Pub Date : 2023-11-20DOI: 10.1097/ipc.0000000000001324
Niloofar Hooshmand, Batool Zarei, Zahra Sadat Mireskandari, F. Sheybani, Mahboubeh Haddad, Sepideh Elyasi, N. Morovatdar, Hamed Hossein Abdollahi Dashtbayaz
Antimicrobial resistance is a serious threat to public health. The ongoing antimicrobial resistance pandemic has been fueled by the COVID-19 pandemic. We analyzed patients 15 years or older with COVID-19 who were admitted to a teaching hospital in Mashhad, Iran, during the period between the third and fourth COVID-19 waves. COVID-19 was diagnosed if the SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction test was positive in patients with compatible clinical syndromes. Overall, 532 episodes of COVID-19 were diagnosed. The median age of patients was 61 years (interquartile range, 48–73). One hundred twenty-five patients (23.4%) with COVID-19 died, and 165 (31%) experienced major complications. Over the study period, 134 DDD (defined daily dose) per 100 hospital bed days of antibacterial were used. Glycopeptides, third-generation cephalosporins, and carbapenems were the antibacterials most frequently used, based on the DDD per 100 hospital bed days. In a multivariate analysis, factors associated with antibacterial prescription in COVID-19 patients were lung involvement of greater than 50% (odds ratio [OR], 14.6), C-reactive protein of greater than 100 mg/L (OR, 3.35), and hypoxia (OR, 3.06). Univariate but not multivariate analysis showed that antibiotic use in COVID-19 patients was associated with 4 times increase in the chance of death (OR, 4.23). Our study highlights a high rate of antibacterial use in COVID-19 patients. Hypoxia, C-reactive protein of greater than 100 mg/L, and severe lung involvement were associated with a higher rate of antibacterial prescription. The patients who received antibiotics died 4.23 times more often than patients treated without antibiotics. These findings emphasize the need for integrating antimicrobial stewardship programs as an integral part of the pandemic response and the need for improving diagnostic tests for early detection of bacterial coinfections in COVID-19 patients.
{"title":"Antibiotic Use in Patients With COVID-19","authors":"Niloofar Hooshmand, Batool Zarei, Zahra Sadat Mireskandari, F. Sheybani, Mahboubeh Haddad, Sepideh Elyasi, N. Morovatdar, Hamed Hossein Abdollahi Dashtbayaz","doi":"10.1097/ipc.0000000000001324","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001324","url":null,"abstract":"Antimicrobial resistance is a serious threat to public health. The ongoing antimicrobial resistance pandemic has been fueled by the COVID-19 pandemic. We analyzed patients 15 years or older with COVID-19 who were admitted to a teaching hospital in Mashhad, Iran, during the period between the third and fourth COVID-19 waves. COVID-19 was diagnosed if the SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction test was positive in patients with compatible clinical syndromes. Overall, 532 episodes of COVID-19 were diagnosed. The median age of patients was 61 years (interquartile range, 48–73). One hundred twenty-five patients (23.4%) with COVID-19 died, and 165 (31%) experienced major complications. Over the study period, 134 DDD (defined daily dose) per 100 hospital bed days of antibacterial were used. Glycopeptides, third-generation cephalosporins, and carbapenems were the antibacterials most frequently used, based on the DDD per 100 hospital bed days. In a multivariate analysis, factors associated with antibacterial prescription in COVID-19 patients were lung involvement of greater than 50% (odds ratio [OR], 14.6), C-reactive protein of greater than 100 mg/L (OR, 3.35), and hypoxia (OR, 3.06). Univariate but not multivariate analysis showed that antibiotic use in COVID-19 patients was associated with 4 times increase in the chance of death (OR, 4.23). Our study highlights a high rate of antibacterial use in COVID-19 patients. Hypoxia, C-reactive protein of greater than 100 mg/L, and severe lung involvement were associated with a higher rate of antibacterial prescription. The patients who received antibiotics died 4.23 times more often than patients treated without antibiotics. These findings emphasize the need for integrating antimicrobial stewardship programs as an integral part of the pandemic response and the need for improving diagnostic tests for early detection of bacterial coinfections in COVID-19 patients.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001322
Yasmeen Ahmed, Mohamed El-Kassas
