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Daptomycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Anouk E. Muller, Inge C. Gyssens
Hyper-IgE Job syndrome (hyperimmunoglobulin E syndrome) is a congenitally acquired primary immune deficiency (impaired phagocytosis). Accordingly, these patients have difficulty in eradicating staphylococcal infections. A case of Job syndrome with MRSA mitral valve endocarditis complicated by extensive metastatic septic complications manifested as brain abscess, multiple epidural abscesses, and multifocal vertebral osteomyelitis has been described. The patient did not respond to 5 days of appropriately dosed linezolid and daptomycin and remained bacteremic despite appropriate therapy because abscess drainage was not an option. High-dose daptomycin (12 mg/kg i.v. every 24 hours) cleared the MRSA bacteremia rapidly. Because daptomycin does not cross the blood–brain barrier in therapeutic concentrations, linezolid was used to treat the brain abscess. The patient’s endocarditis and epidural abscesses/vertebral osteomyelitis were cured. The patient was treated within 8 weeks with no adverse effects (Cunha et al., 2008).
Personalized approaches to bronchiectasis
Published in Expert Review of Respiratory Medicine, 2021
Rosa Maria Girón Moreno, Adrián Martínez-Vergara, Miguel Ángel Martínez-García
As in the cases of primary immune deficiencies and disorders of immune regulation, the knowledge of the underlying genetic causes is of increasing importance for the development of specific therapies and the early identification of patients who would benefit from bone marrow transplantation. The autosomal dominant hyperimmunoglobulin E syndrome (Job’s syndrome) is a rare primary immunodeficiency characteristic of markedly elevated IgE concentrations and clinical findings of eczema, recurrent skin and pulmonary infections, skeletal abnormalities, and coarse facial features. This disease has been more fully defined thanks to the identification of mutations in the signal transduction and activator of transcription 3 (STAT3), the family of transcription factors activated by the Janus (JAK) family of kinases [102]. STAT3 is important for several key airway defense mechanisms, including T helper 17-based cytokine signaling leading to the upregulation of antimicrobial peptides. It is also considered to play a role in successful remodeling after epithelial injury by differentiating between airway basal cells and ciliated cells [103]. Mutations in STAT3 affecting these pathways probably account for the high prevalence of bronchiectasis and the cystic changes (pneumatoceles) associated with it.
Primary Immunodeficiency Diseases Presenting with Chalazia as the First Manifestation
Published in Ocular Immunology and Inflammation, 2021
María Nieves-Moreno, María Granados, Susana Noval
Hyperimmunoglobulin E syndrome is a rare autosomal dominant PID characterized by eczematous skin, candida infections, and recurrent skin and pulmonary infections along with high levels of serum IgE.4 Reports of ocular involvement in patients with Hyper IgE are rare, but recurrent multiple chalazia have been described in the literature.5 Other ocular manifestations of hyperimmunoglobulin E syndrome include retinal detachment, blepharitis, corneal ulcerations, and Candida albicans endophthalmitis.1