RESUMO
BACKGROUND: Little is known about characteristics of seasonal human coronaviruses (HCoVs) (NL63, 229E, OC43, and HKU1) after allogeneic stem cell transplantation (allo-HSCT). METHODS: This was a collaborative Spanish and European bone marrow transplantation retrospective multicenter study, which included allo-HSCT recipients (adults and children) with upper respiratory tract disease (URTD) and/or lower respiratory tract disease (LRTD) caused by seasonal HCoV diagnosed through multiplex polymerase chain reaction assays from January 2012 to January 2019. RESULTS: We included 402 allo-HSCT recipients who developed 449 HCoV URTD/LRTD episodes. Median age of recipients was 46 years (range, 0.3-73.8 years). HCoV episodes were diagnosed at a median of 222 days after transplantation. The most common HCoV subtype was OC43 (nâ =â 170 [38%]). LRTD involvement occurred in 121 episodes (27%). HCoV infection frequently required hospitalization (18%), oxygen administration (13%), and intensive care unit (ICU) admission (3%). Three-month overall mortality after HCoV detection was 7% in the whole cohort and 16% in those with LRTD. We identified 3 conditions associated with higher mortality in recipients with LRTD: absolute lymphocyte count <0.1 × 109/mL, corticosteroid use, and ICU admission (hazard ratios: 10.8, 4.68, and 8.22, respectively; Pâ <â .01). CONCLUSIONS: Seasonal HCoV after allo-HSCT may involve LRTD in many instances, leading to a significant morbidity.
Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Transplante de Células-Tronco Hematopoéticas , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Adolescente , Adulto , Idoso , Betacoronavirus , Criança , Pré-Escolar , Coronavirus Humano 229E , Infecções por Coronavirus/mortalidade , Coronavirus Humano NL63 , Coronavirus Humano OC43 , Feminino , Hospitalização , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/mortalidade , Estudos Retrospectivos , Fatores de Risco , Estações do AnoRESUMO
We describe a case of primary penis lymphoma in a 71 yr old man. We review the bibliography and we emphasize the peculiarity and different sorts of clinical presentation. The initial symptoms were insidious. Physical examination and ultrasound findings made it indistinguishable from other tumors. A MRI confirmed the presence of a tumoral process with a homogeneous density in the distal part of the penis whose biopsy with immune histological processing confirmed us the diagnosis of primary penis lymphoma. The combined treatment with chemotherapy and radiotherapy allowed preserving the sexual organ and being without disease at 48 month of follow up.
Assuntos
Linfoma Difuso de Grandes Células B , Neoplasias Penianas , Idoso , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/cirurgiaRESUMO
BACKGROUND: Bacterial infection remains a frequent complication in patients receiving a hematopoietic stem cell transplantation (HSCT). However, the impact of the antibacterial prophylaxis mortality in these patients is controversial. PATIENTS AND METHODS: Retrospective comparison of 2 consecutive groups of patients undergoing HSCT receiving (n=132) or not (n=107) antibacterial prophylaxis with levofloxacin. RESULTS: 41% of patients receiving prophylaxis with levofloxacin had microbiologically documented infection (MDI) with bacteremia, compared with 40% of those not receiving levofloxacin. The frequency of gram-negative bacteremia was 11 and 38%, the resistance to levofloxacin was 39 and 14%, and the mortality was 8 and 7%, respectively. CONCLUSIONS: In our experience, the use of levofloxacin as prophylaxis in HSCT was associated with a lower frequency of gram-negative bacteremia but was not associated with a decreased rate of MDI and did not influence their outcome. In contrast, there was an increase in quinolone resistance in patients treated with levofloxacin.