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Nocardia Infection Presented as Intramuscular Abscess in a Kidney Transplant Recipient: Case Report and Literature Review.

BACKGROUND: Nocardia is a gram-positive bacterium capable of causing both local and systemic infections, typically in immunocompromised patients. The most common clinical presentation is pulmonary infection. Muscle abscess due to Nocardia infection without disseminated nocardiosis is rare. CASE REPORT: In this report, we describe the case of a 67-year-old male kidney transplant recipient who developed a swelling of the right biceps muscle. CT imaging showed an intramuscular abscess, which was subsequently surgically drained. The drained fluid grew Nocardia pseudobrasiliensis, which was resist

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… Resolution of symptoms [ 10 ] (2012) | 86 | M | NS | Left knee | Yes—cutaneous abscesses | TMP-SMX, CIP | NS | Resolution of symptoms [ 11 ] (2010) | 55 | M | Multiple myeloma with previous allogeneic SCT on cyclosporine, mycophenolate and daclizumab | Pulmonary | Yes—cerebral abscess | Piperacillin-tazobactam …

Five-year remission without disease progression in a patient with relapsed/refractory multiple myeloma with extramedullary disease treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study: a case report.

BackgroundMultiple myeloma remains incurable despite treatment advancements over the last 20 years. LCAR-B38M Cells in Treating Relapsed/Refractory Multiple Myeloma was a phase 1, first-in-human, investigator-initiated study in relapsed/refractory multiple myeloma conducted at four sites in China. The study used LCAR-B38M chimeric antigen receptor-T cells expressing two B-cell maturation antigen-targeting single-domain antibodies designed to confer avidity, and a CD3ζ signaling domain with a 4-1BB costimulatory domain to optimize T-cell activation and proliferation. This chimeric antigen recep

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… He was treated with ibuprofen, dexamethasone, and tocilizumab for CRS and pyrexia; piperacillin/tazobactam for infection prophylaxis; bisoprolol for rapid atrial fibrillation; supplemental oxygen therapy; granulocyte colony-stimulating factor for neutropenia; and diuretics for reducing heart burden and …

Transient Leukemoid Reaction from T-Cell Large Granular Lymphocytes Post Autologous Stem Cell Transplant in a Patient Affected by Hodgkin Lymphoma.

Monoclonal T-cell lymphocytosis has been reported in patients with concomitant autoimmune diseases, viral infections, or immunodeficiencies. Referred to as T-cell large granular lymphocytic leukemia (T-LGLL), most cases cannot identify the triggering cause. Only small case series have been reported in the literature, and no treatment consensus exists. T-cell lymphocytosis may also appear after the transplant of hematopoietic stem cells or solid organs. Rare cases have been reported in patients undergoing autologous stem cell transplant (ASCT) for hematological diseases (including multiple myel

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… The period of post-chemotherapy aplasia was complicated by the onset of fever accompanied by shaking chills on day +1 from the infusion of stem cells and elevated up to 39.6 °C, poorly responsive to empiric therapy with piperacillin/tazobactam and amikacin. …

Community-acquired pneumonia

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… infection For those with pseudomonal risk factors, use an antipseudomonal β-lactam plus either ciprofloxacin/high-dose levofloxacin or the combination of an aminoglycoside with either a macrolide or antipneumococcal quinolone (antipseudomonal β-lactams include cefepime, imipenem, meropenem, piperacillin-tazobactam … For these patients, the therapy should be with an aminoglycoside (amikacin, gentamicin or tobramycin) plus an antipseudomonal β-lactam (cefepime, imipenem, meropenem or piperacillin-tazobactam) plus linezolid or vancomycin 2, 16 (see Chapter 28 for management of nosocomial pneumonia). …

Neutropenic sepsis and septic shock in ICU patients: A single-center experience over the last decade.

PURPOSE: Sepsis and septic shock in patients with neutropenia are associated with high mortality. We investigated the features and outcome predictors of neutropenic sepsis in the last decade. METHODS: Consecutive patients who were admitted to the intensive care unit (ICU) of a French university-affiliated hospital in 2012-2022, met criteria for sepsis or septic shock, and had neutropenia were included retrospectively. Patient features were collected and compared for 2012-2017 and 2018-2022. Factors associated with hospital mortality were sought by univariate and multivariate analyses. RESULT

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… G-CSF, granulocyte colony-stimulating factor; ICU, intensive care unit; LOS, length of stay. a any of the following: cefepime, piperacillin-tazobactam, and carbapenem. b this variable combines antifungal prophylaxis, empirical antifungal treatment and targeted treatment. c defined as in vitro pathogen …

Dengue virus infection in hematopoietic stem cell transplant recipients: A case series and comparative literature review from dengue endemic region.

