Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 2008
Aetiological diagnosis of community acquired pneumonia: utility of rapid microbiological methods with respect to disease severity.
The present study investigated the utility of rapid microbiological methods in the aetiological diagnosis of community acquired pneumonia (CAP) according to the severity of CAP. Between 1999 and 2004, 384 adult patients with CAP were studied prospectively. In addition to standard microbiological methods, PCR and antigen detection techniques were used to identify pathogens. ⋯ Only 1 case of Chlamydia pneumoniae was identified by PCR. In conclusion, besides yielding the aetiological diagnosis rapidly, new methods add to the total diagnostic yield in CAP. The diagnostic yield of rapid methods differs according to the severity of the pneumonia.
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Scand. J. Infect. Dis. · Jan 2008
Review Case ReportsNosocomial post-traumatic cutaneous mucormycosis: a systematic review.
Mucormycosis is a rare, rapidly fatal opportunistic invasive fungal infection occurring in immunocompromised patients. Primary cutaneous mucormycosis usually follows direct inoculation of fungal spores at the site of damaged or traumatized skin. We report a case of fatal nosocomial post-traumatic cutaneous mucormycosis in a diabetic patient and we performed a systematic review of reported cases of nosocomial post-traumatic cutaneous mucormycosis to describe their demographic profile, predisposing factors, treatment and outcome.
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Scand. J. Infect. Dis. · Jan 2008
Comparative StudyTime-course of neopterin levels in patients suffering from severe sepsis treated with and without Drotrecogin-alpha (activated).
Neopterin is secreted by activated monocytes/macrophages upon stimulation with interferon-gamma. The release of this pro-inflammatory mediator permits the activation status of cell-mediated immune system to be examined. We assayed neopterin plasma concentrations in septic patients under treatment with (n=10) and without Drotrecogin-alpha (activated) (n=10) on d 1 and 6 of severe sepsis. ⋯ Neopterin levels correlated significantly with creatinine with regard to all patient groups (range of correlation coefficient, r: 0.73-0.92; p<0.05). In conclusion, Drotrecogin- alpha (activated) was associated with a significant decrease of neopterin plasma levels in septic patients. Neopterin concentrations appear to depend on renal function and enterohepatic circulation.
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Scand. J. Infect. Dis. · Jan 2008
Case ReportsSuccessful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intravenous linezolid in an allogeneic cord blood stem cell transplant recipient.
Methicillin-resistant Staphylococcus aureus (MRSA) is an infectious pathogen that commonly occurs after stem cell transplantation. We report a case of meningoencephalitis with multiple abscess formation caused by MRSA, which occurred in a 62-y-old female soon after allogeneic cord blood transplantation, and which was successfully treated by the administration of intravenous linezolid.
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Scand. J. Infect. Dis. · Jan 2008
Invasive candidiasis in long-term patients at a multidisciplinary intensive care unit: Candida colonization index, risk factors, treatment and outcome.
The incidence of fungal infections in hospitalized patients has increased, and due to demographic changes and increasingly advanced medical methods, the intensive care units (ICU) have emerged as epicentres for fungal infections. The aim of the present study was to investigate Candida colonization pattern and colonization index (CI), in combination with other risk factors and its relation to invasive candida infection (ICI), in 59 consecutive patients with at least 7 d length of stay (LOS) at a multidisciplinary ICU. Surveillance samples were collected on d 7 and then weekly during the ICU stay. ⋯ Overall ICU mortality was 30%. We could demonstrate that both a high colonization index and recent extensive gastroabdominal surgery were significantly correlated with ICI, while a decreased level of HLA-DR (< or = 70%) was not predictive for ICI in this high-risk population. The results indicate that ICU patients exposed to extensive gastroabdominal surgery would benefit from early antifungal prophylaxis.