Infective endocarditis due to Citrobacter koseri following testicular trauma: case report and literature review.

Infective endocarditis (IE) is a condition with low prevalence but high mortality rates within intensive care units. Microbiologically, most cases are attributed to Gram-positive cocci, while Gram-negative bacilli are less commonly involved. This case report describes a patient with IE caused by Citrobacter koseri (C. koseri) with secondary bacteremia due to blunt testicular trauma and epididymitis. We conducted a review of the literature to assess the clinical and associated risk factors of this underreported condition. Elderly and urinary tract infections could be associated with this entity. Cefazolin was used as the final targeted treatment. The use of precision medicine in IE is required for specific interventions.

Infection of the heart valve from testicular injury: a case study and review of medical literature Infective endocarditis (IE) is a serious but rare infection that can lead to death, especially in intensive care units. Typically, it's caused by certain types of bacteria, but our case study focuses on a patient whose IE was caused by a less common bacterium called Citrobacter koseri (C. koseri). This infection occurred after the patient experienced blunt trauma to the testicles, leading to a bloodstream infection. We looked at other similar cases in medical literature and found that older age and urinary tract infections might increase the risk of this type of IE. In this case, IE caused by this unusual bacteria was treated with cefazolin.

Neurological outcomes and quality of life in post-cardiac arrest patients with return of spontaneous circulation supported by ECMO: A retrospective case series.

Post-cardiac arrest brain injury constitutes a significant contributor to morbidity and mortality, leading to cognitive impairment and subsequent disability. Individuals within this patient cohort grapple with uncertainty regarding the potential advantages of extracorporeal life support (ECMO) cannulation. This study elucidates the neurological outcomes and quality of life of post-cardiac arrest patients who attained spontaneous circulation and underwent ECMO cannulation. This is a retrospective case study within a local context, the research involved 32 patients who received ECMO support following an intrahospital cardiac arrest with return of spontaneous circulation (ROSC). An additional 32 patients experienced cardiac arrest with ROSC before undergoing cannulation. The average age was 41 years, with the primary causes of cardiac arrest identified as acute coronary syndrome (46.8%), pulmonary thromboembolism (21.88%), and hypoxemia (18.7%). The most prevalent arrest rhythm was asystole (37.5%), followed by ventricular fibrillation (34.4%). The mean SOFA score was 7 points (IQR 6.5-9), APACHE II score was 12 (IQR 9-16), RESP score was -1 (IQR -1 to -4) in cases of respiratory ECMO, and SAVE score was -3 (IQR -5 to 2) in cases of cardiac ECMO. Overall survival was 71%, and at 6 months, the Barthel score was 75 points, modified Rankin score was 2, cerebral performance categories score was 1, and the SF-12 had an average score of 30. Notably, there were no significant associations between the time, cause, or rhythm of cardiac arrest and neurological outcomes. Importantly, cardiac arrest is not a contraindication for ECMO cannulation. A meticulous assessment of candidates who have achieved spontaneous circulation after cardiac arrest, considering the absence of early signs of poor neurological prognosis, is crucial in patient selection. Larger prospective studies are warranted to validate and extend these findings.

Liposarcoma pleomórfico, reporte de caso / Pleomorphic liposarcoma, case report

Introducción: El liposarcoma pleomórfico es el subtipo con mayor malignidad, presenta recurrencia local de 37% y metástasis en 10 años de 41%, porcentaje que aumenta directamente con el tamaño de la lesión; además, presenta una supervivencia a los 10 años de 39%. Objetivo: Presentar un caso de esta enfermedad en un hombre sin antecedentes de importancia quien presentó metástasis a pulmón posterior al diagnóstico y tratamiento de un liposarcoma pleomórfico. Discusión: En el grupo de los liposarcomas se encuentran 4 tipos diferentes: El liposarcoma bien diferenciado, desdiferenciado, pleomórfico y mixoide. A pesar de tener poca vascularización el porcentaje de metástasis, su pronóstico y dificultad para extirpación quirúrgica varía según el tipo histológico. En cuanto el diagnóstico: la radiografía simple, la ecografía, la Tomografía computarizada (TC) y la resonancia magnética (RM) son herramientas diagnósticas válidas para el estudio del liposarcoma. El tratamiento es controvertido debido a la tasa de recurrencia después de la resección quirúrgica, la cual oscila entre 0-69%. Conclusión: En pacientes con cuadros clínicos característicos de lesiones tumorales es importante hacer un diagnóstico oportuno por medio de herramientas imagenológicas y quirúrgicas como el caso de biopsias intraoperatoria para así clasificarlo según el subtipo de liposarcoma, evaluar el tratamiento de elección y evaluar pronóstico y sobrevida del paciente...(AU)

Introduction: The pleomorphic liposarcoma is a subtype of liposarcoma with the highest malignancy, with a local recurrence of 37% and a metastasis in 10 years of 41%, a percentage that increases directly with the size of the lesion; furthermore, it presents a 10-year survival of 39%. Objective: To show a case of this disease in a man with no relevant background who presented lung metastasis after diagnosis and treatment of the pleomorphic liposarcoma. Discussion: In the group of liposarcomas there are 4 different types: Well-differentiated, dedifferentiated, pleomorphic and myxoid liposarcoma. In spite of having little vascularization the percentage of metastases, its prognosis and difficulty for surgical removal varies according to its histological type. Regarding to the diagnosis: simple x-ray, ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are valid diagnostic tools to study the liposarcoma. Its treatment is controversial because of the recurrence rate after a surgical resection, which ranges from 0% to 69%. Conclusion: In patients with clinical profiles characterized by tumor lesions, it is important to make a timely diagnosis using imaging and surgical tools such as intraoperative biopsies to classify the sample according to the liposarcoma subtype, to evaluate the correct treatment, its prognosis and patient survival...(AU)

Introdução: O lipossarcoma pleomórfico é um subtipo com maior malignidade e apresenta recorrência local de 37% e metástase em10 anos de 41%, o que aumenta diretamente com o tamanho da lesão. Ele apresenta uma sobrevida de 39% em 10 anos. Objetivo: Apresentar um caso desta doença num homem sem história de importância que apresentou metástase no pulmão após o diagnóstico e tratamento do lipossarcoma pleomórfico. Discussão: No grupo de lipossarcoma há 4 tipos diferentes: O lipossarcoma bem diferenciado, indiferenciada, pleomorfo e mixoide. Apesar de ter pouca vascularização a percentagem de metástase, seu prognóstico e dificuldade de remoção cirúrgica varia segundo o tipo histológico. Quanto ao diagnóstico: radiografia simples, ultra-som, tomografia computadorizada (TC) e ressonância magnética (MRI) são ferramentas de diagnóstico válidos para o estudo de lipossarcoma. O tratamento é controvertido porque a taxa de recorrência após a cirúrgia, varia entre 0-69%. Conclusão: Nos pacientes com diagnosticos clínicos caracterizados pelas lesões tumorais é importante fazer um diagnóstico a tempo, através de instrumentos da imagem e quirúrgicos, como o caso de biópsias intra-operatórias para classificar de acordo com o subtipo de lipossarcoma, avaliar o tratamento a escolhar e avaliar o prognóstico e sobrevivência do paciente...(AU)