Heart & lung : the journal of critical care
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Case Reports
Adult Kawasaki's disease with myocarditis, splenomegaly, and highly elevated serum ferritin levels.
Kawasaki's disease is a disease of unknown cause. The characteristic clinical features of Kawasaki's disease are fever> or =102 degrees F for> or =5 days accompanied by a bilateral bulbar conjunctivitis/conjunctival suffusion, erythematous rash, cervical adenopathy, pharyngeal erythema, and swelling of the dorsum of the hands/feet. Kawasaki's disease primarily affects children and is rare in adults. ⋯ To the best of our knowledge, this is the first report of adult Kawasaki's disease with highly elevated serum ferritin levels. This is also the first report of splenomegaly in adult Kawasaki's disease. We conclude that Kawasaki's disease should be considered in the differential diagnosis in adult patients with rash/fever for> or =5 days with conjunctival suffusion, cervical adenopathy, swelling of the dorsum of the hands/feet, thrombocytosis and otherwise unexplained highly elevated ferritin levels.
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Multicenter Study
An evaluation of family-centered care services and organization of visiting policies in Belgian intensive care units: a multicenter survey.
Admission in an intensive care unit (ICU) is a major cause of psychologic stress for the patient and the entire family, and liberalization of visitation has been shown to have a beneficial impact. However, despite the data available, practice has not changed much to incorporate these findings. ⋯ Participating ICUs homogeneously reported restricted visiting policies regarding visiting hours and type and number of visitors. According to the evidence available, providing a plea for more liberal visitation, these results may be a first step toward reorganization of visiting policies in Belgian ICUs.
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Case Reports
Persistent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia due to a linezolid "tolerant" strain.
Antibiotic "tolerance" is a rare cause of antibiotic failure. Antibiotic "tolerance" is defined as an minimal bactericidal concentration (MBC) 32x the minimal inhibitory concentration (MIC) of the isolate. ⋯ We present a case of persistent methicillin-sensitive S. aureus (MSSA) bacteremia due to a linezolid "tolerant" strain unresponsive to daptomycin therapy. We believe this is the first report of persistent MSSA bacteremia due to a linezolid "tolerant" strain.
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The "herald wave" of the H1N1 pandemic spread from Mexico to the United States in spring 2009. Initially, the epicenter of H1N1 in the United States was in the New York area. Our hospital, like others, was inundated with large numbers of patients who presented at the Emergency Department (ED) with influenza-like illnesses (ILIs) for swine influenza testing and evaluation. ⋯ Clinicians can use the Winthrop-University Hospital Infectious Disease Division's Diagnostic swine influenza triad to make a rapid clinical diagnosis of probable H1N1 pneumonia in hospitalized adult patients with negative RIDTs.