Abstract Hepatitis B virus (HBV) is considered a global health-related problem. The World Health Organization estimates an incidence of approximately 1.5 million new cases annually despite an available effective vaccine, and approximately 296 million people worldwide are living with chronic hepatitis B. This large number of patients require continuous monitoring of the treatment efficacy, disease progression, and screening for the HBV-related liver complications. Recently, it has become more evident that we need better predictive markers to allow treatment cessation when there is a reduced risk of viral reactivation, in addition to the present need to predict disease outcome and improve the management of people living with chronic hepatitis B. Novel HBV biomarkers are focused on in this minireview. These new markers include quantification of serum HBV RNA, hepatitis B core–related antigen, quantitative hepatitis B surface antigen, quantitative anti–hepatitis B core antigen, and detection of HBV nucleic acid–related antigen. The target of finding new markers for HBV replication is to provide crucial clinical data in a noninvasive way for detecting the replicative and transcriptional activity of the virus. This may support better management of patients compared with the criterion-standard invasive marker for detecting the intrahepatic replication and transcription of HBV, which is the quantification of covalently closed circular DNA.
{"title":"Interpreting Serogical Markers in Hepatitis B Virus Infection","authors":"Yasmeen Ahmed, Mohamed El-Kassas","doi":"10.1097/ipc.0000000000001322","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001322","url":null,"abstract":"Abstract Hepatitis B virus (HBV) is considered a global health-related problem. The World Health Organization estimates an incidence of approximately 1.5 million new cases annually despite an available effective vaccine, and approximately 296 million people worldwide are living with chronic hepatitis B. This large number of patients require continuous monitoring of the treatment efficacy, disease progression, and screening for the HBV-related liver complications. Recently, it has become more evident that we need better predictive markers to allow treatment cessation when there is a reduced risk of viral reactivation, in addition to the present need to predict disease outcome and improve the management of people living with chronic hepatitis B. Novel HBV biomarkers are focused on in this minireview. These new markers include quantification of serum HBV RNA, hepatitis B core–related antigen, quantitative hepatitis B surface antigen, quantitative anti–hepatitis B core antigen, and detection of HBV nucleic acid–related antigen. The target of finding new markers for HBV replication is to provide crucial clinical data in a noninvasive way for detecting the replicative and transcriptional activity of the virus. This may support better management of patients compared with the criterion-standard invasive marker for detecting the intrahepatic replication and transcription of HBV, which is the quantification of covalently closed circular DNA.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135927820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001316
Hossein Yarmohammadi, Seyyed-Alireza Motevalizadeh, Amir-Mohammad Asgari, Mohammad Keshavarzi, Ghasem Azimi
Background COVID-19 has a variety of presentations and complications, and this study aimed to report the incidence of COVID-19 patients presenting with pneumothorax and bronchopleural fistula (BPF). Methods Documents of hospitalized COVID-19 patients with positive SARS-COV-2 polymerase chain reaction tests were reviewed respectively, and patients presenting with pneumothorax were included. Laboratory data, treatment, and the outcome were also gathered for each patient. Results The incidence of COVID-19 patients presenting with pneumothorax and BPF was 0.93% and 0.62%, respectively. Three cases were determined, and all were male adults. Two had BPF and one received thoracotomy. These 2 patients had significantly elevated inflammatory markers. Patients were treated with antibiotics, corticosteroids, anticoagulants, remdesivir, and tocilizumab. Unfortunately, all expired as 2 patients had a cardiac arrest and one had a multiorgan failure. Conclusions Presenting with pneumothorax among COVID-19 patients is not common but needs appropriate management to prevent further complications. It seems that BPF, as a rarely reported complication of COVID-19, might be linked to the inflammatory storm and indicates poor prognosis.
