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1.
Artigo em Inglês | MEDLINE | ID: mdl-39167329

RESUMO

PURPOSE: Few data have been published on the efficacy of linezolid in enterococcal urinary tract infection (e-UTI). The aims of this study were to describe the characteristics of patients with enterococci UTI treated with linezolid, and to evaluate the efficacy and the tolerance of linezolid treatment. METHODS: An observational multicentre retrospective study was conducted in 5 hospitals in France. Patients were included if they met the following criteria: ≥18 years, clinical and microbiological criteria for enterococcal UTI and linezolid treatment > 48 h. Primary outcome was clinical failure. RESULTS: Eighty-one patients were included between January 2015 and December 2021. The median age was 73.0 [64; 83] years and 47 (58%) were men. The median Charlson comorbidity index was 3.00 [2; 6]. E. faecium was reported in 65 (80%) cases and E. faecalis in 26 cases (32%). Polymicrobial infections occurred in 41 (51%) cases. No enterococci was resistant to vancomycin. Before linezolid prescription an empiric antimicrobial treatment was started in 48 (59%) cases and was effective against enterococci in 19/48 (39.5%) patients for a median of 3.5 days [2.0; 4.0]. The median duration of linezolid antibiotic treatment was 13 days [10; 14]. Three adverse events were reported, none were serious but one led to discontinuation of treatment. Treatment failure was reported in 2 cases (2.5%). CONCLUSION: This study provides evidence for efficacy and safety of linezolid in enterococcal UTI.

2.
Ticks Tick Borne Dis ; 15(6): 102383, 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39067329

RESUMO

We report a case of posterior reversible encephalopathy syndrome in an adult patient fulfilling criteria for proven early Lyme neuroborreliosis.

3.
Emerg Microbes Infect ; 13(1): 2373305, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38922299

RESUMO

We report a rare case of confirmed early neurosyphilis with serofast state in HIV-negative patient, with uncontrolled type 2 diabetes mellitus. Syphilitic meningitis was diagnosed initially on serology and cerebrospinal fluid (CSF) analysis. The patient had persistently raised non-treponemal titres on serum with negative CSF venereal disease research laboratory result, following treatment during 3 years of follow-up.


Assuntos
Neurossífilis , Humanos , Neurossífilis/diagnóstico , Neurossífilis/tratamento farmacológico , Neurossífilis/complicações , Masculino , Treponema pallidum/isolamento & purificação , Treponema pallidum/imunologia , Diabetes Mellitus Tipo 2/complicações , Antibacterianos/uso terapêutico , Pessoa de Meia-Idade , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/líquido cefalorraquidiano
4.
Eur J Case Rep Intern Med ; 11(5): 004278, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38715881

RESUMO

Background: Annular erythema is a rare manifestation of leukocytoclastic vasculitis. It may be associated with various drugs, infections, malignancies, or systemic diseases. Case description: A 36-year-old woman with no personal medical history presented with annular erythema with target lesions and petechial purpura. The patient had fever and joint arthralgia. A skin biopsy showed leukocytoclastic vasculitis with IgA deposits on direct immunofluorescence. The diagnosis of immunoglobulin A vasculitis with annular leukocytoclastic vasculitis was made. The patient showed global improvement with topical steroids without relapse. Conclusion: An annular variant of leukocytoclastic vasculitis is a rare manifestation of immunoglobulin A vasculitis. LEARNING POINTS: Annular erythema may reveal an IgA vasculitis.Annular leukocytoclastic vasculitis is a rare manifestation of IgA vasculitis.This presentation is treated with topical steroids.

