1/37. Central line sepsis in a child due to a previously unidentified mycobacterium.A rapidly growing mycobacterium similar to strains in the present mycobacterium fortuitum complex (M. fortuitum, M. peregrinum, and M. fortuitum third biovariant complex [sorbitol positive and sorbitol negative]) was isolated from a surgically placed central venous catheter tip and three cultures of blood from a 2-year-old child diagnosed with metastatic hepatoblastoma. The organism's unique phenotypic profile and ribotype patterns differed from those of the type and reference strains of the M. fortuitum complex and indicate that this organism may represent a new pathogenic taxon.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/37. stenotrophomonas maltophilia: an increasing problem in patients with acute leukaemia.stenotrophomonas maltophilia (previously Pseudomonas maltophilia and xanthomonas maltophilia) is an increasing problem as an opportunistic pathogen in immunocompromised patients such as those with acute leukaemia. Infection is difficult to treat and eradicate due to its inherent and quickly acquired resistance to many antibiotics. Presentation with unusual cutaneous lesions is not uncommon and can present diagnostic difficulties. We present two cases which highlight the classical features of this infection in leukaemic patients, and discuss the need for early antibiotic treatment with regimens including cotrimoxazole, and the consideration of prompt central venous catheter removal.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
3/37. Opportunistic infection with rhodotorula in cancer patients treated by chemotherapy: two case reports.rhodotorula species are commensal yeasts of variable pathogenicity. The authors report the case histories of two patients presenting with febrile neutropenia. The first was a 3-year-old girl who had been treated with combination chemotherapy for a tumour of the posterior fossa. The second was a 46-year-old man who had received chemotherapy for lymphoplasmocytic lymphoma, followed by consolidation treatment with autologous bone marrow transplantation. Investigation revealed infection caused by rhodotorula. The outcome was favourable after removal of the catheter in both patients. rhodotorula species have been isolated during a variety of infectious complications. Almost all published cases of fungaemia concern patients with central venous catheters that have been in place over long periods, who have also been treated with broad spectrum antibiotics. Neoplasia represents the most frequent underlying disease. The pathogenicity of rhodotorula species appears to be moderate in most cases; fungal therapy or the removal of infected catheters is generally effective. Nevertheless, rhodotorula has been reported to provoke fatal endocarditis or meningitis and can probably cause septic shock.- - - - - - - - - - ranking = 3keywords = catheter (Clic here for more details about this article) |
4/37. methylobacterium mesophilicum infection: case report and literature review of an unusual opportunistic pathogen.methylobacterium mesophilicum is a methylotrophic, pink pigmented, gram-negative rod that was initially isolated from environmental sources that is being increasingly reported as a cause of opportunistic infections in immunocompromised hosts. We present the case of an immunocompromised woman who developed a central catheter infection with M. mesophilicum and review the other 29 cases reported in the literature, noting that it is frequently resistant to beta-lactam agents but is generally susceptible to aminoglycosides and quinolones.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
5/37. Localised necrosis of scrotum (Fournier's gangrene) in a spinal cord injury patient - a case report.BACKGROUND: Men with spinal cord injury (SCI) appear to have a greater incidence of bacterial colonisation of genital skin as compared to neurologically normal controls. We report a male patient with paraplegia who developed rapidly progressive infection of scrotal skin, which resulted in localised necrosis of scrotum (Fournier's gangrene). CASE PRESENTATION: This male patient developed paraplegia at T-8 level 21 years ago at the age of fifteen years. He has been managing his bladder by wearing a penile sheath. He noticed redness and swelling on the right side of the scrotum, which rapidly progressed to become a black patch. A wound swab yielded growth of methicillin-resistant staphylococcus aureus (MRSA). Necrotic tissue was excised. culture of excised tissue grew MRSA. A follow-up wound swab yielded growth of MRSA and mixed anaerobes. The wound was treated with regular application of povidone-iodine spray. He made good progress, with the wound healing gradually. CONCLUSION: It is likely that the presence of a condom catheter, increased skin moisture in the scrotum due to urine leakage, compromised personal hygiene, a neurogenic bowel and subtle dysfunction of the immune system contributed to colonisation, and then rapidly progressive infection in this patient. We believe that spinal cord injury patients and their carers should be made aware of possible increased susceptibility of SCI patients to opportunistic infections of the skin. Increased awareness will facilitate prompt recourse to medical advice, when early signs of infection are present.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