{"title":"COVID-19 Patients Presenting With Pneumothorax and Bronchopleural Fistula","authors":"Hossein Yarmohammadi, Seyyed-Alireza Motevalizadeh, Amir-Mohammad Asgari, Mohammad Keshavarzi, Ghasem Azimi","doi":"10.1097/ipc.0000000000001316","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001316","url":null,"abstract":"Background COVID-19 has a variety of presentations and complications, and this study aimed to report the incidence of COVID-19 patients presenting with pneumothorax and bronchopleural fistula (BPF). Methods Documents of hospitalized COVID-19 patients with positive SARS-COV-2 polymerase chain reaction tests were reviewed respectively, and patients presenting with pneumothorax were included. Laboratory data, treatment, and the outcome were also gathered for each patient. Results The incidence of COVID-19 patients presenting with pneumothorax and BPF was 0.93% and 0.62%, respectively. Three cases were determined, and all were male adults. Two had BPF and one received thoracotomy. These 2 patients had significantly elevated inflammatory markers. Patients were treated with antibiotics, corticosteroids, anticoagulants, remdesivir, and tocilizumab. Unfortunately, all expired as 2 patients had a cardiac arrest and one had a multiorgan failure. Conclusions Presenting with pneumothorax among COVID-19 patients is not common but needs appropriate management to prevent further complications. It seems that BPF, as a rarely reported complication of COVID-19, might be linked to the inflammatory storm and indicates poor prognosis.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001304
Daniel Strayve, Jarom Ruby, Mustafa Abidalhassan, Gerald J. Hutfles, Kurt B. Schaberg, Dongguang Wei, Michael Corwin, Sepideh Gholami
Abstract We report a rare case of hepatic malakoplakia mimicking malignancy both in its clinical presentation and appearance on 4-phase computed tomography. This case highlights both an interesting variation by which this disease process can manifest and a multidisciplinary approach, which may be used to identify and treat future patients.
{"title":"Malignant Mimicry in a Rare Case of Hepatic Malakoplakia","authors":"Daniel Strayve, Jarom Ruby, Mustafa Abidalhassan, Gerald J. Hutfles, Kurt B. Schaberg, Dongguang Wei, Michael Corwin, Sepideh Gholami","doi":"10.1097/ipc.0000000000001304","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001304","url":null,"abstract":"Abstract We report a rare case of hepatic malakoplakia mimicking malignancy both in its clinical presentation and appearance on 4-phase computed tomography. This case highlights both an interesting variation by which this disease process can manifest and a multidisciplinary approach, which may be used to identify and treat future patients.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001330
Munshi Moyenuddin
{"title":"Future Pandemic Could Be Worse","authors":"Munshi Moyenuddin","doi":"10.1097/ipc.0000000000001330","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001330","url":null,"abstract":"","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001309
Atousa Salehani, Ramesh Nathan
Abstract The incidence of infections with Candida parapsilosis has been increasing, and this fungus is the second most commonly isolated Candida species from blood cultures. It has an affinity for intravascular devices, prosthetic devices, and total parenteral nutrition. We describe an uncommonly reported case of breakthrough bloodstream infection with C. parapsilosis in a patient receiving chronic total parenteral nutrition who was receiving micafungin for Candida glabrata fungemia. We also briefly discuss the challenges of diagnosis and management of fungemia caused by different Candida species.
