A facultatively anaerobic gram-positive bacillus, Erysipelothrix rhusiopathiae is widely present in the environment and also as a commensal and pathogenic organism associated with livestock, birds, and fish. Invasive infections in humans are rare, classically affect patients with exposures to animal products, and frequently progress to include endocarditis. Here we present our successful experience of treating 2 patients with E. rhusiopathiae bacteremia, both frequently exposed to fish. One patient presented in new-onset heart failure after a protracted illness and was found to have subacute aortic and mitral valve endocarditis successfully treated with surgical valve replacement and prolonged intravenous penicillin therapy. The other patient had acute uncomplicated bacteremia responsive to ceftriaxone followed by step-down treatment with oral penicillin, the first published report using such regimen. Our experience highlights the spectrum of clinical disease seen in E. rhusiopathiae bacteremia and offers new perspectives to optimize treatment for these patients.
Background: Although there is a wide breadth of literature on glucose homeostasis in infants, standardization of perioperative hypoglycemia diagnosis and management is lacking.Aims: Survey of academic pediatric anesthesiology departments across the USA to evaluate institutional policies regarding the perioperative use of glucose containing solutions in infants less than 6 months of age. Methods:A questionnaire was sent to 20 United States university affiliated academic pediatric anesthesiology departments. Results:The responses suggest that, in the centers surveyed, glucose administration in infants is largely practitioner dependent. Two respondents (10%) claim to have a departmental policy regarding glucose administration in infants less than 6 months of age. In premature infants, 75% of respondents administer glucose. When administering glucose, 75% of physicians surveyed replete infants at their maintenance intravenous fluid rate. There was discrepancy among practitioners regarding initiation of hypoglycemia treatment, 35% treat infants at a blood glucose level of 70 mg/dl, 30% at BG 60 mg/dl, 25% at 50 mg/dl, and 10% are unsure.Discussion: This survey highlights the lack of consensus, at least among pediatric anesthesiologists working in US academic centers, regarding blood glucose management in infants less than 6 months of age. There is a need to define the indications for using glucose containing solutions in infants during the perioperative period, their ideal content, the appropriate thresholds for hypo-and hyperglycemia as well as the optimal point-of care glucose monitoring intervals.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.