietoterapia , Gota/diagnóstico por imagem , Gota/tratamento farmacológico , Supressores da Gota/uso terapêutico , Hepatomegalia/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios X , UltrassonografiaAssuntos
Fístula Arteriovenosa/diagnóstico , Debilidade Muscular/etiologia , Neurofibromatose 1/diagnóstico , Lesões do Ombro , Artéria Vertebral/lesões , Idoso , Angiografia Digital , Fístula Arteriovenosa/etiologia , Vértebras Cervicais , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Debilidade Muscular/diagnóstico , Neurofibromatose 1/complicações , Tomografia Computadorizada por Raios X , Extremidade Superior , Artéria Vertebral/anormalidadesRESUMO
Fungal pulmonary infections are becoming more prevalent as a consequence of the rising prevalence of immunocompromised patients. Besides ubiquitous opportunistic fungi such as Aspergillus spp and geographically delimited mycoses, fungi that were previously thought to be of uncertain pathogenicity, such as hyaline and dematiaceous molds, are increasingly being diagnosed as the causes of invasive disease in profoundly immunosuppressed hosts. Overall progress in the clinical management of fungal pulmonary infections has been slow compared with other areas of infectious diseases. However, recent encouraging advances in fungal diagnostics and therapeutics have resulted in improved clinical outcomes, particularly in vulnerable patient populations such as solid organ or allogeneic hematopoietic stem cell transplant recipients. This article provides an overview of endemic mycoses and other emerging fungal pulmonary infections. Recent developments in terms of the diagnosis and clinical management of these infections are also discussed.