{"title":"The Battle of Two Fungi","authors":"Atousa Salehani, Ramesh Nathan","doi":"10.1097/ipc.0000000000001309","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001309","url":null,"abstract":"Abstract The incidence of infections with Candida parapsilosis has been increasing, and this fungus is the second most commonly isolated Candida species from blood cultures. It has an affinity for intravascular devices, prosthetic devices, and total parenteral nutrition. We describe an uncommonly reported case of breakthrough bloodstream infection with C. parapsilosis in a patient receiving chronic total parenteral nutrition who was receiving micafungin for Candida glabrata fungemia. We also briefly discuss the challenges of diagnosis and management of fungemia caused by different Candida species.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1097/ipc.0000000000001326
Ahmed Elkhapery, Sheza Malik, Pratibha Chaudhary, Zeinab Abdalla, Chengu Niu, Tripti Jain, Soon Khai Low, Ali Abdelhay, Carlos Portales-Castillo, Omar Al Ali, Abdullah A. Orakzai, Michael N. Gurell, Maryrose Laguio-Vila
Abstract Fusobacteriae are anaerobic gram-negative bacilli, classically involved in the development of septic thrombophlebitis of the internal jugular vein in Lemierre syndrome. The goal of this study is to describe the various presentations, treatment course, and outcomes of patients with Fusobacterium liver abscess(es) and review available literature on this topic. We retrospectively reviewed our microbiologic database for positive cultures of Fusobacteriae species in a tertiary care hospital from July 2018 through November 2022 and identified 5 cases of liver abscess that involved Fusobacterium nucleatum species. Patients presented with a syndrome of fever and chills, abdominal pain, and nausea and vomiting. Laboratory investigations revealed leukocytosis and transaminitis, and imaging revealed liver abscess(es). The identification of the F. nucleatum bacteria involved invasive aspiration of the abscess in all but one case, where it was identified on blood cultures. One patient had a florid picture of sepsis and acute respiratory distress syndrome. All patients responded well with intravenous antibiotics and were discharged home to complete a prolonged course until radiographic resolution. In 3 patients, history and imaging were suggestive of possible sources that may have hematogenously spread to the liver, with history of recent appendectomy in 1 patient, possible appendicitis on computed tomography of the abdomen in another patient, and recent dental manipulation in the third patient. In conclusion, Fusobacteriae should be included in the differential diagnosis of liver abscess, especially in the setting of recent appendicitis or dental disease. Effective treatment includes surgical drainage when feasible and prolonged course of antibiotics with goal of radiologic resolution.
{"title":"Liver Abscesses Due to Fusobacterium nucleatum: A Case Series","authors":"Ahmed Elkhapery, Sheza Malik, Pratibha Chaudhary, Zeinab Abdalla, Chengu Niu, Tripti Jain, Soon Khai Low, Ali Abdelhay, Carlos Portales-Castillo, Omar Al Ali, Abdullah A. Orakzai, Michael N. Gurell, Maryrose Laguio-Vila","doi":"10.1097/ipc.0000000000001326","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001326","url":null,"abstract":"Abstract Fusobacteriae are anaerobic gram-negative bacilli, classically involved in the development of septic thrombophlebitis of the internal jugular vein in Lemierre syndrome. The goal of this study is to describe the various presentations, treatment course, and outcomes of patients with Fusobacterium liver abscess(es) and review available literature on this topic. We retrospectively reviewed our microbiologic database for positive cultures of Fusobacteriae species in a tertiary care hospital from July 2018 through November 2022 and identified 5 cases of liver abscess that involved Fusobacterium nucleatum species. Patients presented with a syndrome of fever and chills, abdominal pain, and nausea and vomiting. Laboratory investigations revealed leukocytosis and transaminitis, and imaging revealed liver abscess(es). The identification of the F. nucleatum bacteria involved invasive aspiration of the abscess in all but one case, where it was identified on blood cultures. One patient had a florid picture of sepsis and acute respiratory distress syndrome. All patients responded well with intravenous antibiotics and were discharged home to complete a prolonged course until radiographic resolution. In 3 patients, history and imaging were suggestive of possible sources that may have hematogenously spread to the liver, with history of recent appendectomy in 1 patient, possible appendicitis on computed tomography of the abdomen in another patient, and recent dental manipulation in the third patient. In conclusion, Fusobacteriae should be included in the differential diagnosis of liver abscess, especially in the setting of recent appendicitis or dental disease. Effective treatment includes surgical drainage when feasible and prolonged course of antibiotics with goal of radiologic resolution.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135931603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.1097/ipc.0000000000001306
