Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2002
Review[Therapeutic principles of staphylococcal infections--Role and limitations of standard compounds].
Antibiotic therapy plays an important (but not exclusive) role in the treatment of staphylococcal infections. Measures aimed at reducing the bacterial inoculum through local procedures must be envisaged as often as possible. The removal of any foreign, infected materials is essential to success. ⋯ In the light of these data, we propose a therapeutic approach to severe bacterial infection caused by a cluster of Gram-positive cocci. Staphylococcal infections pose daily therapeutic problems, whether in open-care practice or intensive care units. The specificity of staphylococcal infections encountered in an intensive care setting require a therapeutic approach which takes account of the context, and particularly of the incidence of resistant staphylococcal infections.
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Increasing frequency in antibiotic resistance in Staphylococcus aureus is worrying. In this review, we briefly describe the mechanisms of resistance to antibiotics in staphylococci and we report the current incidence of antibiotic resistance in France. Methicillin-resistance is mostly confined to hospitals. ⋯ By contrast, incidence of multiply resistance in hospitals remains high. After a recent decrease, incidence of oxacillin resistance seems to be stabilized. A new and recent feature is the great variety of resistance phenotypes which can be found in methicillin-resistant strains, in particular with gentamicin susceptibility.
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Ann Fr Anesth Reanim · May 2002
Case Reports[Fusarium pleural effusion after a ventricular assist device].
We report the case of a 36-year-old man with a pleural effusion that complicates the postoperative period after the implantation of a ventricular assist device (VAD). The epidemiological, etiologic and therapeutic features of Fusarium infections were reviewed. Complete recovery of the infection was obtained after a treatment by liposomal amphotericine B (AmBisome) and 5 fluorocytosine.
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Ann Fr Anesth Reanim · May 2002
Case Reports[Hemoperitoneum and pregnancy in a patient with von Willebrand's disease type 3].
A 24-year-old woman with type 3 (characterised by a blood level of von Willebrand factor less than 1%) was admitted to the surgical intensive care unit with an haemorrhagic shock. She was pregnant (Beta HCG = 115 Ul. L-1), the echography of the abdomen, soon after admission, revealed a haemoperitoeum. ⋯ The surgeon found an ovarian haemorrhagic cyst. Later the course of pregnancy was normal and she was delivered by caesarean section. We describe the therapeutic strategy of that care.