RESUMEN
Stenotrophomonas maltophilia has become a common cause of opportunistic infections in immunocompromised hosts and critical care patients. The most common disease manifestations are pneumonia and bacteremia, with a mortality ranging from 9% to 60.5% depending of the type of infection and host related underlying risk factors. Patients with hematological malignancies may develop a hemorrhagic pneumonia with a rapidly progressive and universally fatal disease course, despite appropriate treatment with trimethoprim/sulfamethoxazole or combination therapy. We report the first two patients with hematologic malignancies and hemorrhagic pneumonia due to S. maltophilia with successful treatment outcomes after early institution of combination therapy with TMP/SMX, polymyxin, and/or moxifloxacin.
Asunto(s)
Infecciones por Bacterias Gramnegativas/microbiología , Neoplasias Hematológicas/complicaciones , Leucemia Mieloide Aguda/complicaciones , Neumonía Bacteriana/microbiología , Leucemia-Linfoma Linfoblástico de Células T Precursoras/complicaciones , Adolescente , Adulto , Antibacterianos/uso terapéutico , Infecciones por Bacterias Gramnegativas/complicaciones , Humanos , Masculino , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/microbiología , Neumonía Bacteriana/complicaciones , Stenotrophomonas maltophilia/aislamiento & purificaciónRESUMEN
Dengue infection has been associated with multiple renal complications, including glomerulonephritis, acute tubular necrosis, tubulointerstitial nephritis, and thrombotic microangiopathy (TMA), this last one being a rare complication of dengue, with only a few reported cases. TMA associated with dengue can be explained by an alteration in the activity of the enzyme ADAMTS13, leading to thrombotic thrombocytopenic purpura; or it can be secondary to direct or indirect endothelial injury by the virus, which leads to hemolytic uremic syndrome. Here, we present a case of severe TMA, not related to ADAMTS13, which was clearly associated with dengue infection.
Asunto(s)
Dengue/complicaciones , Intercambio Plasmático/métodos , Microangiopatías Trombóticas/terapia , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Lesión Renal Aguda/virología , Adolescente , Adulto , Niño , Dengue/sangre , Femenino , Síndrome Hemolítico-Urémico/etiología , Síndrome Hemolítico-Urémico/terapia , Síndrome Hemolítico-Urémico/virología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The gram-negative bacillus Yokenella regensburgei (of the Enterobacteriaceae family) can be found in groundwater and foodstuffs, as well as the digestive tracts of insects and reptiles. Although it has been isolated from humans since its original description, it has rarely been reported as a cause of infection, and then, only in immunosuppressed patients. We report the first case of post-surgical secondary osteomyelitis due to Y. regensburgei in an immunocompetent woman who had undergone a craniotomy.
Asunto(s)
Craneotomía , Infecciones por Enterobacteriaceae/microbiología , Enterobacteriaceae/aislamiento & purificación , Osteomielitis/microbiología , Infección de la Herida Quirúrgica/microbiología , Hueso Temporal/microbiología , Anciano , Antibacterianos/uso terapéutico , Drenaje , Farmacorresistencia Bacteriana Múltiple , Enterobacteriaceae/efectos de los fármacos , Infecciones por Enterobacteriaceae/diagnóstico por imagen , Infecciones por Enterobacteriaceae/etiología , Femenino , Humanos , Hipofisectomía , Huésped Inmunocomprometido , Osteomielitis/diagnóstico por imagen , Osteomielitis/etiología , Neoplasias Hipofisarias/cirugía , Prolactinoma/cirugía , Infección de la Herida Quirúrgica/diagnóstico por imagen , Hueso Temporal/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Yokenella regensburgei es un bacilo Gram negativo de la familia Enterobacteriaceae, que puede encontrarse en agua de pozos, alimentos y en el tubo digestivo de insectos y reptiles. Aunque se ha aislado de muestras provenientes de seres humanos, pocas veces se ha reportado como causante de infección y, en tales casos, especialmente en pacientes inmunosuprimidos. Se presenta aquí el primer caso de osteomielitis secundaria a una infección por Y. regensburgei en una paciente inmunocompetente después de un procedimiento quirúrgico.
The gram-negative bacillus Yokenella regensburgei (of the Enterobacteriaceae family) can be found in groundwater and foodstuffs, as well as the digestive tracts of insects and reptiles. Although it has been isolated from humans since its original description, it has rarely been reported as a cause of infection, and then, only in immunosuppressed patients. We report the first case of post-surgical secondary osteomyelitis due to Y. regensburgei in an immunocompetent woman who had undergone a craniotomy.