This case series describes the wide spectrum of clinical presentation, laboratory findings, and morbidity/mortality associated with dengue fever in hematopoietic stem cell transplant recipients, treated in a dengue endemic region. The risk of acquiring viral infections increases manifold after transplant due to the severely immunocompromised state amid conditioning toxicity and immunosuppressive therapy. The classical warning signs of dengue viremia are often masked in posttransplant patients, leading to a missed diagnosis of dengue and grave consequences observed in some of the patients. Accu

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… Piperacillin/tazobactam and amikacin were started empirically. He grew Escherichia coli in urine culture with raised C-reactive protein and procalcitonin. Laboratory workup was negative for dengue NS1, malarial parasite, galactomanan, BKV, and Cytomegalovirus (CMV). …

Oncological emergencies associated with gastrointestinal tumors.

Oncological emergencies are defined as acute life-threatening conditions in cancer patients either as a result of the malignancy or as a result of its treatment. In this review, we focus on oncological emergencies associated with gastrointestinal tumors. They can be categorized by their system of origin as hematologic, neurologic or metabolic. Furthermore, we discuss mechanical emergencies such as intestinal obstruction and vena cava superior syndrome as well as acute gastrointestinal bleeding and pulmonary embolism. The patients' performance status as well as prognosis are essential during de

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… Treatment consists of broad-spectrum antibiotics (ex. piperacillin-tazobactam), nasogastric suction as well as fluid and nutritional support. In case of perforation, abscess formation or persistent bleeding, surgery is the only option. …

Acute Pneumonia

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Review of Hematology-Oncology Emergencies for Internal Medicine Residents.

The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover sp

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… Ideally, treatment should be started within one hour of presentation with intravenous broad-spectrum antibiotics with pseudomonal coverage (cefepime, piperacillin-tazobactam, and meropenem), even if risk stratification has not been completed [ 41 ]. …

MRONJ of the Mandible-From Decortication to a Complex Jaw Reconstruction Using a CAD/CAM-Guided Bilateral Scapula Flap.

Medication-related osteonecrosis of the jaw (MRONJ) has been an integral part of the maxillofacial patient population for some time. The therapeutic concept ranges from conservative approaches over less extended decortications to major jaw resections, which can result in a considerable loss of quality of life. Based on three case reports, this paper presents the long-term history of patients with MRONJ of the mandible, whose disease ultimately resulted in partial or total mandibular resection and subsequent multisegmental reconstruction using a microvascular anastomosed bone flap. Furthermore,

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… Antibiotic therapy with piperacillin and tazobactam 4.5 g for a total of 8 days was given due to suspected aspiration pneumonia. This led to a decrease in infection parameters and symptoms. …

Safety and Efficacy of Antibiotic De-escalation and Discontinuation in High-Risk Hematological Patients With Febrile Neutropenia: A Single-Center Experience.

BACKGROUND: There is currently no consensus on optimal duration of antibiotic treatment in febrile neutropenia. We report on the clinical impact of implementation of antibiotic de-escalation and discontinuation strategies based on the Fourth European Conference on Infections in Leukaemia (ECIL-4) recommendations in high-risk hematological patients. METHODS: We studied 446 admissions after introduction of an ECIL-4-based protocol (hereafter "ECIL-4 group") in comparison to a historic cohort of 512 admissions. Primary clinical endpoints were the incidence of infectious complications including s

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… doses) | 24 (0–129) | 17 (0–82) | <.001 Amikacin Used (yes/no) | 444 (86.7) | 395 (88.6) | Duration of treatment, d, median (range) | 5 (1–23) | 4 (1–20) | <.001 Meropenem Used (yes/no) | 455 (88.9) | 407 (91.3) | Duration of treatment, d, median (range) | 12 (1–53) | 10 (1–46) | .002 Piperacillin-tazobactam …

COVID-19 in 96 Patients With Hematologic Disease: The First Single-center Experience From the Czech Republic.

