Asunto(s)
Candida parapsilosis/aislamiento & purificación , Candidemia/complicaciones , Endocarditis/complicaciones , Glomeruloesclerosis Focal y Segmentaria/etiología , Prótesis Valvulares Cardíacas/efectos adversos , Infecciones Relacionadas con Prótesis/complicaciones , Lesión Renal Aguda/etiología , Adulto , Anticuerpos Anticitoplasma de Neutrófilos , Antifúngicos/uso terapéutico , Candidemia/tratamiento farmacológico , Candidemia/inmunología , Susceptibilidad a Enfermedades , Quimioterapia Combinada , Endocarditis/tratamiento farmacológico , Endocarditis/inmunología , Endocarditis/microbiología , Glomeruloesclerosis Focal y Segmentaria/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/inmunología , Glomeruloesclerosis Focal y Segmentaria/patología , Humanos , Glomérulos Renales/patología , Masculino , Prednisona/uso terapéutico , Infecciones Relacionadas con Prótesis/inmunología , Infecciones Relacionadas con Prótesis/microbiología , Cardiopatía Reumática/complicaciones , Cardiopatía Reumática/cirugía , Infarto del Bazo/etiologíaRESUMEN
Aspergillus spp. invasive external otitis (IEO) is a rare infection. We performed a seven-year, single-centre retrospective study from 2007 to 2014 including all patients with proven Aspergillus spp. IEO. Twelve patients were identified. All patients had a poorly controlled diabetes mellitus and one underwent solid organ transplant. The most frequently isolated species was Aspergillus flavus (n = 10) and voriconazole was the first-line therapy in all cases, with a median length of treatment of 338.5 days (158-804 days). None of the patients underwent extensive surgery. The clinical outcome was excellent. However, otological sequelae were reported, including hearing impairment (n = 7) and facial palsy (n = 3).
Asunto(s)
Aspergilosis/diagnóstico , Aspergilosis/patología , Aspergillus/aislamiento & purificación , Necrosis/patología , Otitis Externa/diagnóstico , Otitis Externa/patología , Adulto , Anciano , Antifúngicos/uso terapéutico , Aspergilosis/tratamiento farmacológico , Aspergilosis/microbiología , Aspergillus/clasificación , Complicaciones de la Diabetes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Órganos/efectos adversos , Otitis Externa/tratamiento farmacológico , Otitis Externa/microbiología , Estudios Retrospectivos , Resultado del Tratamiento , Voriconazol/uso terapéuticoRESUMEN
OBJECTIVE: To compare H1N1 (2009) influenza A infection characteristics between transplant recipient patients and non-transplanted patients. To assess the evolution of transplanted patients up to 6 months following infection. METHODS: Patients diagnosed with confirmed influenza A infection from three Parisian transplant centers between September 1st, 2009 and February 15th, 2010. Clinical symptoms, biological, and radiological findings, and management were analysed and retrospectively compared between transplanted (T) and non-transplanted patients (NT). The evolution was assessed by a follow-up questionnaire, CT results 1 to 3 months after influenza infection and FEV1 variation. RESULTS: Seventy patients were included. Thirteen patients had an allograft (lung: eight, kidney: four, stem cells: one): (1) hospitalization: 100% (13 out of 13) in group T, 54% (31 out of 57) in group NT (P=0.0013); (2) pneumonia: 62% (eight out of 13) in group T, 26% (eight out of 57) in group NT (P=0.004); (3) mortality rate among hospitalized patients: 7.7% (one out of 13) in the group T, 9.7% (three out of 57) in group NT (P=NS); (4) chest CT scan abnormalities remained in four lung transplanted patients; (5) a minimum 10% decrease in FEV1 was detected in four lung transplant recipients. CONCLUSION: Our results suggest that H1N1(2009) influenza A infection in transplant recipient patients compared to non-transplanted patients: (1) more often leads to hospitalization; (2) is more frequently associated with pneumonia; (3) is responsible for a persistent graft functional impairment in lung transplant recipients; (4) has a low mortality rate similar to admitted non-transplanted patients.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana , Trasplante de Órganos , Complicaciones Posoperatorias , Adulto , Femenino , Humanos , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Estudios RetrospectivosRESUMEN
We describe a patient with confirmed novel H1N1 (swine-like) influenza A virus who had daily nasal swabs tested during oseltamivir therapy. Nasal shedding remained positive for 2 days and became negative on day 3. This report presents the first available data on the kinetics of shedding of this novel virus under antiviral therapy.