The Netherlands journal of medicine
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The preferred treatment for severe methicillin-sensitive Staphylococcus aureus infections is flucloxacillin, a small-spectrum antibiotic administered intravenously (IV) and orally. However, clinicians switch to the less preferred broad-spectrum antibiotics because of the variable absorption after oral administration of flucloxacillin. A classical oral absorption test (OAT) requires overnight fasting and interruption of IV therapy, and is laborious. In the current study, we investigated whether a simplified OAT can be utilized in a clinical setting to guide antibiotic treatment in patients with severe S. aureus infections. For this, OAT IV therapy is continued and oral dosing is performed after a one-hour fast and implemented after a small study. ⋯ The simplified version of the OAT is useful to identify patients with adequate oral flucloxacillin absorption, and to ensure the effective continuation of an oral small-spectrum treatment.
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This case report describes a patient with a nearly fatal spontaneous haemorrhage of a hepatic adenoma that occurred in association with anabolic androgenic steroid (AAS) use. The patient was addicted to AAS and had been using exceptionally high dosages as well as growth hormone. After cessation of AAS use, testosterone replacement therapy was started to prevent post-AAShypogonadism and consequent relapse.
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A 65-year-old male was admitted to the Intensive Care Unit after being resuscitated because of a hypoxic cardiac arrest caused by influenza. Blood cultures taken at time of admission surprisingly grew Bacillus mycoides, a spore-producing apathogenic agriculture bacterium. ⋯ We hypothesised that our patient was colonised from the freights of his barge, and bloodstream infection occurred during resuscitation with either the bacterium itself or its spores. To our knowledge, this is the first report on bloodstream infection with Bacillus mycoides in a human patient.