Acute eosinophilic pneumonia induced by varnish particles: a diagnostic challenge

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[Tunnelled central venous catheter infection during treatment with epoprostenol]. / Infection de cathéter veineux central tunnelisé survenue sous traitement par époprosténol.

INTRODUCTION: Pulmonary arterial hypertension is a pulmonary vascular disease with a poor prognosis. Continuous intravenous treatment with prostacyclin analogues requires the placement of a tunnelled catheter. The occurrence of catheter-related infections in this context is unusual due to the alkaline pH of the prostacyclin analogue solutions. OBSERVATION: A 50-year-old patient with inherited pulmonary artery hypertension, treated with bosentan, sildenafil and epoprostenol, experienced generalized malaise associated with a weight loss of 9kg over a 12-month period without evidence of a source of infection or malignancy. There was no evidence of hemodynamic disturbance. The diagnosis was made after 1 year of follow-up, when the patient presented with a 38° fever and a biological inflammatory syndrome. Repeated peripheral blood cultures were positive for Dietzia, an alkalophilic coryneform bacillus. The patient's condition responded favourably to antibiotic therapy. CONCLUSION: Infection of a tunneled intravenous catheter should be considered in the case of non-specific symptoms or where there is evidence of sepsis, in patients treated with intravenous prostacyclin analogues administered intravenously. In this context, the laboratory should be warned to search for slow-growing organisms.

[Anaerobic bacteria in infections of lower limb ulcerations in patients with chronic atherosclerotic arterial occlusion]. / Bakterie beztlenowe w zakazeniach owrzodzen konczyn dolnych u chorych z przewlekla miazdzycowa niedroznoscia tetnic.

In 76 patients with lower limb ulcerations in the course of atherosclerotic arterial occlusion, quantitative and quantitative bacteriological examinations, angiographic examinations and ultrasonographic measurements of pressures with simultaneous calculation of ankle/arm index were performed. At the same time the progression of ulceration healing was assessed after the operation. From the samples from four patients anaerobic bacteria were cultured: three times P. prevotii and twice P. acnes. It was found that these bacteria showed resistance to antibiotics used routinely in the treatment of diseases in which they may be the aetiological factor. The usefulness was demonstrated of quantitative examination of the bacterial flora in the ulcerations for the evaluation of their healing progression. Performing of antibiograms for anaerobic bacteria was found useful.