5.
Pan Afr Med J ; 47: 54, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38646137

RESUMO

Our study aimed to assess the benefit of intrapleural fibrinolysis before resorting to surgery to treat complicated parapneumonic effusion and empyema. We conducted a retrospective and descriptive study, including all patients hospitalized in the intensive care unit (ICU) of the Abderhaman Mami hospital, Tunisia for empyema treated with instillation of intrapleural fibrinolytic therapy between the 1st January 2000 and 31st December 2016. In all patients, empyema was diagnosed on clinical features, imaging findings (chest X-ray, thoracic echography and/or computed tomography (CT), and microbiological data. The fibrinolytic agent used was streptokinase. The efficiency of intrapleural fibrinolytic therapy was judged on clinical and paraclinical results. Among 103 cases of complicated parapneumonic effusion and empyema, 34 patients were included. The mean age was 34 years [15-81] with a male predominance (sex ratio at 2.77). Median APACH II score was 9. Fifty (50%) of the patients (n=17) had no past medical history; addictive behavior was described in 17 patients (50%). All patients were admitted for acute respiratory failure and one patient for septic shock. Pleural effusion was bilateral in 7 patients. Bacteria isolated were Streptococcus pneumonia (6 cases), Staphylococcus aureus (3 cases, including one which methicillin-resistant), Staphylococcus epidermidis (1 case), anaerobes (5 cases), and Klebsiella pneumoniae (1 case). First-line antimicrobial drug therapy was amoxicillin-clavulanate in 20 patients. A chest drain was placed in all cases in the first 38 hours of ICU admission. The median number of fibrinolysis sessions was 4 [2-9] and the median term of drainage was 7 days [3-16]. No side effects were observed. Video-assisted thoracoscopic surgery was proposed in 5 patients. The median length of hospitalization stay was 15 days [6-31]. One patient died due to multi-organ failure.


Assuntos
Empiema Pleural , Fibrinolíticos , Tempo de Internação , Derrame Pleural , Estreptoquinase , Terapia Trombolítica , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Fibrinolíticos/administração & dosagem , Estreptoquinase/administração & dosagem , Derrame Pleural/tratamento farmacológico , Derrame Pleural/terapia , Empiema Pleural/tratamento farmacológico , Empiema Pleural/terapia , Idoso , Tunísia , Terapia Trombolítica/métodos , Adulto Jovem , Adolescente , Tempo de Internação/estatística & dados numéricos , Idoso de 80 Anos ou mais , Unidades de Terapia Intensiva/estatística & dados numéricos , Resultado do Tratamento
6.
Braz J Infect Dis ; 28(2): 103739, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38679059

RESUMO

Chlamydia psittaci ‒ related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional exposition to birds. The diagnosis was confirmed with positive specific polymerase chain reaction in bronchoalveolar lavage. The patient was treated with spiramycin for two weeks with anti-inflammatory treatment for myocarditis for three months. Clinical and biological improvement was rapidly observed followed by normalization of electrocardiogram and chest CT scan. No relapse was reported for over a two-year follow-up.


Assuntos
Chlamydophila psittaci , Miocardite , Psitacose , Humanos , Masculino , Miocardite/microbiologia , Miocardite/tratamento farmacológico , Miocardite/diagnóstico por imagem , Psitacose/microbiologia , Psitacose/tratamento farmacológico , Psitacose/diagnóstico , Chlamydophila psittaci/isolamento & purificação , Adulto , Reação em Cadeia da Polimerase , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Doença Aguda , Adulto Jovem
8.
Eur J Clin Microbiol Infect Dis ; 43(6): 1051-1059, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38530466

RESUMO

INTRODUCTION: In case of pneumonia, some biological findings are suggestive for Legionnaire's disease (LD) including C-reactive protein (CRP). A low level of CRP is predictive for negative Legionella Urinary-Antigen-Test (L-UAT). METHOD: Observational retrospective study in Nord-Franche-Comté Hospital with external validation in Besançon University Hospital, France which included all adults with L-UAT performed during January 2018 to December 2022. The objective was to determine CRP optimal threshold to predict a L-UAT negative result. RESULTS: URINELLA included 5051 patients (83 with positive L-UAT). CRP optimal threshold was 131.9 mg/L, with a negative predictive value (NPV) at 100%, sensitivity at 100% and specificity at 58.0%. The AUC of the ROC-Curve was at 88.7% (95% CI, 86.3-91.1). External validation in Besançon Hospital patients showed an AUC at 89.8% (95% CI, 85.5-94.1) and NPV, sensitivity and specificity was respectively 99.9%, 97.6% and 59.1% for a CRP threshold at 131.9 mg/L; after exclusion of immunosuppressed patients, index sensitivity and NPV reached also 100%. CONCLUSION: In case of pneumonia suspicion with a CRP level under 130 mg/L (independently of the severity) L-UAT is useless in immunocompetent patients with a NPV at 100%. We must remain cautious in patients with symptoms onset less than 48 h before CRP dosage.