Aaja Alosious, Mariya Luvis, Roshitha Ann Shaji, Antriya Annie Tom
Abstract Background Dengue, a vector-borne viral infection, is a concern in the tropical and subtropical regions across the world. The rampant use of antibiotics in dengue patients in India reinforces the anticipated threat of emergence of antimicrobial resistance. Aim We aimed to retrospectively investigate the prescribing pattern of antibiotics and compare the clinical status of dengue patients treated with and without antibiotics. Methods Between January 2016 and December 2020 period, data of patients who tested positive for at least 1 of the 3 screening tests (nonstructural protein 1, immunoglobulin M, or immunoglobulin G) were collected from patient medical chart, and we assessed the clinical outcome of dengue patients treated with and without antibiotics. Results Of 370 patients, 196 (52.97%) were managed with antibiotics and 174 (47.02%) were managed without antibiotics along with other supportive measures. A peak in the percentage of prescriptions with antibiotics was seen in 2019, 168 (85.71%) were prescribed with a single antibiotic with a majority of them, and 56.6% received third generation cephalosporins. Only 46 (23.46%) had bacterial co-infection while 150 (76.53%) had no co-infection. Thirty-five patients (70%) with dengue hemorrhagic fever were clinically managed with antibiotics compared with 50% patients in the “dengue fever” category. Only 8% of patients with mild dengue were given 2 antibiotics, whereas 13% with moderate dengue and 16% with severe dengue were prescribed with 2 antibiotics. Conclusions The increased number of prescriptions with antibiotics for a viral infection when not recommended by the guideline may lead to emergence of antibiotic resistance in hospitals as well as community.
{"title":"Misuse of Antibiotics in Dengue Fever—A Contributor to Antimicrobial Resistance?","authors":"Aaja Alosious, Mariya Luvis, Roshitha Ann Shaji, Antriya Annie Tom","doi":"10.1097/ipc.0000000000001306","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001306","url":null,"abstract":"Abstract Background Dengue, a vector-borne viral infection, is a concern in the tropical and subtropical regions across the world. The rampant use of antibiotics in dengue patients in India reinforces the anticipated threat of emergence of antimicrobial resistance. Aim We aimed to retrospectively investigate the prescribing pattern of antibiotics and compare the clinical status of dengue patients treated with and without antibiotics. Methods Between January 2016 and December 2020 period, data of patients who tested positive for at least 1 of the 3 screening tests (nonstructural protein 1, immunoglobulin M, or immunoglobulin G) were collected from patient medical chart, and we assessed the clinical outcome of dengue patients treated with and without antibiotics. Results Of 370 patients, 196 (52.97%) were managed with antibiotics and 174 (47.02%) were managed without antibiotics along with other supportive measures. A peak in the percentage of prescriptions with antibiotics was seen in 2019, 168 (85.71%) were prescribed with a single antibiotic with a majority of them, and 56.6% received third generation cephalosporins. Only 46 (23.46%) had bacterial co-infection while 150 (76.53%) had no co-infection. Thirty-five patients (70%) with dengue hemorrhagic fever were clinically managed with antibiotics compared with 50% patients in the “dengue fever” category. Only 8% of patients with mild dengue were given 2 antibiotics, whereas 13% with moderate dengue and 16% with severe dengue were prescribed with 2 antibiotics. Conclusions The increased number of prescriptions with antibiotics for a viral infection when not recommended by the guideline may lead to emergence of antibiotic resistance in hospitals as well as community.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135366341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.1097/ipc.0000000000001317
Eric Santana, Ken S. Rosenthal
Abstract Monoclonal antibodies (mabs) and small molecule Janus kinase (JAK) inhibitors (nibs) are useful for treating inflammatory disease, autoimmune disease, and tumors, especially leukemia. Inhibition or depletion of the cytokines or cells with these drugs can result in loss of important protection against certain microbial infections. Recurrences of tuberculosis, hepatitis B and C, and zoster are especially sensitive to immune depletion. The consequences of inhibition of cytokines, molecules, pathways and cells by these drugs are described, depicted, and tabulated.