BackgroundCoronavirus disease 2019 (COVID-19) represents an important infectious complication associated with high mortality rates in patients with hematologic diseases. There have not been published any epidemiologic studies from Czech Republic so far.Patients and methodsThis study is the first analysis of patients with hematologic malignancies and bone marrow failure syndromes treated at single hematology center in the Czech Republic between March 1 and December 31, 2020, in whom COVID-19 infection was confirmed.ResultsThe sample comprised 96 patients aged 26 to 84 years (median, 66.0 years)

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… All hospitalized patients with lung involvement confirmed by imaging modalities (radiographs or high-resolution computed tomography scan) underwent initial antibiotic therapy targeting pathogens causing community pneumonia containing cefotaxime or piperacillin-tazobactam combined with clarithromycin, …

Molecular Mechanisms and Biomarkers Associated with Chemotherapy-Induced AKI.

Acute kidney injury (AKI) is a life-threatening condition characterized by a rapid and transient decrease in kidney function. AKI is part of an array of conditions collectively defined as acute kidney diseases (AKD). In AKD, persistent kidney damage and dysfunction lead to chronic kidney disease (CKD) over time. A variety of insults can trigger AKI; however, chemotherapy-associated nephrotoxicity is increasingly recognized as a significant side effect of chemotherapy. New biomarkers are urgently needed to identify patients at high risk of developing chemotherapy-associated nephrotoxicity and s

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… A drug combination that has gained recent attention for an additive risk of nephrotoxicity is vancomycin plus piperacillin–tazobactam. In order to establish whether kidney injury associated with this combination is a valid clinical concern, [TIMP-2]∙[IGFBP7] have been employed. … Evaluating Renal Stress Using Pharmacokinetic Urinary Biomarker Data in Critically Ill Patients Receiving Vancomycin And/or Piperacillin-Tazobactam: A Secondary Analysis of the Multicenter Sapphire Study Drug Saf. 2019 42 1149 1155 10.1007/s40264-019-00846-x 31240688 192. Rosolem M.M. …

FDA-Approved Drugs Containing Amide Functionality in the Last Five Years (2021-2025): Pharmaceutical Use, Trends and Synthetic Approaches.

The amide functional group remains a cornerstone of medicinal chemistry, serving as an indispensable scaffold in the design of modern therapeutics. This review presents an analysis of FDA-approved drugs (small molecules and peptides with MW ®), amides form the structural backbone of peptidomimetics, enabling high-affinity binding to a viral protease. In precision oncology, as seen with adagrasib (Krazati®), the amide acts as a critical, metabolically stable linker that positions a covalent warhead for selective inhibition of a mutant kinase. This analysis underscores that amide's unique combin

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… The FDA approval was supported by results from a Phase 3, randomized, double-blind clinical trial comparing cefepime/enmetazobactam with piperacillin/tazobactam in patients with complicated urinary tract infections. … Enmetazobactam is a β-lactamase inhibitor structurally related to tazobactam but modified to improve potency and spectrum. While both are penicillanic acid sulfones (PAS), the structural difference lies in the addition of a methyl group to the triazole moiety of enmetazobactam. …

Клиническое представление лептоспироза: ретроспективное исследование 34 Пациенты поступили в одно учебное заведение во Франции.

Лептоспироз имеет весьма изменчивое клиническое представление, которое может быть связано с различными заражающими сероварами, факторами хост-компьютеров или их комбинацией. Это исследование проводилось ретроспективно 34 Число пациентов с серологическим подтвержденным лептоспирозом, принятых в течение отчетного периода 1992-2002. Наиболее частыми симптомами при поступлении в школу были лихорадка (см.100%), головная боль75%), миальгии55%), артхальгии45%) и рвотой (т.е.39%). Применяемые лабораторные исследования включали в себя лимфопенцию (см.85%), тромбоцитопенсия75%), повышенные ферменты пече

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… Most PSA isolates were susceptible to AM, TAZ, piperacillin/tazobactam, ticarcillin and imipenem (IMI) in both departments (74-100%). …

A Case of Light Chain Deposition Disease Leading to Acute Liver Failure and Review of Literature.

