We report a case of clinically significant migration of polytetrafluoroethylene (Teflon) paste particles to the lungs after periurethral injection. These particles were identified by standard and polarized light microscopy. Since the long-term effects in humans are not sufficiently known, we strongly warn against the use of polytetrafluoroethylene paste in children or young adults with a normal life expectancy.
successful HTs in patients with active Staphylococcus BSI and suspected mechanical circulatory support device (MCSD) infection. Methods: All HTs performed at The Mount Sinai Hospital from 2009 through 2015 were reviewed. All patients with active Staphylococcus BSI at the time of transplant, defined as bacterial growth in the most recent blood culture prior to transplant, were included. Results: Patient characteristics, microbiology data, and outcomes are described in Table 1. Four patients had previous BSI episodes with the same bacteria. The mean duration of the most recent BSI prior to HT was 19 days. Blood cultures were positive on the day of HT in two patients and within 4 days prior to HT in all others. All but one patient had microbiologic evidence of device infection at the time of HT. All patients underwent radical debridement at the time of HT, and all received post-operative intravenous antibiotics for a mean of 36 days. No induction immunosuppression was given; MMF and azathioprine were avoided post-transplant. Two patients required further debridement after HT, and BSI persisted for nine days in one patient before clearing. Post-operative blood cultures were negative in all other patients. After a mean follow-up of 9.3 months, no patients developed a relapsed Staphylococcus infection. One patient died of unrelated causes with no autopsy evidence of infection. Conclusion: This case series suggests that HT can be successfully performed in patients with active Staphylococcus BSI by using a multimodal approach that includes appropriate antimicrobial therapy, radical debridement at the time of HT, and judicious use of immunosuppression. These findings challenge the traditional belief that an active BSI is an absolute contraindication to HT.
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