Assuntos
Proteína C-Reativa , Legionella pneumophila , Doença dos Legionários , Humanos , Doença dos Legionários/diagnóstico , Doença dos Legionários/microbiologia , Legionella pneumophila/isolamento & purificação , Proteína C-Reativa/análise , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Sensibilidade e Especificidade , Sorogrupo , Adulto , França , Curva ROC , Valor Preditivo dos Testes
9.
Epidemiol Infect ; 152: e46, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38356388

RESUMO

We report an outbreak of confirmed Mycoplasma pneumoniae community-acquired pneumonia (CAP) in Nord Franche-Comté Hospital, France, from 14 November 2023 to 31 January 2024. All 13 inpatients (11 adults with a mean age of 45.5 years and 2 children) were diagnosed with positive serology and/or positive reverse transcription polymerase chain reaction (RT-PCR) on respiratory specimens. All patients were immunocompetent and required oxygen support with a mean duration of oxygen support of 6.2 days. Two patients were transferred to the intensive care unit (ICU) but were not mechanically ventilated. Patients were treated with macrolides (n = 12, 92.3%) with recovery in all cases. No significant epidemiological link was reported in these patients.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia por Mycoplasma , Criança , Adulto , Humanos , Pessoa de Meia-Idade , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Hospitais , Oxigênio , França/epidemiologia , Surtos de Doenças
11.
Biomedicines ; 12(1)2024 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-38255222

RESUMO

Eosinophilic ascites is a rare disorder, reported in both adult and pediatric patients, characterized by high eosinophil counts in the peritoneal fluid. Eosinophilic ascites appears as a manifestation of various diseases such as parasitic and fungal infections, malignancy, and hypereosinophilic syndrome. It also represents an uncommon manifestation of eosinophilic gastroenteritis, usually treated with corticosteroids. We present the case of a 16-year-old woman with abdominal distention related to abundant ascites. Further work-up concluded that it was eosinophilic gastroenteritis complicated with eosinophilic ascites. The patient was on oral steroids for three weeks, but various abdominal relapses were observed, leading to the introduction of benralizumab, as a steroid-sparing therapy with a favorable outcome.

13.
Braz. j. infect. dis ; 28(2): 103739, 2024. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1564145

RESUMO

ABSTRACT Chlamydia psittaci - related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional exposition to birds. The diagnosis was confirmed with positive specific polymerase chain reaction in bronchoalveolar lavage. The patient was treated with spiramycin for two weeks with anti-inflammatory treatment for myocarditis for three months. Clinical and biological improvement was rapidly observed followed by normalization of electrocardiogram and chest CT scan. No relapse was reported for over a two-year follow-up.

14.
Viruses ; 15(11)2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-38005897

RESUMO

We highlighted in this current paper similar prolonged respiratory presentation with COVID-19 pneumonia in four severely immunocompromised patients currently being treated with anti-CD20 monoclonal antibodies (mAbs), such as ocrelizumab and rituximab, for multiple sclerosis or rheumatoid polyarthritis. Real-time reverse transcription-polymerase chain reaction on a nasopharyngeal swab specimen was negative in all patients. SARS-CoV-2 infection was confirmed from bronchoalveolar lavage fluid. A high titer of post-vaccine COVID-19 convalescent plasma was administered with complete recovery in all patients.