Light chain deposition disease (LCDD) is a monoclonal immunoglobulin deposition disease characterized by light chain deposition in soft tissues and viscera, causing systemic organ dysfunction with an underlying lymphoproliferative disorder. While the kidney is the most affected organ, cardiac and hepatic involvement is also seen with LCDD. Hepatic manifestation can range from mild hepatic injury to fulminant liver failure. Herein, we are presenting a case of an 83-year-old woman with a monoclonal gammopathy of undetermined significance (MGUS), who presented to our institution with acute liver

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… Lastly, DILI from vancomycin and piperacillin-tazobactam was unlikely because the liver injury was present before the initiation of these antibiotics. Adequate perfusion via vasopressors was also maintained, making shock liver less likely. …

Risk factors for prolonged hospitalization and disease course in osteomyelitis: a single-centre cohort study.

OBJECTIVE: To investigate pathogen epidemiology and clinical characteristics in osteomyelitis patients for optimizing clinical management strategies. METHODS: Confirmed osteomyelitis cases required pathogen isolation with radiological correlation. The cohort included both confirmed (culture-positive) and probable (culture-negative but meeting clinical and radiological criteria) cases, Radiation-induced osteomyelitis, sclerosing osteomyelitis and drug-associated osteomyelitis. Clinical specimens underwent standardized culture and VITEK Compact II or MALDI-TOF MS identification. SPSS 22.0 analy

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… Empirical antibiotic therapy was initiated immediately after obtaining deep cultures in patients with sepsis or severe local inflammation, based on local antimicrobial susceptibility patterns (e.g., vancomycin + piperacillin/tazobactam). …

Clinical Implementation of β-Tubulin Gene-Based Aspergillus Polymerase Chain Reaction for Enhanced Aspergillus Diagnosis in Patients with Hematologic Diseases: A Prospective Observational Study.

The β-tubulin (benA) gene is a promising target for the identification of Aspergillus species. Assessment of the clinical implementation and performance of benA gene-based Aspergillus polymerase chain reaction (PCR) remains warranted. In this study, we assessed the analytical performance of the BenA probe PCR in comparison with the Aspergenius kit. We prospectively collected bronchoalveolar lavage (BAL) fluid via diagnostic bronchoscopy from adult patients with hematologic diseases. BenA gene-based multiplex real-time PCR and sequential melting temperature analysis were performed to detect the

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… It has been expected to replace or supplement GM, since there is a minimal decrease in sensitivity by AFT, no false positive results caused by antibiotics such as piperacillin/tazobactam, and no effect on the metabolism in the kidney and liver, unlike in the GM assay [ 10 , 11 , 12 , 13 , 14 ]. …

Bloodstream Infections in Patients with Hematologic Diseases: Causative Organisms and Factors Associated with Resistance.

BackgroundPatients with hematologic diseases are at high risk of bloodstream infections (BSIs). This study aimed to analyze clinical features and distributions of microorganisms in patients with hematologic diseases presenting at a tertiary care university-affiliated hospital in Korea.Materials and methodsWe retrospectively reviewed all BSI episodes recorded in patient medical records at two hematologic wards of the Catholic Hematology Hospital from January to December 2020. Our aim was to analyze demographic and clinical characteristics relevant to BSIs. We also described the antimicrobial re

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… Monotherapy with cefepime (2 g q8h by IV) was selected as the first-line empirical antimicrobial, piperacillin/tazobactam (4.5 g q8h by IV) was selected as the second-line antimicrobials, and carbapenems were chosen as the third-line treatment for use in empirical therapy. …

Genetic Risk Surveillance for Invasive Aspergillosis in Hematology Patients: A Prospective Observational Study.

IntroductionThe association between genetic background and the risk of invasive aspergillosis (IA) has not been addressed in Thailand. We conducted genetic risk surveillance for IA among Thai hematologic patients.MethodsWe conducted a prospective observational cohort study including moderate- to high-risk hematology patients at Ramathibodi Hospital. IA occurrence, relevant clinical data, and genetic analyses were assessed. Odds ratios (ORs) of IA were assessed for the presence of the selected single nucleotide polymorphism genotype using logistic regression.ResultsA total of 357 patients were

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… Factors potentially associated with false positive galactomannan status were recorded and were carefully reviewed, namely concomitant use of piperacillin–tazobactam and amoxicillin–clavulanic acid, diagnoses of other fungal infection such as histoplasmosis, and certain types of dietary consumption [ …