6/37. agrobacterium radiobacter bacteremia in pediatric patients: case report and review.agrobacterium radiobacter is an opportunistic pathogen often associated with indwelling catheters. We report five children with central venous catheter-associated A. radiobacter bacteremia and review the characteristics of pediatric agrobacterium infections. Cure was achieved with appropriate antibiotics, often ticarcillin-clavulanate and gentamicin, and removal of the catheter.- - - - - - - - - - ranking = 3keywords = catheter (Clic here for more details about this article) |
7/37. Disseminated infection due to scedosporium apiospermum in a patient with acute myelogenous leukemia.A 62-year-old man diagnosed with acute myelogenous leukemia which had developed from myelodysplastic syndrome received cytarabine and idarubicine as an induction therapy. The patient developed pneumonia and bacterial sepsis during profound neutropenia. fever and sepsis improved by using many anti-bacterials and anti-fungals but he became febrile again and complained of severe lumbar pain. 67Ga scintigram showed abnormal uptake in the lumbar vertebra and left sternoclavicular joint, suggesting a diagnosis of discitis and osteomyelitis in the lumbar vertebra and sternoclavicular arthritis. We biopsied the site several times but culture of the biopsy specimen could not isolate any pathogens, and high fever persisted for about 10 months despite administration of various anti-bacterials and anti-fungals. Finally we inserted a catheter into the abscess at the iliopsoas muscle and scedosporium apiospermum was isolated in the bloody pus obtained from the catheter. itraconazole and amphotericin b were restarted, and the high fever and lumbar pain improved rapidly. The findings of S. apiospermum infection in this patient emphasizes the importance of being aware of this pathogen in patients with hematologic malignancy during the neutropenic phase.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
8/37. fungemia caused by Hansenula anomala: successful treatment with fluconazole.fungemia, due to Hansenula anomala, developed in an adult patient with small cell lung cancer who received anti-cancer chemotherapy and plasmapheresis for a sensori-motor neuropathy complication. Treatment with intravenous infusion of fluconazole in addition to the removal of the central venous catheter was successful in treating the fungemia. Pathogenic Hansenula anomala infections are rare, but reports of this infection have been increasing. The use of fluconazole treatment for this infection has not been reported in the literature, and this is the first case of an adult infection of Hansenula anomala in japan.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
9/37. Successful induction of immune tolerance with FIX recombinant in a patient with haemophilia B with inhibitor.We describe successful induction of immune tolerance in a 12-month-old patient with severe haemophilia B and low-titre and low response antifactor IX inhibitor at 5 Bethesda Unit (BU). immune tolerance induction (ITI) was started with recombinant factor (rFIX) at 40-50 U kg(-1) day(-1) (1000 U three times per week) and 2 years after the beginning of therapy the inhibitor had been reduced to undetectable values. As complications, which appeared during the ITI, the patient presented minor haemorrhagic complications, which remitted following the administration of rFVIIa, and recurring infections of the catheter, requiring the withdrawal and subsequent placement of a new catheter.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
10/37. pseudomonas infections in children with human immunodeficiency virus infection.Thirteen bacteremias and 25 nonbacteremic infections caused by Pseudomonas spp. occurred in 22 of 236 children with human immunodeficiency virus infection with a rate of infection of 0.098 (bacteremia, 0.030) per patient year. Four patients were neutropenic (less than 500/microliters). Central venous catheter (CVC)-related infections were most frequent (n = 20) followed by otitis externa (n = 6) and pneumonia (n = 5). pseudomonas aeruginosa was the most common isolate and caused both CVC-related and CVC-unrelated infections, whereas other Pseudomonas spp. and xanthomonas maltophilia were almost exclusively associated with CVC-related infections. The children who received appropriate therapy had a favorable outcome. In 7 CVC-related infections (35%) the catheter was removed. Pseudomonas spp. are of increasing importance in human immunodeficiency virus-infected children causing significant morbidity and increased hospitalization. These infections may be life-threatening if appropriate therapy is not vigorously initiated.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
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