Heart & lung : the journal of critical care
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Patent foramen ovale (PFO) is frequent but rarely associated with platypnea-orthodeoxia syndrome and with no pulmonary hypertension. ⋯ PFO may be patent and responsible for hypoxemia without pulmonary hypertension. This condition is easily recognized with transesophageal echocardiography, leading in most cases to a percutaneous closure resulting in a dramatic correction of hypoxemia.
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Case Reports
Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia due to a linezolid "tolerant" strain.
Persistent Staphylococcus aureus bacteremia is most frequently related to S. aureus acute bacterial endocarditis, myocardial abscess, extracardiac abscess, or a device-associated infection. Patients with continuous high-grade bacteremia who do not have acute bacterial endocarditis, an abscess, or a device-related infection should be considered to have antimicrobial "tolerance" as a possible cause. Antimicrobial "tolerance" is defined as a wide discrepancy between the minimal inhibitory concentration and the minimal bactericidal concentration of an isolate. ⋯ The lack of bactericidal activity of the antibiotic becomes apparent when minimal bactericidal concentrations are determined for "tolerant" strains, and there is a great discrepancy between the minimal inhibitory concentration being used. Antibiotic tolerance to S. aureus has been described with a variety of antibiotics. To the best of our knowledge, this is the first case of continuous, high-grade methicillin-resistant S. aureus bacteremia due to a linezolid-tolerant strain.