RESUMO
INTRODUCTION: Oncologic patients can have severe infections due to Aeromonas. This study aims to investigate the clinical characteristics and outcomes of cancer patients with bloodstream infections (BSI) caused by Aeromonas. METHODOLOGY: We included patients with bacteremia caused by Aeromonas species from 2011 to 2018. RESULTS: Seventy-five BSI events in the same number of patients were identified. Forty patients were men (53.3%); the mean age was 49 years (IQR 28-61). A. caviae was the most frequent isolate (n = 29, 38.6%), followed by A. hydrophila (n = 23, 30.6%), A. sobria (n = 15, 20%), and A. veronii (n = 8, 10.6%). The most frequent underlying diagnosis was hematologic malignancy (n = 33, 44%), followed by breast cancer (n = 12, 16%) and gastrointestinal tract cancer (n = 8, 10.6%). The most frequent type of bacteremia was CRBSI in 32 cases (42.6%), followed by mucosal barrier injury-laboratory confirmed BSI (n = 20, 26.7%). Sixteen (26.2%) were hospital-acquired BSI. Attributable mortality occurred in 11 patients (14.6%). In univariate analysis A. hydrophila bacteremia, liver failure, skin/soft tissue infection, septic shock, inappropriate antimicrobial treatment, and relapse or cancer progression were associated with 30-day mortality. In multivariate analysis, only septic shock, inappropriate antimicrobial treatment, and relapse or cancer progression were associated with 30-day mortality. CONCLUSIONS: Aeromonas species should be considered one of the causative pathogens of healthcare-associated bacteremia, especially in immunocompromised patients. In addition, it can be associated with high fatality, particularly in patients with severe clinical infections.
Assuntos
Aeromonas , Anti-Infecciosos , Bacteriemia , Infecções por Bactérias Gram-Negativas , Choque Séptico , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Recidiva Local de Neoplasia , Anti-Infecciosos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologiaRESUMO
Two unusual occurrences of pleural trichomonosis due to a new Tetratrichomonas species previously reported but not named were confirmed. In one patient, Trichomonas tenax and a Tetratrichomonas species were also detected in the oral cavity by molecular methods. We suggest that this new Tetratrichomonas species be named Tetratrichomonas empyemagena.
Assuntos
Empiema Pleural/diagnóstico , Empiema Pleural/parasitologia , Infecções por Protozoários/diagnóstico , Infecções por Protozoários/parasitologia , Trichomonadida/classificação , Trichomonadida/isolamento & purificação , Adulto , Análise por Conglomerados , DNA Intergênico/química , DNA Intergênico/genética , DNA de Protozoário/química , DNA de Protozoário/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Boca/parasitologia , Filogenia , RNA Ribossômico 5,8S/genética , Análise de Sequência de DNA , Trichomonadida/genéticaRESUMO
HIV infection is a major risk factor for tuberculosis. We describe the case of a 30-year-old male presenting with headache, compromised mental status, seizures, neck stiffness and fever that was subsequently diagnosed with HlV and neuroinfection. Clinical data, cerebrospinal fluid and brain imaging supported a diagnosis of neurotuberculosis. Cranial magnetic resonance imaging showed diffuse arachnoidal enhancement, mainly at the basal cisterns and cortical encephalitis. Such imaging findings play a key role in the diagnosis of central nervous system tuberculosis.
Assuntos
Aracnoidite/etiologia , Encefalite/etiologia , Soropositividade para HIV/complicações , Tuberculoma Intracraniano/etiologia , Adulto , Humanos , MasculinoRESUMO
La infección por VIH es uno de los mayores factores de riesgo para tuberculosis. Presentamos el caso de un paciente de 30 años que ingresó al hospital con datos neurológicos caracterizados por cefalea, alteración del alerta, crisis convulsivas, signos meníngeos y fiebre, a quien subsecuentemente se le diagnosticó VIH y neuroinfección. Los datos clínicos, el examen del líquido cefalorraquídeo y la neuroimagen sustentaron el diagnóstico de neurotuberculosis. La resonancia magnética de cráneo reveló aracnoiditis generalizada de predominio basal, así como encefalitis cortical. Los hallazgos de imagen desempeñan un papel fundamental en el diagnóstico integral de la tuberculosis del sistema nervioso central.
HIV infection is a major risk factor for tuberculosis. We describe the case of a 30-year-old male presenting with headache, compromised mental status, seizures, neck stiffness and fever that was subsequently diagnosed with HlV and neuroinfection. Clinical data, cerebrospinal fluid and brain imaging supported a diagnosis of neurotuberculosis. Cranial magnetic resonance imaging showed diffuse arachnoidal enhancement, mainly at the basal cisterns and cortical encephalitis. Such imaging findings play a key role in the diagnosis of central nervous system tuberculosis.
