Cunninghamella bertholletiae infection occurs most frequently in neutropenic patients affected by haematological malignancies, is associated with an unfavourable outcome. We report a case of rhino-mastoidal fungal infection in a leukaemic patient. Bioptical tissue cultures yield the isolation of a mould with typical properties of Cunninghamella species. Liposomal amphotericin B (L-Amb) therapy combined with surgical intervention brought the lesion to recovery. Nevertheless, the patient died 14 days after bone marrow transplantation (BMT) from bacterial sepsis. Mastoiditis was documented at CT-scan. The conditioning regimen probably caused the reactivation of the Cunninghamella infection that led to the patient's fatal outcome; fungal hyphae were detected after autopsy of brain and lung tissue.
Onychomycosis due to non-dermatophytic fungi is a well-known and increasingly common infection. For the first time ever, we report two cases of onychomycosis caused by Aspergillus persii, a recently described new Aspergillus species. After ten and three years respectively, both patients showed relapsing nail infections, and mycological tests were still positive for A. persii. In vitro antifungal susceptibility tests demonstrated that both strains were only susceptible to itraconazole, voriconazole, posaconazole and terbinafine of the agents tested.
Appendicitis is a frequent clinical condition in normal children that may be complicated by community-acquired secondary peritonitis (CASP). We evaluated the potential efficacy of different drugs for initial treatment of this condition, as recommended by recent Consensus Conference and Guidelines for paediatric patients. Susceptibility to ampicillin-sulbactam, ertapenem, gentamycin, piperacillin, piperacillin-tazobactam, vancomycin, and teicoplanin was evaluated according to EUCST 2012 recommendations in aerobic bacteria isolated from peritoneal fluid in CASP diagnosed from 2005 to 2011 at 'Istituto Giannina Gaslini', Genoa, Italy. A total of 114 strains were analysed: 83 E. coli, 15 P. aeruginosa, 6 Enterococci, and 10 other Gram-negatives. Resistance to ampicillin-sulbactam was detected in 37% of strains, while ertapenem showed a potential resistance of 13% (all P. aeruginosa strains). However, the combination of these drugs with gentamicin would have been increased the efficacy of the treatment to 99 and 100%, respectively. Resistance to piperacillin-tazobactam was 3%, while no strain was resistant to meropenem. Our data suggest that monotherapy with ampicillin-sulbactam or ertapenem for community-acquired secondary peritonitis would present a non-negligible rate of failure, but the addition of gentamycin to these drugs could reset to zero this risk. On the contrary, monotherapy with piperacillin-tazobactam or meropenem is highly effective.
<p>La toxicidad de varias especies del género Senecio es bien conocida a nivel mundial. En Argentina se han descrito casos en bovinos pero los registros son escasos. En este trabajo se describen cuadros de seneciosis equina en dos predios rurales del noroeste argentino (Salta). Se mencionan los hallazgos clínicos y patológicos, caracterizados por fibrosis hepática, megalocitosis, hiperplasia biliar y colestasis. En individuos afectados se observó pérdida de peso, depresión, ataxia y dificultad para deambular. En las áreas de pastoreo se identificó la presencia de Senecio rudbeckiaefolius, S. madagascariensis y S. hieronymi. Se identificaron y cuantificaron alcaloides pirrolizidínicos en estas tres especies, mediante cromatografía gaseosa acoplada a espectrometría de masa. Se determinó la presencia de senecionina, integerrimina, usaramina, jacozina, jacobina, senecivernina, platyphyllina y neoplatyphyllina. Los resultados obtenidos confirman la intoxicación de equinos por Senecio en Argentina y ponen de manifiesto los primeros hallazgos de alcaloides pirrolizidínicos en tres especies de Senecio endémicas para el noroeste del país.</p>
Streptococcus agalactiae is not only a well-known cause of severe infections in the first 3 months of life but also an unusual organism to be isolated in case of septic arthritis, especially in children. We report a case of a monoarticular arthritis in a 6-month-old girl.
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