{"title":"Ablative Treatment of Inflammatory and Other Diseases With Monoclonal Antibodies (Mabs) or Janus Kinases (Nibs) Increases Risk for Infection","authors":"Eric Santana, Ken S. Rosenthal","doi":"10.1097/ipc.0000000000001317","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001317","url":null,"abstract":"Abstract Monoclonal antibodies (mabs) and small molecule Janus kinase (JAK) inhibitors (nibs) are useful for treating inflammatory disease, autoimmune disease, and tumors, especially leukemia. Inhibition or depletion of the cytokines or cells with these drugs can result in loss of important protection against certain microbial infections. Recurrences of tuberculosis, hepatitis B and C, and zoster are especially sensitive to immune depletion. The consequences of inhibition of cytokines, molecules, pathways and cells by these drugs are described, depicted, and tabulated.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135412942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.1097/ipc.0000000000001315
Phuong-Uyen Vo, Roger B. Chaffee, Joseph P. Myers
Background Pasteurella multocida , a gram-negative coccobacillus associated with dog, cat, and other animal contact, often causes human bite infection, cellulitis, and osteomyelitis, but infective endocarditis is rare. We present a patient with P. multocida aortic valve endocarditis whose animal exposure was contact with his dog's saliva from frequent licking of patient's skin in the perioral area. Case Presentation A 62-year-old man with successfully treated hepatitis C presented to hospital after a syncopal episode while chasing his dog. He had previously noted night sweats, fever, generalized weakness, and dyspnea on exertion. He denied bites or scratches but admitted allowing his dog to lick around his mouth. On presentation, he was in septic shock with lactic acidosis. White blood cell count was 20,000/μL. Pasteurella multocida was isolated from both admission blood cultures. The patient was treated with antimicrobial therapy and resuscitated. Transthoracic echocardiogram revealed critical bicuspid aortic valve stenosis with root abscess and ascending aortic aneurysm. Transesophageal echocardiogram showed reduced ejection fraction and severe aortic stenosis but no definitive vegetations. At surgery, there were nodular lesions on the aortic valve, left ventricular outflow tract perforation, and annular abscess of aortic valve. He had mechanical aortic valve replacement, annular reconstruction, and aortic aneurysm repair. The patient received 6 weeks of postoperative intravenous ceftriaxone and remained infection-free at 1-year follow-up visit.
{"title":"Heartbreak From Puppy Love: A Case of Pasteurella multocida Endocarditis and Review of the Literature","authors":"Phuong-Uyen Vo, Roger B. Chaffee, Joseph P. Myers","doi":"10.1097/ipc.0000000000001315","DOIUrl":"https://doi.org/10.1097/ipc.0000000000001315","url":null,"abstract":"Background Pasteurella multocida , a gram-negative coccobacillus associated with dog, cat, and other animal contact, often causes human bite infection, cellulitis, and osteomyelitis, but infective endocarditis is rare. We present a patient with P. multocida aortic valve endocarditis whose animal exposure was contact with his dog's saliva from frequent licking of patient's skin in the perioral area. Case Presentation A 62-year-old man with successfully treated hepatitis C presented to hospital after a syncopal episode while chasing his dog. He had previously noted night sweats, fever, generalized weakness, and dyspnea on exertion. He denied bites or scratches but admitted allowing his dog to lick around his mouth. On presentation, he was in septic shock with lactic acidosis. White blood cell count was 20,000/μL. Pasteurella multocida was isolated from both admission blood cultures. The patient was treated with antimicrobial therapy and resuscitated. Transthoracic echocardiogram revealed critical bicuspid aortic valve stenosis with root abscess and ascending aortic aneurysm. Transesophageal echocardiogram showed reduced ejection fraction and severe aortic stenosis but no definitive vegetations. At surgery, there were nodular lesions on the aortic valve, left ventricular outflow tract perforation, and annular abscess of aortic valve. He had mechanical aortic valve replacement, annular reconstruction, and aortic aneurysm repair. The patient received 6 weeks of postoperative intravenous ceftriaxone and remained infection-free at 1-year follow-up visit.","PeriodicalId":13952,"journal":{"name":"Infectious Diseases in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135367317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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