Assuntos
Antineoplásicos , COVID-19 , Humanos , COVID-19/diagnóstico , COVID-19/terapia , SARS-CoV-2/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Soroterapia para COVID-19 , Anticorpos Monoclonais/uso terapêutico , Nasofaringe , Anticorpos Antivirais , Teste para COVID-19
15.
Infect Med (Beijing) ; 2(2): 148-152, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38013741

RESUMO

In this current case series, all Coronavirus disease 2019 patients had predominant ophthalmological presentation. Only one patient sough care for concomitant respiratory symptoms. We reported herein 2 cases with cranial oculomotor nerve palsy, one patient with confirmed diagnosis of branch retinal vein occlusion, and the last one patient presenting for acute kareto-conjunctivitis with several recurrences, which was unsuccessfully treated with steroids and requiring cliclosporin. These case series highlights the importance of collecting a careful history of ocular presentation, including exposures to possible infected patients with SARS-CoV-2. This this will lead to an early diagnosis and treatment and to make appropriate infection control measures.

16.
Clin Case Rep ; 11(11): e8111, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38028102

RESUMO

We reported herein a case of isolated cerebral actinomycosis in a 54-year-old immunocompetent man. Brain MRI showed a left frontal intra-axial lesion and perilesional edema. We performed an open biopsy of the left frontal enhancing lesion. Intraoperative findings showed a yellowish, malleable, and capsulated lesion that was well defined with surrounding normal tissue within pus inside and lacked any necrotic content. MR spectroscopy showed a high level of choline, lactate, and lipid peaks with a choline/N-Acetylaspartic acid ratio of 1.8. The diagnosis was confirmed histologically, and the patient was treated successfully for 3 months after surgical aspiration. Surgical management allowed to confirm the diagnosis with a shorten antibiotics, a rapid resolution of symptoms, and a complete recovery.

17.
Emerg Infect Dis ; 29(11)2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37877803

RESUMO

Campylobacter fetus accounts for 1% of Campylobacter spp. infections, but prevalence of bacteremia and risk for death are high. To determine clinical features of C. fetus infections and risks for death, we conducted a retrospective observational study of all adult inpatients with a confirmed C. fetus infection in Nord Franche-Comté Hospital, Trevenans, France, during January 2000-December 2021. Among 991 patients with isolated Campylobacter spp. strains, we identified 39 (4%) with culture-positive C. fetus infections, of which 33 had complete records and underwent further analysis; 21 had documented bacteremia and 12 did not. Secondary localizations were reported for 7 (33%) patients with C. fetus bacteremia, of which 5 exhibited a predilection for vascular infections (including 3 with mycotic aneurysm). Another 7 (33%) patients with C. fetus bacteremia died within 30 days. Significant risk factors associated with death within 30 days were dyspnea, quick sequential organ failure assessment score >2 at admission, and septic shock.


Assuntos
Bacteriemia , Infecções por Campylobacter , Adulto , Humanos , Campylobacter fetus , França/epidemiologia , Bacteriemia/epidemiologia , Infecções por Campylobacter/epidemiologia , Dispneia , Estudos Observacionais como Assunto
18.
New Microbes New Infect ; 54: 101177, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37727501

RESUMO

•Lactobacillus rhamnosus bacteremia was diagnosed in a patient with radiation enteritis after prophylactic probiotic consumption.•L. rhamnosus was identified by culture and MALDI-TOF-MS.•L. rhamnosus may have high MIC values for amoxicillin.•In case of L. rhamnosus bacteremia, bowel diseases should be considered as a possible source of infections.

19.
Emerg Infect Dis ; 29(4): 860-862, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36918376

RESUMO

A 26-year-old patient in France who worked as a butcher sought care initially for erythema multiforme. Clinical examination revealed a nodule with a crusty center, which upon investigation appeared to be an orf nodule. Diagnosis was confirmed by PCR. The patient was not isolated and had a favorable outcome after basic wound care.


Assuntos
Ectima Contagioso , Eritema Multiforme , Mpox , Animais , Ovinos , Humanos , Adulto , Ectima Contagioso/diagnóstico , Ectima Contagioso/epidemiologia , Eritema Multiforme/diagnóstico , Eritema Multiforme/epidemiologia , França/epidemiologia , Surtos de Doenças
20.
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