Clinical features, risk factors, and antimicrobial resistance of pseudomonas putida isolates.

Pseudomonas putida rarely results in infection, primarily in patients undergoing invasive procedures or immunocompromised hosts. We aimed to investigate the characteristics of Pseudomonas putida infections. This is a retrospectively designed cross-sectional observational study. We retrospectively scanned the data from our hospital for the 10 years before February 15, 2022. The patients with Pseudomonas putida growth in the microbiological cultures and with antibiotic susceptibility tests were included in the study. We recorded culture isolates types, age, gender, comorbidities, immunosuppressive factors, symptoms, invasive medical procedures, length of hospital stay, and radiological findings. The mean age of the patients was 66.2 ±â€…14.5 years, and the male patients predominated (76.3%, n = 58/76). There was growth in bronchial lavage in 33 patients, sputum in 28, pleural effusion fluid in 12, and tracheal aspirate in 3 patients. The rate of antibiotic-resistant strains was 56.6% (n = 43). All strains were sensitive to colistin (100%), and carbapenem, amikacin, and gentamicin sensitivity rates were high. We observed that the risk of antibiotic resistance increased 4.29 times in the patients in the intensive care unit (Cl:1.27-14.47, P = .01). The patients with Diabetes Mellitus had a higher risk (OR 4.33, Cl:1.11-16.77, P = .03), and in cancer cases, the risk was 3.31 times higher (Cl:1.06-10.32, P = .03). The risk of Pseudomonas putida infection should be considered, particularly in patients with comorbid disorders causing immunosuppression, including Diabetes Mellitus and Cancer.

Clinical and radiological characteristics of pulmonary actinomycosis mimicking lung malignancy.

INTRODUCTION: Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer. METHODS: A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography. RESULTS: In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (κ=0.701 and p<0.001). CONCLUSION: Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.

Clinical and radiological characteristics of pulmonary actinomycosis mimicking lung malignancy

SUMMARY INTRODUCTION: Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer. METHODS: A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography. RESULTS: In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (κ=0.701 and p<0.001). CONCLUSION: Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.

Our experience of 200 patients: usage and maintenance of long-term oxygen therapy and non-invasive ventilation devices at home.

OBJECTIVE: To evaluate the patients' attitudes about the devices, of which they use for long-term respiratory support at home. METHOD: 200 consecutive patients were questioned about the treatment and devices of respiratory support at home by face to face questionnaire. Their records were taken from the archives of Social Security Agency. RESULTS: 123 (61.5%) of the patients were men and 77 (38.5%) were women. The mean age was 65.8 ± 11.9 (15-92) years. The most frequently prescribed device was oxygen concentrator and BIPAP was the one that follows. The most common indications were hypoxic and hypercapnic respiratory failure due to COPD. The devices were prescribed by the state university hospitals, most commonly. The average daily oxygen usage duration was 16.3 ± 3.1 hours, the average duration was 7.4 ± 3.1 hours, for BIPAP. Twenty one (11.4%) of the patients, who were treated with LTOT, stated that they were taking oxygen less than 15 hours a day. Higher education levels of the patients was correlated with the higher rates of visiting the companies - that they bought the devices- both for information about and control of the devices (p=0.002). The rate of visiting companies/firms was significantly higher in patients, who use BIPAP and respiratory support combined with it (p=0.010). Twenty three (47.9%) of the 48 patients, who notified that their devices were impaired, waited for repairment by the firm, 20 (41.6%) investigated special repair facilities and the rest (10.5%) rented a new device. CONCLUSION: Effective and continuous technical maintenance support must be provided to the patients, who are treated with long-term respiratory support at home.

Sarcoidosis caused by interferon therapy.

Interferon alpha (IFN-alpha) is an immunomodulator that is used as an antiviral agent in active chronic viral hepatitis C. IFN therapy can cause an induction or exacerbation of sarcoidosis. Although several reports in the gastroenterology literature have suggested an association between IFN therapy and sarcoidosis, this association has rarely been described elsewhere. A 47-year-old woman developed sarcoidosis after cessation of treatment with IFN and ribavirin for chronic hepatitis C. Her sarcoidosis showed liver, pulmonary and skin involvement. She continues to be monitored regularly in the Department of Pulmonary Diseases without steroid therapy. Her sarcoidosis improved spontaneously. We conclude that patients should be monitored for sarcoidosis during and after IFN therapy.

Pulmonary hypertension and acute pulmonary edema in a 23-year-old male with a history of an upper respiratory tract infection.

The pathophysiology of upper-airway obstruction (UAO) is complex. Possible causes of UAO that may lead to acute respiratory failure, are as follows: infections like acute epiglottitis and croup, obstructing tumors in the base of the tongue, larynx or hypopharynx, aspirated food or liquid contents, obesity and anatomical variations. Management changes according to the pathogenesis of the disorder. In patients with severe carbon dioxide retention or apnea, emergency endotracheal intubation must be carried out. Hereby, we describe a 23-year-old patient with susceptible upper-airway anatomy and UAO occurred following an upper respiratory infection and complicated with pulmonary hypertension and pulmonary edema. Our patient seems to be one of the complicated UAO cases, with an unusual but critical clinical presentation, evaluated in a wide spectrum and nicely returned to life.