RESUMO
Mycobacterium haemophilum is an environmental organism that rarely causes infections in humans. We report a patient with acquired immunodeficiency syndrome who had central nervous system infection due to M. haemophilum. The diagnosis required brain tissue procurement and molecular identification method while the treatment outcome was unfavourable.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Síndrome da Imunodeficiência Adquirida/complicações , Infecções do Sistema Nervoso Central/microbiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium haemophilum/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Antibacterianos/uso terapêutico , Biópsia , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/tratamento farmacológico , Evolução Fatal , Feminino , Humanos , Dados de Sequência Molecular , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium haemophilum/genética , RNA Bacteriano/análise , RNA Ribossômico 16S/análise , TailândiaAssuntos
Atitude do Pessoal de Saúde , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Atenção Plena , Médicos/psicologia , Infecções Urinárias/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Infecção Hospitalar/prevenção & controle , Profissionais Controladores de Infecções/psicologia , Enfermeiras e Enfermeiros/psicologia , Segurança do Paciente , Atitude do Pessoal de Saúde , Coleta de Dados , Hospitais Universitários , Humanos , Controle de Infecções/organização & administração , Liderança , Cultura Organizacional , TailândiaRESUMO
The diagnosis of gnathostomiasis typically includes a triad of eosinophilia, migratory skin lesions, and exposure risk. The cutaneous manifestations are protean yet often involve intermittent migratory swellings and creeping skin eruptions with abscesses or nodules, which vary in onset and duration. We report the first case of gnathostomiasis presenting as fever and eosinophilia without cutaneous migratory and internal organ involvement.
Assuntos
Infecções Assintomáticas/terapia , Eosinofilia/diagnóstico , Gnatostomíase/diagnóstico , Adulto , Ceftazidima/uso terapêutico , Eosinofilia/tratamento farmacológico , Eosinofilia/etiologia , Eosinofilia/parasitologia , Doenças Transmitidas por Alimentos/parasitologia , Gnatostomíase/complicações , Gnatostomíase/tratamento farmacológico , Humanos , Larva Migrans/diagnóstico , Larva Migrans/etiologia , MasculinoRESUMO
OBJECTIVES: To evaluate the epidemiology and outcomes for initiation of inappropriate urinary catheterization (IUC) among hospitalized patients. SETTING: A 450-bed, tertiary-care hospital. PATIENTS: All patients admitted to the hospital from September 1, 2003 to June 12, 2004 with urinary catheter (UC). An independent observer reviewed the patient's chart, interviewed the patient and nursing staff, and assessed the need for the UC daily until the catheter was removed or the patient was discharged. RESULTS: One hundred thirty-one (15%) of 895 patients had initiation of IUC. The median age was 61 (range, 15-92). Medicine (0.52 catheter utilization ratio), surgery (0.24 catheter utilization ratio) and the ICUs (0.32) had the most UC use. Main reasons for initial IUC included no clear indication (28%), inappropriate urine output monitoring (26%), and urinary incontinence (18%). Admission to the medical ICU (adjusted odds ratio [aOR]=2.3; P<0.001), nonambulatory functional status (aOR=2.1; P<0.001), and female sex (aOR=1.9; P=0.001) were independently associated with IUC. Catheter-associated urinary tract infections (CA-UTI) occurred in 129 patients (14%). Patients with IUC had a longer duration of catheterization (12 vs. 3 days; P<0.01) were more likely to develop CA-UTI (82% vs. 8%; P=0.001) and had prolonged hospital length of stay (median, 15 vs. 5 days; P<0.001). The mean monthly cost of antibiotics for treatment of CA-UTI was $3480 (range, $1874-$5584). CONCLUSION: UC were inappropriately used more commonly among female, nonambulatory, and medical ICU patients. Careful attention to this aspect of medical care may reduce the incidence CA-UTI with subsequent decreases in length of stay, cost of hospitalization, and cost for treatment of CA-UTI.
