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Infection in the Hematopoeitic Stem Cell Transplant Recipient with Autoimmune Disease
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Valentina Stosor, Teresa R. Zembower
Polymyositis and dermatomyositis are idiopathic inflammatory myopathies characterized by proximal limb and neck weakness, sometimes associated with muscle pain.52 Malignancy, cardiac and pulmonary dysfunction, and infections are the most common causes of death.53,54 The most common infectious complication is aspiration pneumonia due to respiratory muscle weakness. A case series of four patients with fulminant PCP is described in patients receiving corticosteroids. Three of the patients died in the first month of steroid therapy of overwhelming PCP.55 Herpes zoster is reported to occur with high frequency in these patients. Interestingly, it occurs more commonly in the inactive stages of disease and is not associated with steroid therapy.56 Two cases of nosocomial pneumonia with Stenotrophomonas maltophilia and one case of disseminated N. brasiliensis infection have been described.57,58
Trimethoprim and Trimethoprim–Sulfamethoxazole (Cotrimoxazole)
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
Jason A. Trubiano, M. Lindsay Grayson
Stenotrophomonas maltophilia is being found with increasing frequency as a cause of serious infection, especially in cancer patients (Safdar and Rolston, 2007). CoT has been considered the drug of choice of S. maltophilia infections for many years (Marshall et al., 1989). Dosing regimens of CoT similar to those used for Pneumocystis pneumonia are generally recommended (Safdar and Rolston, 2007; Abbott and Peleg, 2015).
Bacterial infections after lung transplantation
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Jennifer Delacruz, Jennifer L. Steinbeck, Kenneth Pursell, David Pitrak
Patients with CF are known to be colonized with bacteria in both the upper and lower airways. It has been suggested that the sinuses may serve as a reservoir from which bacteria can spread and infect the lung allograft, thereby leading to deleterious effects. Therefore, some centers advocate either pretransplant or posttransplant sinus surgery; however, the data are conflicting and our center does not do so routinely.107–109 Some lung transplant candidates, such as those with CF, may be colonized or previously infected with resistant and difficult-to-treat pathogens, such as B. cepacia, PsAR, Stenotrophomonas maltophililia, Acinetobacter, or Alcaligenes xylosoxidans. Published data suggest decreased graft and patient survival in cases of infection or colonization with extensive drug-resistant Burkholderia and Stenotrophomonas. Withholding a transplant because of the presence of resistant bacteria is a decision to be made by each individual transplant center.44
Short- versus prolonged-course antibiotic therapy for sepsis or infectious diseases in critically ill adults: a systematic review and meta-analysis
Published in Infectious Diseases, 2022
Kenji Kubo, Yutaka Kondo, Jumpei Yoshimura, Kazuya Kikutani, Nobuaki Shime
We identified two OSs of severe infections in a systematic review that did not meet the criteria for inclusion in the meta-analysis (Supplementary Table 3) [24,25]. Pereira et al. prospectively evaluated the association between antibiotic therapy and prognosis in 502 patients with severe community-acquired pneumonia in 14 ICUs in Portugal. All patients had sepsis (sepsis, 278; septic shock, 224) [24]. Adjusted multivariate logistic regression analysis showed that prolonged antibiotics (>7 days) were associated with a longer ICU stay (14 vs. 7 days; p< .001) and length of hospital stay (25 vs. 17 days; p< .001). Guerci et al. retrospectively evaluated the association between antibiotic therapy and prognosis in 282 patients with hospital-acquired Stenotrophomonas maltophilia VAP in 25 ICUs in France [25]. The distribution of severity scores was very similar to that of the study by Pereira et al., and pneumonia-related septic shock occurred in 123 patients (43.6%). A survival analysis did not show any benefit from prolonged antibiotic therapy for >7 days (hazard ratio = 1.06, 95% CI: 0.6–1.86, p= .84).
Efficacy and safety of idelalisib for the treatment of indolent B-cell malignancies
Published in Expert Opinion on Pharmacotherapy, 2020
Piotr Smolewski, Dominika Rydygier
In a study of five patients with pneumonitis related to idelalisib treatment, all patients complained of coughing, dyspnea, and fever. Four demonstrated progressions of clinical symptoms over three to 9 weeks, whereas one had progression over 5 days. A lung computed tomography (CT) scan showed diffuse ground-glass opacities (n = 3), consolidations (n = 2), diffuse micronodules (n = 1), and pleural effusions (n = 2). One patient was diagnosed with Stenotrophomonas maltophila. An extensive search for pathogens, including respiratory viruses, bacteria, and fungi, was negative in the BAL. All patients received broad-spectrum antibiotics with no significant efficacy. Four received steroids, but only three of the four demonstrated resolution of pneumonitis; one patient died due to multiorgan failure. The patient with S. maltophilia did not receive any targeted antibiotics and had a favorable outcome with steroids [40].
Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey
Published in Infectious Diseases, 2019
Hicaz Zencirkiran Agus, Serkan Kahraman, Cagdas Arslan, Gamze Babur Guler, Ali Kemal Kalkan, Cafer Panc, Fatih Uzun, Mehmet Erturk, Mustafa Yildiz
The pathogens causing IE are shown in Table 2. The most common causative pathogen was coagulase-negative staphylococci in 37 patients (methicillin sensitive coagulase negative staphylococci in 13 (8.4%), methicillin resistant coagulase negative staphylococci in 24 (15.5%)) followed by S. aureus in 15 (methicillin sensitive S. aureus in 11 (7.1%), methicillin resistant S. aureus in 4 (2.6%)), streptococci in 10 (6.5%), Enterococcus faecalis in eight (5.2%), Candida in three (1.9%) patients. Stenotrophomonas was the causative pathogen in two patients. Besides that Escherichia coli, Brucella, Pseudomonas, Serratia marcescens were one by one detected only in one patient's blood culture (Table 2). Staphylococci were the most frequent causative microorganisms isolated in both NVE (n = 30, 31.8%), PVE (n = 21, 38.9%) and device related IE cases (n = 1), with an overall involvement of 52 cases (33.5%). Blood cultures were negative in 73 patients (48.4%).