RESUMEN
Stenotrophomonas maltophilia can present as bacteremia, respiratory tract infection, urinary tract infection, soft tissue and wound infections, bone and joint infections, meningitis, and endocarditis especially in immunosuppressed patients and those with underlying medical conditions. The incidence and impact of S. maltophilia in young children with heart disease are poorly defined. A single center retrospective observational study was conducted in infants <180 days of age with positive S. maltophilia cultures over a period of 5 years. The overall incidence for S. maltophilia infection was 0.8 % (n = 32/3656). Among 32 identified infants, there were 47 episodes of S. maltophilia infection 66 % of infants had prior exposure to broad spectrum antibiotics. 97 % of positive isolates were susceptible to trimethoprim/sulfamethoxazole and 91 % to levofloxacin as well as ticarcillin/clavulanate. Ventilator-free days and absolute lymphocyte count prior to acquiring infection were significantly lower in non-survivors than in survivors. 100 % of survivors had clearance of positive cultures compared to 50 % in non-survivors (p < 0.05). The crude all-cause mortality rate was 37.5 %. All non-survivors had increased length of ICU stay and duration of mechanical ventilation and had delayed clearance of infection and required longer duration of treatment.
Asunto(s)
Antibacterianos/administración & dosificación , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/mortalidad , Stenotrophomonas maltophilia/aislamiento & purificación , Antibacterianos/uso terapéutico , Ácidos Clavulánicos/administración & dosificación , Femenino , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/epidemiología , Humanos , Incidencia , Lactante , Recién Nacido , Unidades de Cuidados Intensivos , Levofloxacino/administración & dosificación , Masculino , Estudios Retrospectivos , Factores de Riesgo , Stenotrophomonas maltophilia/efectos de los fármacos , Ticarcilina/administración & dosificación , Combinación Trimetoprim y Sulfametoxazol/administración & dosificaciónRESUMEN
Murine typhus in the pediatric population has increased substantially in recent years. The most common clinical presentation of murine typhus includes fever, rash, headaches and myalgias. Murine typhus presenting with predominant myositis and/or encephalopathy is rare. It is important to recognize unusual clinical manifestations of murine typhus in children for early diagnosis and treatment.
Asunto(s)
Antifúngicos/uso terapéutico , Enfermedades Endémicas , Histoplasmosis/diagnóstico , Infecciones Fúngicas Invasoras/diagnóstico , Hígado/patología , Biopsia con Aguja , Insuficiencia de Crecimiento/diagnóstico , Insuficiencia de Crecimiento/etiología , Femenino , Estudios de Seguimiento , Histoplasma/aislamiento & purificación , Histoplasmosis/tratamiento farmacológico , Humanos , Inmunohistoquímica , Lactante , Infecciones Fúngicas Invasoras/tratamiento farmacológico , Hígado/fisiopatología , Enfermedades Raras , Medición de Riesgo , Resultado del Tratamiento , Vómitos/diagnóstico , Vómitos/etiología , Pérdida de PesoRESUMEN
We report a case of a 5-year-old girl with invasive colitis and secondary bacteremia caused by group A beta-hemolytic streptococcus. Although group A beta-hemolytic streptococcus is occasionally isolated from stool, it is a rare cause of colitis. This is the first report of group A beta-hemolytic streptococcus pancolitis with secondary bacteremia.